Why can't I sleep during menopause?

Image of a woman having difficulty sleeping

Going through menopause brings about many hormonal changes which can impact our day-to-day life in several ways. Having trouble sleeping is one of the most common symptoms. 

Women are more likely than men to experience sleep problems. According to research, 16–42% of pre-menopausal women report having sleep disturbances, making it rather frequent among women even before menopause.

When we add menopause into the mix, sleep issues affect 39-47% of peri-menopausal women and this rises to 35-60% of postmenopausal women!

A lack of sleep can make you irritable and can make concentrating on things more difficult, so taking steps to improve sleep duration and quality makes life more manageable and enjoyable. So, let's find out why menopause can have such a major effect on our sleep and what we can do about it.

Why does menopause affect our sleep 

As with many of the symptoms of menopause, we can put the changes in our sleep down to the shift in hormones that occurs, namely the reduction in oestrogen. This leads to common symptoms such as hot flushes, night sweats, vaginal dryness, as well as changes in our mood and often increased anxiety and depression. 

Hot flushes can occur at any time of the day, even at night, and along with those pesky night sweats, can have a major effect on sleep, leading to a disturbed night and difficulty getting back to sleep. 

Anxiety levels can increase during menopause, which can be another reason why women may find it more difficult to sleep during this period of life.  

Some women may have restless leg syndrome, which is characterised by tingling sensations in the legs and a strong urge to move the legs. This can happen at any point in life, but women are more likely to experience it and it may happen more frequently throughout menopause. Women who experience this could also have trouble falling asleep.

How to promote sleep when going through menopause 

Sleep is so important as it provides you with the rest you need and it support many aspects of life such as mental and physical wellbeing.

Luckily there are some things we can do to help promote a good night’s sleep during menopause. Let’s take a look! 

1. Hormone replacement therapy 

Hormone replacement therapy (HRT) is a treatment to relieve the symptoms of menopause and is the gold standard for treating hot flushes. It replaces the hormones that are lower during menopause, there are oestrogen only forms of HRT as well as combined forms that contain both oestrogen and progesterone, and there are many different ways to take HRT. These treatments can improve sleep in women with symptoms of hot flushes. It is important to discuss your suitability for HRT with your doctor to find out if it is the right option for you.

2. Improve your sleep hygiene 

Many of us are guilty of not having the best environment for us to get to sleep and stay asleep. With a few small tweaks, you can create an environment that supports a restful night's sleep, which can help you to both fall asleep more easily and to stay asleep for longer:

  • Ensure that your bedroom is cold and dark. If not, consider what you can do to make things better, such as putting up blinds, donning an eye mask, or turning on a fan in the bedroom. 
  • Try to limit screen time an hour before night and avoid eating a heavy meal just before bed as these things can make it harder to fall asleep.
  • Aim to go to bed at a similar time every day, try to avoid napping in the late afternoon so that you are tired and ready for bed when the time comes.
  • An important one to remember is caffeine! Caffeine is one of the most common stimulants and it can have a strong influence on whether you can sleep easily or not. Avoid a large total caffeine intake, and steer clear of caffeine in the afternoon and see if this makes a difference.
  • Alcohol is something that can often be thought to help us with falling asleep but it can actually worsen sleep quality and lead to more night awakenings so be mindful of intake. 

3. Supplements 

Some people may choose to use supplements to support menopause symptoms including poor sleep, and the good news is that there is evidence to show they can help! For example, ashwagandha, a medicinal herb made from the evergreen shrub Withania Somnifera, contains compounds that can relieve symptoms of hot flushes in menopause which could promote sleep and can improve sleep quality in people suffering with insomnia

Another popular supplement that can be used to support sleep is magnesium. Magnesium helps to regulate levels of the hormone melatonin which promotes sleep. Supplementation with magnesium has been shown to improve sleep duration and quality - so this is certainly one to consider! 

4. Exercise 

When we are tired, exercise might be the last thing that is on our minds but funnily enough, staying active and engaging in some form of physical activity can actually help to improve sleep quality, especially for women who suffer from hot flushes and night sweats. However, try not to do too much vigorous exercise before bed as this can sometimes keep you awake - so think about the timing of your exercise too. 

5. Manage stress

Stress, worry or anxiety can make for a very active mind which can get in the way of sleep. Everyone’s reasons for stress are different, so it’s important to consider your own stress levels and the reasons for them. Can anything be done to help to manage the situation? Taking time for self-care can help to reduce stress levels which could positively impact your sleep. 

6. Opt for a sleep promoting diet 

We mentioned magnesium, and of course, we should aim for a magnesium-rich diet too! Magnesium rich foods include nuts, seeds, green leafy vegetables and soy. 

Soy is also a great source of phytoestrogens which, along with increased fruit, vegetables and whole grains, has been shown to improve symptoms related to hot flushes which can in turn help to promote sleep. 

Omega-3which can be found in oily fish such as salmon or mackerel, is associated with improved menopausal symptoms which could improve sleep outcomes. 

Food high in tryptophan such as white meat, nuts, seeds and milk, and melatonin such as fish eggs and nuts are thought to improve sleepHow does your diet compare to this? Are there any changes you feel you could make?

The takeaway

If you have encountered sleep problems during menopause, you are not alone. The good news is that there are several things you may do to improve the quality of your sleep. Take some time to consider what changes make sense for you, to help you enjoy a restful night's sleep.

If you continue to experience issues with your sleep, do reach out to your doctor or another healthcare professional who can support you further.