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Sleep and Menopause: how to get a better night's sleep

Menopause. It’s something we just don’t talk enough about. So, this October for World Menopause Month we're teaming up with Lisa Snowdon and Henpicked - a community of women sharing knowledge - to answer questions, provide support, and start the conversation about all things Menopause.

Plus, throughout October, experts from Henpicked will be hosting FREE sessions in Pausa Cafes at selected stores where you will be able to find out more about getting a good night's sleep during menopause and ask any questions you might have.

October has been officially recognised as World Menopause Month since 2009, thanks to the World Health Organisation (WHO) and the International Menopause Society. We sat down with Dr. Clare Spencer, a registered menopause specialist and GP from www.mymenopausecentre.com and Henpicked, to get the lowdown on what menopause is actually all about.

So, Clare, what is menopause?

Menopause is a transition that occurs as your hormones change and your periods eventually stop. On average this transition starts in your mid 40s. The average age of women experiencing the menopause is 51 but it can occur between the ages of 45 and 55, with 1% of women going through the menopause under the age of 40. The menopause can happen naturally or can happen as a result of surgery, cancer treatment, illness or other reasons. The menopause is said to have occurred when you have had no period for 12 consecutive months due to your ovaries having stopped making hormones.

What kind of symptoms can we expect?

Hormonal changes can result in a wide range of symptoms, both physical and psychological. In research, the ones women have said affect them most include:

Difficulty sleeping, insomnia or fatigue

Hot flushes during the day or night

Low mood, depression or changes in mood

Nervousness, worry or anxiety

Reduced ability to concentrate or focus

Problems with memory recall

Migraines or headaches

Aches and pains

Irregular and/or heavy periods

Urinary issues, e.g. increased frequency

A pretty big change, then. What do we do once we’ve started to notice these symptoms?

We always recommend you go to your healthcare practitioner if you’re experiencing menopausal symptoms or want to talk about your long-term health. They can discuss different options with you, including hormone replacement therapy (HRT), and advise on any lifestyle changes that could help. They should also be able to sign post you to information about the menopause and ways of managing symptoms.

Anything we can do ourselves?

A little preparation will help you get the best from your appointment, particularly if you’re feeling nervous or forgetful. It’s a good idea to record your symptoms and detail your menstrual cycle history. Healthcare practitioners in the UK use the NICE (National Institute for Health & Care Excellence) guidelines to help women manage their menopause; you can read the guidelines to find more information about symptoms and treatments here. Make sure to research any other facts on up-to-date, trusted websites, and think about ways you’d like to manage not just your menopause symptoms, but your long-term health, too.

Can you tell us more about how menopause affects sleep?

Broken sleep can be directly connected to some of the physical symptoms of the menopause; you may be woken up by joint pains or hot flushes and night sweats, for example, or you might need to get up in the middle of the night to go to the loo, which is something you probably didn’t do before menopause.

Psychological symptoms, such as anxiety and increased stress, can leave you tossing and turning, too. We know that sleep is affected by low mood and depression, for instance.

And this all because of menopause?

To an extent, but it’s probably not the full picture. Although the changes in hormones are thought to play an important part in causing sleep problems, sleep quality does decline with age anyway, in both men and women.

What other factors can affect our sleep?

Lots of things:

Alcohol may be able to get you off to sleep, but the resulting quality of sleep can be poor. You experience a lighter sleep and don’t feel rested when you wake.

Caffeine in tea and coffee is a stimulant, of course, and drinking caffeine before bed, or having too much during the day may keep you awake at night.

Nicotine is also a stimulant, so smoking can cause difficulty with sleeping, too.

Conditions such as chronic pain and some medications.

But if we lose a little sleep, that’s surely not too bad. Right?

Well, in research conducted by the British Menopause Society, up to 60% of the women interviewed mentioned sleep problems, and the effects of these sleep issues can be debilitating and take their toll on your daily life. Lack of sleep can affect your short-term behaviours, and your long-term health.

How so?

Studies have shown that a lack of sleep can really affect your mood, making your brain focus on negative thinking and even a tendency for your brain to remember unhappy events rather than happy ones. It can impair your judgement and concentration, too, which doesn’t help the experience of menopausal brain fog. Inadequate sleep can also impair your reaction time, so you can become more accident-prone and clumsy.

Ok. What do we need to do to improve our sleep?

Make sure your bedroom is cool and dark. That can make all the difference.

Cooling cotton sheets and a good choice of nightwear (something that lets your skin breathe) can also help.

Get into a bedtime routine that involves time away from screens. Try to keep your bedroom for sleep only (and not for working, scrolling on your phone or watching TV).

Try to avoid going to bed too early, which often means that you’ll lie awake for long periods. And, if you’re tossing and turning in the night, get up for a while. You’re trying to train your brain to associate your bedroom with sleep, and so getting up when you’re lying awake can help with that. Go to another room and do something soothing, like reading a book, and only go back to bed when you’re feeling tired.

It's easier said than done, but try to manage stress and worry so that panicky thoughts don’t keep you awake.

There are lifestyle-related changes you can make, too:

Avoid large meals that are rich in heavy or spicy foods before you go to bed.

Try to avoid caffeine for at least four hours before bed, or from the early afternoon.

Try to limit how much alcohol you drink in the day. Alcohol is a known stimulant and decreases sleep quality, so avoiding this may help.

If you’re a smoker, try your best to quit. Smoking is also a stimulant (as well as being bad for your health more generally).

Is there any additional help we can reach out for?

There is. If you want to explore a medical approach to managing your symptoms, you can discuss Hormone Replacement Therapy (HRT) with your GP. Cognitive Behavioural Therapy (CBT) has also been proven to help manage menopause symptoms and can help improve sleep, too.