By Diana Bitner, MD, Spectrum HealthBeat
Many of the women who come to our midlife and menopause clinic have a common problem: sleep issues.
As an OB/Gyn doctor who still delivers babies, I admit I don’t always get as much sleep as I should, but I do strive to get my seven to eight hours most nights.
Also, as a doctor, I am well aware of the problems people often encounter as a result of poor sleep habits: decreased cognitive function (also known as brain fog), difficulty remembering things, decreased job performance, and an increased chance of having a vehicle accident.
If you aren’t sleeping well, your overall quality of life suffers, and you may feel less motivated to follow a healthy and active lifestyle. This, in turn, can cause mood disturbances such as anxiety and depression. You may not suffer from major depression, but even having an underlying sense of dread or being in a bad mood is not a healthy way to live your life.
Having a hard time sleeping?
It may make you feel better to know that you’re not alone. In fact, about 69 percent of people have sleep problems, and women have 50 percent more problems with sleep than men.
Nearly 20 percent of people have chronic sleep issues that can cause serious medical risks, especially if they average less than six hours per night and have poor quality sleep. Some of these health threats include an increased risk for high blood pressure, heart disease, stroke, Type 2 diabetes and obesity.
These are serious health issues for people of all ages, but for women who are also navigating their way through menopause, sleep issues add more stress to an already difficult time in their lives.
So, why do sleep problems become worse during midlife and menopause, and what can you do to start getting more (and better) sleep?
The answer to the first question has to do with hormones. My experience with helping women in midlife and menopause has shown that a common pattern develops in women during this time, especially as their hormones start to change.
Even if your periods are regular, as you get older, your hormones can change three days before your period, causing night sweats. Early in the transition, you might not even think you are having night sweats, but waking three nights in a row in the middle of the night can actually be a slight nighttime hot flash.
Unfortunately, what happens to we busy women is that we turn a simple night of waking up into a catastrophe that may look something like this:
“OMG—I’m awake! I cannot afford to be awake. Oh geez, I have to pee, but I don’t want to get up to pee. Now I really have to pee, but if I get up, I might not be able to fall back asleep. What should I do? Oh, I will just lie here. Well, that is not working. Toss, turn, toss, turn. Fine—I will get up! Now that I’m up and can’t sleep, maybe I should clean, or check email, or watch TV, or check Facebook. Maybe then I will feel tired.”
Of course, then you fall back asleep at 4:30 a.m. or so, and the alarm goes off at 5:30 or 6 a.m. You wake up and you feel stressed, cranky and craving sugar.
Does this scenario sound familiar? If so, you know how poor sleep makes you feel, and it’s not good. To make matters worse, as women progress into perimenopause and then into menopause, the symptoms can stretch from happening three days a month to every night.
The result is what I call a hot mess.
What can I do about it?
Don’t fret. There is hope.
There are several treatments for sleep disorders, but it really comes down to how well you follow the recommendations and treatment guidelines from your physician. It’s important to treat any medical conditions, such as snoring, sleep apnea and obesity, that may be causing your sleep issues to worsen.
I talk to patients about using hormone replacement therapy for improving sleep issues. Such therapy is not a sleep medicine, but it can reduce hot flashes and night sweats, thereby reducing nighttime waking events.
We also discuss sleep hygiene, which includes developing a regular sleep schedule, avoiding stimulation such as caffeine or screen time before sleep, avoiding naps longer than 20 minutes in the afternoon, and keeping a regular exercise schedule of at least 20 minutes per day.
Probably the most effective recommendation I make for my patients is to make time each night before bed for metered breathing.
If you’re not familiar with this technique, here’s a quick explanation: Find a peaceful place in your house, outside of the bedroom. I call this your Zen spot. Turn on a low light and get into a comfortable position. Close your mouth, open your eyes, stare at a particular spot in the room, and just breathe. Breathing should not deep or forced. It should be relaxed.
Be aware of the sound of your breath. As you are aware of your breathing and focused on one visual stimuli, your mind will become still. If an annoying thought or worry enters your mind, simply think about it for a second and then go back to the sound of your breath.
Do this for five minutes, then go straight to bed, close your eyes and enter dreamland.
It may take several nights of practice before it works effectively. If you wake in the middle of the night and can’t fall back asleep, go to your Zen spot and do your metered breathing.
You will be pleasantly surprised how well it works.
