When sleep health expert Dr Moira Junge entered midlife, good sleep went out the window. Here, the health psychologist and Sleep Health Foundation CEO looks at why sleep can suffer around menopause – and what to do about it.
When you're not sleeping well, it can be mildly upsetting through to highly distressing.
Our data shows that among perimenopausal and menopausal women in Australia, 34% experience no changes to their sleep. But for many women, sleep gets worse at this stage of life, with 24% reporting they wake too many times. Other sleep problems midlife women have shared with us include:
The simple answer is that it's likely a combination of factors. But it's unclear if some factors hurt sleep more than others – there just isn't enough sleep research on midlife women to be sure.
We know that around menopause, changes in the hormones oestrogen and progesterone can cause a range of symptoms. One of them is night sweats, which unsurprisingly disrupt sleep.
For many women, unwanted weight gain also happens at midlife, which can put pressure on the upper airway during sleep, leading to snoring and sleep apnoea.
Midlife is also chaotic. Women often find themselves dealing with stress, increased caring responsibilities, new health challenges and more demanding roles at work, which can all impact our shut-eye.
When I entered midlife, hormonal and other physical changes didn't really affect my sleep – at least they haven't yet. But something I never anticipated was the worry that would disrupt my sleep as my kids got older. When they were primary school-age, we had consistency and routines that made sleep easier. But once they hit 18, I found myself waking up waiting for them to come home at 4 in the morning, stressing about them driving and going to nightclubs.
Good sleep needs a calm mind and healthy routines, which can both go out the window at midlife.
Good sleep needs a calm mind and healthy routines, which can both go out the window at midlife.
Dr Moira Junge
As a sleep expert, I urge women not to put up with poor sleep long term. It’s normal to toss and turn from time to time, but if you’re struggling for months or years on end, it’s important to find a healthy solution. If medication or a medical condition isn’t driving your sleep problems, these tips may help.
1. Forget one size fits all – Good sleep looks different for everyone. A friend of mine gets up every few hours throughout the night to support her son who has a disability. She has accepted the sleep disruption and doesn't stress about it, so most nights she is able to return to bed and get the sleep she needs to function well. Remember, good sleep doesn’t have to come in one big uninterrupted chunk. It's about what works for you.
2. Value, protect and prioritise your sleep – It’s easy for sleep to fall down the priority list. Try to find a way to carve out enough shut-eye in your 24 hours, remembering that between 6 and 10 hours' sleep a night is normal for most adults.
3. Be true to your body clock – Healthy sleep doesn't necessarily mean going to bed early. If you're someone who doesn't feel sleepy until late at night and has the flexibility to get up later in the morning, go with that. Unfortunately though, most of us have to get up early.
4. Use the light and dark – To help your body maintain healthy levels of the sleep hormone melatonin, expose yourself to darkness or dim light a couple of hours before bed. When you wake, get good doses of bright light by going outside or sitting near a window.
5. Unwind your way – Try to have a calming, pre-sleep routine that helps you unplug from worry and responsibility. You might like to shower, read a book, listen to a podcast, watch television or spend some time on your phone (with night mode switched on). Some screen time before bed is fine as long as it isn’t distressing, stimulating, prolonged or too bright.
6. Play catch-up – Current guidelines say it's OK to have an hour or 2 of catch-up sleep on less busy days if you need it. Just try not to sleep in too late and upset the rest of your sleep schedule.
7. Manage troubling night sweats – Explore the different ways to manage hot flushes and nights sweats, which are common around menopause.
8. Don't look at the clock – If you wake in the night, resist the temptation to check the time, especially if it causes stress.
9. Consider different therapies – I'm a big fan of mindfulness as it can help you relax and reduce your worry about not sleeping. If you struggle with insomnia, cognitive behavioural therapy for insomnia (CBT-I) is another good option you could try.
10. Get help – If good sleep still won’t come, make an appointment to see your doctor. If needed, they can refer you to a sleep specialist or psychologist.
For more sleep tips and information, visit the Sleep Health Foundation.
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