Forget sleeping like a baby. Most women I know who are experiencing menopause and insomnia want to sleep like a husband, or a teenager, or the family dog: asleep within 10 minutes, awake again in seven to nine hours. If that sounds like a far-off fantasy to you, you’re not alone.
Perimenopause is the time (on average four years, but it may last as long as 10 years) when progesterone and estrogen decline and before menopause — which is defined as a woman’s not having had a period for 12 consecutive months — begins. Both progesterone and estrogen are important for sleep: Progesterone acts as a sedative, while estrogen increases REM cycles and is linked to serotonin. When estrogen levels are high, we tend to fall asleep more quickly, wake up less often, and fall asleep longer. Add hot flashes and anxiety to our list of symptoms during perimenopause, and it’s no wonder 61 percent of women experience insomnia during this tricky time.
According to experts — and by that I mean not only scientists and doctors, but also women in menopause who have found relief — these are some things you can do and some natural remedies you can try to cure your menopause insomnia and sleep like grown men, teenagers, and the family dog, bless their hearts:
1. Limit caffeine.
Many doctors advise us to cut caffeine entirely (cue the laughter), but I for one am confused as to how we are supposed to go through perimenopause without cappuccinos. Therefore, let’s just try to limit our caffeine as best we can, and enjoy only herbal tea and decaf in the afternoon and evening. (According to the American Academy of Sleep Medicine, one study found that consuming caffeine six hours before bedtime reduced total sleep time by one hour.)
2. Exercise —preferably outside, preferably in the morning.
Being in the sunshine helps set our circadian rhythms, and if we exercise too close to bed, we may experience a burst of energy that will keep us awake. But exercising daily, in general, makes us tired, which will help us sleep better. (And besides, it’s good for us!)
3. Practice yoga and Tai Chi.
Gina S., age 45, of Santa Monica, is a worrier. She lies in bed at night with her mind going a “million miles a minute,” as she puts it. Since she’s begun to go through perimenopause, her insomnia has only gotten worse. “I’d go to bed at 11, not fall asleep until 1 or 2, and then wake up 10 more times before my alarm would go off at 6. Every day my co-workers would tell me, ‘You look tired.’ No kidding!” It was one of these co-workers who “dragged” her to tai-chi. “I thought it was what retired people did in the park. But it really has relaxed me. My body and mind feel more calm. I still wake up due to hot flashes, but not nearly as often, and now? I fall asleep just about as soon as my head hits the pillow!” Yoga is said to have the same relaxing benefits, and unlike more aerobic exercises, it’s okay to do these activities any time of the day, including in the evening.
4. Eat to sleep.
Christiane Northrup, M.D., author of The Wisdom of Menopause, writes that a diet high in protein and low in simple carbs (with little or no “white foods” and refined sugar) is the best diet for women during perimenopause. She recommends adding soy, avoiding alcohol, and not eating three hours before bed for better sleep.
5. Take a supplement — with your doctor’s okay.
Some women find that melatonin helps their menopause insomnia, in that it helps them fall asleep faster, or that it helps them stay asleep. Valerian root (which can be taken in tea or pill form) has been found to be effective at helping some women fall asleep faster. Magnesium is an element found in many foods (such as nuts, avocados, spinach, and legumes), and is crucial to our health; it may also help treat sleep problems (and, by the way, even help with anxiety and depression). Important: All three of these supplements may interfere with some prescription medications, so be sure to talk to your doctor before taking any of them.
6. Keep cool.
Research shows that people sleep best when the room temperature is set at about 65 degrees. According to the North American Menopause Society, 75 percent of women experience hot flashes during menopause, so keeping the room cool is an especially important tip to help us sleep through the night. Sleeping with a cooling pillow, wearing moisture-wick pajamas, and sleeping with a fan may also help.
7. Inhale lavender.
According to a study published by the US National Library of Medicine, lavender has been shown in single-blind studies to be an effective treatment for insomnia in midlife women. You can use a store-bought lavender linen spray or be do-it-yourselfie and make your own: Mix 2 tablespoons of witch hazel, 10 drops of lavender essential oil, and 6 tablespoons of water into a spray bottle; spray on pillows and sheets before bed. You can also mix organic lavender essential oil with a base such as organic coconut oil to rub on your wrists, temples, and neck before sleep. The scent is wonderful — and indeed relaxing.
8. Do mindfulness-based stress reduction therapy.
This form of stress reduction involves sitting quietly and simply being in the moment, letting thoughts come and go as you focus on your breathing. According to studies reported in The Natural Menopause Solution, people who participated in this activity improved their sleep by 26 percent.
9. And if you need a little guidance, download a sleep-inducing app.
This was one of the most popular remedies on an over-40 women’s discussion group I belong to, and according to the women who have used these apps, they are very effective. One of the most popular one seems to be Calm, but other popular and effective meditation apps, some of them free, can be found here.
10. Block out light.
Artificial light after dark and before bedtime seems to reduce sleep quality by suppressing production of the hormone melatonin — but are you ready to read by candlelight and give up Younger? Me either. However, there are two relatively easy things we can do: use black shades to block out street lights, and turn off all indoor lights near us while we sleep. These steps are important, researchers say, because exposure to artificial light while we sleep suppresses melatonin levels by more than 50 percent. And of course, we all know that we’re supposed to stop using all electronics (including laptops, phones, and TVs) at least 30 minutes to an hour before bed, as the blue light they emit delays the release of melatonin. (We don’t quite need to read by candlelight, but at least we can read books on paper, by electric light, just before bed.)
11. Consider HRT.
Finally, since one of the main reasons women might be experiencing menopause and insomnia is due to lowered estrogen and progesterone, an obvious solution might be to discuss with your doctor the possibility of HRT (Hormone Replacement Therapy). There are many different options, as well as many different benefits — and risks — so it’s important to discuss your family and personal history with your doctor to know which one (if any) might be right for you. There might be a right medication for you, but you’ll never know if you don’t start the discussion. According to a Red Hot Mamas survey, 62 percent of women experiencing menopause and insomnia didn’t discuss the issue with their doctor, and of those who did, 92 percent said they had to start the conversation. So please, tell your doctor, “I’m going through menopause, why can’t I sleep?” or, “I’m experiencing perimenopause and have insomnia. Help!”
We have to take charge of our own health by talking to our doctors and following these guidelines if we want to sleep like the family dog — or like our pre-perimenopausal selves. And just imagine what we could accomplish with the wisdom we have during this time of our lives, combined with the energy we’d have if we consistently got a good night’s sleep. That sounds like a new sort of superheroine to me.
This post was written by Kelly Dwyer, a novelist, playwright, and freelance writer.