How menopause affects sleep – and tips for a more restful night

Sleep is a critical pillar of health, like nutrition and physical activity, that affects us all. Quality sleep is vital for repairing the body, boosting cognitive function, strengthening the immune system and improving mental health, among many key benefits.

Restless nights can have an important bearing on women experiencing menopause, with reports stating that 40-56% of menopausal women have difficulty sleeping, one of the most common symptoms of this stage of midlife.

A lack of sleep - for example, less than seven to eight hours a night – can affect menopausal women already battling brain fog, increased family stresses and work pressures. Common issues include:

• Hot flushes: Sudden feelings of intense heat, often accompanied by a rapid heartbeat and sweating, can cause fragmented sleep, leading to daytime fatigue. Hot flushes are caused by fluctuating oestrogen levels.
• Insomnia: Hormonal changes during menopause, especially reduced oestrogen and progesterone, can trigger the sleep disorder insomnia, where a person has difficulty falling asleep, staying asleep or waking too early. Combined with symptoms such as hot flushes and anxiety, insomnia during menopause can be particularly debilitating.
• Restless legs syndrome: A nervous system disorder that causes an uncontrollable and uncomfortable urge to move the legs, restless legs syndrome can typically worsen at night. It can be triggered during menopause due to falling oestrogen levels, leading to poor sleep and tiredness.
• Anxiety and low mood: Changes to a woman’s mood can be common mental health symptoms of menopause and perimenopause. Low mood, anxiety, low self-esteem, irritability and sadness are symptoms that can have a big impact on daily life, including relationships and work.

Tips to get a more restful sleep during menopause

Here are five tips to help you get through if you’re struggling to get a decent night’s sleep or to foster healthy sleeping habits that leave you feeling refreshed and restored rather than fed up and exhausted:

1. Create your sleep environment

   Firstly, a top priority to help you get more shut eye is to check your bedroom environment. Has anything changed, such as the lighting or temperature – or does it even sound the same? If so, make some changes to create a more calming and relaxing atmosphere, keeping the room cool, quiet, well-ventilated and dark, even using black-out curtains if needed.
   
   Choose breathable bedding and comfortable pillows, and sleep in breathable fabrics like linen or bamboo. Keep spare pyjamas or sheets nearby for quick changes after night sweats, with the aim of getting back to sleep quickly afterwards.
2. Be in tune with your own rhythm

   There is no compelling reason to be tucked up in bed by 10pm on the dot – everyone is different. In fact, people have varying ‘chronotypes’, meaning that they’re inclined to feel sleepier at different points of time. If you go to bed earlier than your body is ready, you might struggle to fall asleep and end up having less sleep overall.
   
   Don’t overthink it if you feel good once you’re awake. If your life and routine help you to complete your sleep cycles and you wake up feeling okay, that’s the important thing - how you function matters more than hitting the magic number.
3. The ‘low arousal’ way

   While some sleep guides offer rigid wind-down rules, simply ask yourself if the activity is relaxing, or stimulating? If something is too mentally engaging, or ‘high arousal’, that’s the opposite of what your brain needs before sleep.
   
   Choose something you can easily put down instead, such as doing a jigsaw or flicking through a magazine. And keep things similarly low-key if you wake during the night. One client of mine would save his washing up to do in the night, because he’d keep waking up – only for his brain to learn that he should be waking up - to do the dishes. Once he’d switched to low arousal activities instead, the nocturnal wake-ups stopped.
4. Park your mental list

   Lots of us know the feeling – you’re staring at the ceiling in the middle of the night with your brain whirring, full of thoughts, ideas or worries and what you need to do tomorrow.
   
   That constantly buzzing state can be fixed, though. My advice is to grab a piece of paper earlier in the evening and jot down whatever tasks are troubling you and how you can tackle them once you’ve had a good sleep. You need to get out of productivity mode earlier in the evening, long before your head hits the pillow. You’ll feel more at ease – in offloading your to-do list, you’re giving your mind one less responsibility.
5. Tip 5: See the light

   Exposure to natural daylight, especially in the morning, can help the body to sleep later – and better – by signalling the brain to stay alert in the day and helping to trigger the release of melatonin at night. It helps regulate the body’s circadian rhythm, the internal clock that controls sleep and wake cycles. During menopause, hormonal changes can disrupt this rhythm.
   
   Even being outside on greyer days can still build the sleep pressure or the biological drive that sends you to sleep later. Consider investing in a specialist lamp to treat Seasonal Affective Disorder (SAD) that simulates natural daylight and helps dispel the ‘winter blues’.