Perimenopause, the transitional phase leading up to menopause, is a time of significant hormonal changes in a woman's body. Alongside these changes, many women experience difficulties with sleep, particularly insomnia. Personally, I have been struggling with sleep over the past few years- and even bought an Oura ring to try and gain insights into my sleep. One of the biggest things I have noticed is that drinking wine leads to night sweats or as I call them "wine sweats" which affects my sleep and my mood for days. Inadequate sleep is stressful to our bodies, and perimenopausal women are already dealing with higher levels of cortisol. Did you know that cortisol declines 6X more slowly in people who are short on sleep then those properly rested? Having these constant higher levels of cortisol due to poor sleep can lead to insulin resistance, which in turn results in the increased abdominal fat. In this article, we will explore why perimenopausal women struggle with insomnia, discuss strategies to manage sleep issues, and delve into the latest research on the connection between circadian rhythm, hormones, and sleep during perimenopause.
Why Do Perimenopausal Women Experience Insomnia?
Hormonal Fluctuations: During perimenopause, estrogen and progesterone levels begin to decline, leading to irregularities in the menstrual cycle. These hormonal fluctuations can disrupt the natural sleep-wake cycle, making it difficult to fall asleep or stay asleep throughout the night.
Hot Flashes and Night Sweats: Hot flashes, sudden sensations of heat, and night sweats are common symptoms experienced during perimenopause- due to the decline in estrogen. These episodes can occur at any time, including during sleep, leading to disrupted sleep patterns and insomnia. Especially if I have had a couple glasses of wine!
Emotional and Psychological Factors: Perimenopause can bring about mood swings, increased anxiety, and feelings of depression. These emotional and psychological changes can contribute to sleep disturbances, making it harder to fall asleep or stay asleep. If anything is ever really causing me stress/anxiety I find getting it out - by writing it in a journal helpful. Also reading and doing breathing exercises help me.
Physical Discomfort: Women may experience physical discomforts during perimenopause, such as breast tenderness, headaches, or muscle aches. These symptoms can make it challenging to find a comfortable position for sleep, leading to difficulty in achieving a restful night's sleep.
Strategies to Improve Sleep during Perimenopause:
Sleep Environment: Create a sleep-friendly environment by ensuring your bedroom is cool, dark, and comfortable. This is a constant struggle with my husband who likes to turn off the AC and night during the summer and crank the heat during the winter. Consider using earplugs, white noise machines, or blackout curtains to block out external disruptions.
Sleep Routine: Establish a regular sleep schedule, going to bed and waking up at consistent times. This helps regulate your body's internal clock and promotes better sleep quality. This is the one strategy that has worked the best for me personally. I use the Health app on my iPhone and have a regular sleep schedule planned out for the week. My iPhone notifies me when it's getting close to bed time, and turns off any notifications. It has now become a habit that once I get this notification at 9, to then tell my kids it's time to get off devices and brush teeth and get to bed. Once kids tucked in I read till about 10 can often fall asleep pretty quickly (especially if I woke up that day at 5:45 for a 6:30 workout).
Relaxation Techniques: Practice relaxation techniques before bed, such as deep breathing exercises, progressive muscle relaxation, meditation, or gentle yoga. These techniques can help calm the mind and prepare the body for sleep. If reading doesn't calm me down enough and my mind is still going, I do finding breathing exercises helpful.
Lifestyle Modifications: Limit exposure to electronic devices that emit blue light, especially before bedtime. Engage in regular exercise during the day, but avoid intense exercise close to bedtime. Additionally, be mindful of your diet, avoiding heavy meals, caffeine, and alcohol before bed. Having a dog guarantees at least two- 30-60 min walks a day, and with the kids and our busy schedule we typically eat early to get kids to all their sports- this has been super helpful in not eating late and close to bedtime as research shows that eating 2-3 hours before bed can lead to sleep issues.
Latest Research on Circadian Rhythm and Hormones in Perimenopause: Recent studies have shed light on the intricate relationship between circadian rhythm, hormones, and sleep during perimenopause. Researchers have found that hormonal fluctuations impact the body's internal clock, affecting sleep-wake patterns.
Melatonin: Melatonin, a hormone responsible for regulating sleep-wake cycles, may be affected by hormonal changes during perimenopause. Some studies suggest that declining estrogen levels can disrupt melatonin production, leading to sleep disturbances (mentioned below; tart cherry juice before bed can help raise melatonin levels).
Core Body Temperature: The drop in estrogen levels during perimenopause can impact body temperature regulation, leading to hot flashes and night sweats. These temperature disruptions can disturb sleep and contribute to insomnia (consider taking a cool shower to lower core body temperature before bed).
Individual Variations: Research indicates that individual variations in hormone levels and sensitivity to hormonal changes play a significant role in sleep disturbances during perimenopause. Understanding these variations can help personalize treatment approaches.
Are the natural products I can take to help reduce stress and promote sleep?
Adaptogens are natural substances that can help the body adapt to stress and promote balance. While it's important to consult with a healthcare professional before starting any new supplements, here are some adaptogens that are commonly used to help reduce stress and promote sleep in perimenopausal women:
Ashwagandha: Ashwagandha is an adaptogenic herb that has been traditionally used in Ayurvedic medicine. It may help reduce stress, anxiety, and promote better sleep quality.
Rhodiola Rosea: Rhodiola Rosea is known for its ability to improve mood and reduce fatigue. It may help combat stress and enhance sleep quality.
Holy Basil: Holy Basil, also known as Tulsi, is an adaptogenic herb that can support the body's response to stress and promote relaxation.
Maca: Maca root is an adaptogen that may help balance hormone levels, alleviate symptoms of stress and anxiety, and promote better sleep.
Ginseng: Ginseng, particularly American ginseng and Asian ginseng, is known for its stress-reducing properties. It may also help improve sleep quality.
Eleuthero (Siberian Ginseng): Eleuthero is another adaptogen that can help the body cope with stress and support better sleep.
Tart cherry juice: is heigh in melatonin and enhances your body's own production of melatonin, is rich in antioxidants and has anti-inflammatory properties.
Remember that adaptogens can interact with certain medications or have individual variations in effectiveness. It's essential to consult with a healthcare professional before incorporating adaptogens into your routine to ensure they are suitable for you and won't interfere with any existing medical conditions or medications you may be taking. A healthcare professional can guide you on the appropriate dosage and potential interactions.
Conclusion: Insomnia and sleep disturbances are common challenges experienced by perimenopausal women. Understanding the underlying causes, such as hormonal fluctuations and hot flashes, can assist in finding effective solutions. By implementing lifestyle modifications, establishing a sleep routine, and utilizing relaxation techniques, adaptogens, women can improve their sleep quality during this transitional phase. Ongoing research on the connection between circadian rhythm, hormones, and sleep in perimenopause provides valuable insights for developing targeted interventions and personalized treatment approaches. Remember, consulting with a healthcare professional is crucial for personalized guidance and support in managing sleep issues during perimenopause.
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