Menopausal Sleep Problems

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Getting a good night’s sleep — that means an uninterrupted 7-9 hours per night, most nights — is essential to good physical, mental, and emotional health. Physically, sleep helps to balance the fluids in your body, flush out chemicals from muscles, boost your immune system, and promote normal cell growth and development. Mentally, sleep helps your mind make sense of the day’s events, process what’s happened, and add data to your memory bank.

Everyone has trouble sleeping from time to time, but sleep problems tend to get worse and occur more frequently when your body enters menopause. When you’re not sleeping well night after night, this starts to take its toll. You may not be able to function well at home or work. Concentration and memory can suffer. You may get easily irritated or upset by people or situations that didn’t bother you before.

We’re not yet exactly sure how changing levels of estrogen and other hormones interfere with the sleep cycle. It could be that estrogen affects the production of the brain chemical serotonin, which in turn is needed to produce melatonin, the sleep hormone. However, we do know that the hormonal changes of menopause cause symptoms such as hot flashes and night sweats, depression, mood changes, and weight gain — all of which can interfere with a good night’s sleep.

Menopausal women are at increased risk of:

  • Insomnia: This is a general term for difficulty sleeping, and it can take many different forms. You may find you have trouble going to sleep, or you may wake up frequently and have trouble going back to sleep. Or you may wake up much earlier than you planned and/or feel tired when you wake up. Over time, insomnia can make it hard to function at home and concentrate on tasks. It also can make you irritable.
  • Sleep apnea: Sleep apnea means that your breathing stops temporarily during sleep. Central sleep apnea occurs when the brain doesn’t automatically tell the muscles that control your airway to take a breath. Obstructive sleep apnea happens when your airway is blocked, usually by the soft tissue at the back of your throat. If you have a sleeping partner, he or she may notice that you snore, gasp, or breathe heavily during sleep. You may awaken during the night as a result, or you may simply feel tired during the day. Hypopnea, or shallow breathing, is another form of sleep apnea. With both conditions, your supply of oxygen decreases and this affects the quality of sleep. Obesity is a risk factor for sleep apnea.

There is perhaps nothing more frustrating than being awake while the rest of the world sleeps! If you’re having sleep problems, first try to figure out if there could be an underlying cause. Many women wake up as a result of hot flashes or night sweats, or they can’t fall asleep due to worry or inability to relax. Some women are bothered by a condition known as Restless Legs Syndrome, or RLS, marked by uncomfortable sensations that are relieved only by moving — and symptoms tend to worsen at night. If you work with your doctor to get these issues under control, then the quality of your sleep is likely to improve.

Also, review your current medications with your doctor to see if any might be contributing to sleep issues. You may be able to adjust the dosage or timing, or even change the medication altogether, to see if your sleep improves.

If you’re sleeping through the night but still experience fatigue during the day, be sure to see your doctor. It’s possible to have sleep apnea without even realizing it, especially if you don’t have a bed partner. Other medical issues, such as an underactive thyroid gland or heart disease, can cause fatigue. So can depression, lack of exercise, and certain breast cancer treatments. For more information, visit Breastcancer.org’s section Managing Fatigue.

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