Insomnia & Sleeping Difficulties

What are Insomnia and Sleep Disturbances?

Insomnia is the most common sleep disorder, characterized by difficulty sleeping for days, weeks or even months. It may include having trouble falling asleep, trouble staying asleep through the night or waking early and being unable to get back to sleep. Insomnia may also be caused by poor quality sleep, where you wake up feeling unrefreshed. [2]

Insomnia can be short term, caused by stress or changes to your schedule. When insomnia occurs at least 3 times per week lasting for more than 3 months, it becomes chronic insomnia. Chronic insomnia can be experienced by about 10% of adults but it is more common during perimenopause, with 40% to 60% of women experiencing difficulty sleeping. [2]

Insomnia has lasting effects into the day, causing lingering feelings of tiredness and/or “brain fog” – impaired brain function leading to memory loss, trouble concentrating and loss of ability to plan. Sleep loss caused by the environment (too much light or noise) is not insomnia.

Insomnia is a serious condition. Deep sleep is crucial for overall health and muscle and nerve repair. Lack of deep sleep due to insomnia increases headaches and inflammation. It can also lead to an increased risk for high blood pressure, cardiovascular disease, obesity, depression and other illnesses.

Insomnia in perimenopause is associated with an increased risk of neurodegenerative diseases including Alzheimer’s disease. [2] [3] [9]

For women in the menopausal transition, perimenopause insomnia and perimenopause sleep problems can be the main issue. [13] However insomnia is often a secondary condition caused by other symptoms such as hot flashes and night sweats, mood disorders, psychosocial factors, or other sleep disturbances such as obstructive sleep apnea (OSA) or restless legs syndrome (RLS). Insomnia and night sweats commonly occur together.

Estrogen and progesterone decline may be involved, as well as the sleep hormone melatonin . These hormones are involved in maintaining daily (circadian) biorhythms. [8]

Insomnia during perimenopause is often coupled with physical pain, chronic stress, anxiety, depression and/or hot flashes. Insomnia increases the risk of developing depressive symptoms during perimenopause by 2 to 3 times. [4]

Depression and insomnia are bidirectional: they reinforce each other, becoming a feedback loop – depression leads to insomnia, which leads to more depression, which leads to more insomnia, and so on. Similarly, chronic stress often increases anxiety, and both interfere with sleep. [3] [4]

Self-Care & Natural Remedies for Menopause Insomnia

It is important to seek medical help if insomnia lasts for a few weeks or more. A physician can help rule out any underlying health conditions that might interfere with quality sleep. 

Menopause insomnia treatment is available. In fact you can also start by taking steps at home to address sleep issues, starting with improvements to your sleep hygiene.

➜ Use your bedroom only for sleep and sex. The bedroom is not for watching TV or spending time on electronic devices. This helps train the brain to leave worries and stress from the day outside of the sleeping environment.
➜ >Sleep in a cool, very dark room.
➜ Don’t look at bright lights before bedtime, especially those in the blue light range. While all visible light suppresses secretion of melatonin, blue light is particularly disruptive. Smartphones, televisions and computers emit in the blue light range, so minimize screen time on phones and computers 2 hours before bedtime.
➜ Keep a similar bedtime every day, and eat at regular times during the day.
➜ Avoid alcohol two hours before bedtime.
➜ Quit or cut back on smoking or other use of tobacco products, as nicotine is a stimulant also known to disrupt sleep.
➜ Melatonin therapy may help short term insomnia but may not help over the long term. Sunshine boosts melatonin production, and studies have shown an improvement in sleep with exposure to sunshine during the day.
➜ Exercise, particularly in outdoor daylight, to improve circulation and relaxation and to increase your natural sleep drive.
➜ Journal the events in your life to see how they correlate with insomnia. 
➜ Some people find that meditation and mindfulness exercises before bedtime improves sleep.
➜ Shift work harms sleep quality, which is further disrupted during menopausal transition. Shift workers may need professional therapy to help with the combined effects of the menopausal transition and altered schedules.