Vol. 27: Sleep & Perimenopause

Vol. 27: Sleep & Perimenopause

One of the common themes that comes up with my clients is how much their quality of sleep deteriorates in perimenopause. For some women, this looks like taking a longer time to fall asleep, for others it looks like sudden wakings in the middle of the night and some are finding that they're experiencing hot flashes during the night, all of which can severely affect sleep quality and how we feel the next day. We know that quality sleep is essential for feeling good, for our long term health, and managing our mood and productivity.

The idea of getting a full seven-to-eight hours of sleep can feel laughable at times, but it's so important that we don't accept poor sleep as our new normal in perimenopause. The good news is that there are many tools at our disposal to help us improve our sleep. I recommend trying out one or two, to figure out whether they make a positive impact for you. Work your way down the list, keep the routines that help you and leave the rest!

Creating Sleep Opportunity: We can't control how long we sleep for, and we know that we're not going to immediately fall asleep the moment we get into bed. This is why it's important to give ourselves more time in bed than we want to spend asleep. If we know that we need seven hours to feel our best, then it's important to give ourselves more than that amount of time in bed to transition to sleep (or back to sleep if we wake in the middle of the night). Generally I try to give myself eight hours of time in bed if I want to get seven hours of sleep. 

Regular Sleep and Wake times: Just as you set an alarm to wake up in the morning, try setting a bed-time reminder on weeknights, Sunday through Thursday. This can help create a better-regulated sleep schedule which can not only impact the quality of your sleep, but have impacts on your mental health, physical health and overall performance. I generally set my alarm for 10PM on weeknights and even though I'd love to stay up and watch Netflix, I know that future-me will be thankful if I head upstairs.

Creating a routine to wind-down: Creating a relaxing ritual that tells your mind and body that it's bedtime can be really helpful. It doesn't need to be intricate and could include things like: switching to dimmer lighting, reading a book, listening to music or doing a short meditation. I usually dim the lights on the main floor and upstairs of the house after dinner. I also find that brushing my teeth before I relax on the couch is helpful for a quick transition to bed. Keeping a consistent routine can help your body and brain prepare for sleep.

Exercise: Regular exercise can help decrease stress and the time it takes to fall asleep. It can also help to kickstart biological processes in the brain that contribute to better quality sleep. There's some evidence to suggest that exercise can help alleviate insomnia. One note, though, it's best to avoid strenuous exercise close to bedtime if it affects your sleep. 

Daily Meditation: Meditation can calm racing thoughts and put our nervous system into a parasympathetic state. When we meditate we can shift our state from fight-or-flight to a rest and digest mode so that we're better prepared for sleep and might even fall asleep more easily. If the idea of meditation feels daunting to you, start with something as short as five minutes, and don't get hung up on doing it perfectly. Just tuning into the breath and slowing it down can be helpful! I'm currently loving Megan Telpner's 5-minute coherence practice and DIY Box Breathing - you will literally feel like a new person after doing either of these for five minutes.

Environment: There are lots of changes we can make in the bedroom to set ourselves up for a better night's sleep: it's best to keep the room cool and dark. Consider testing out a sleep mask to block out light and help minimize distractions - this is a go-to for me and it's also super helpful when you're travelling. White noise can help to decrease disturbances and distract from intrusive thoughts. Personally, I use a fan on my bedside table for white noise.  Bedding made of breathable and natural fibres are the best choice if you're experiencing night sweats. 

Eat to Support Your Sleep: Some people find that eating an earlier dinner or a smaller dinner can be helpful. The composition of your plate can also contribute to improved sleep. Eating protein and complex carbohydrates at dinner triggers the production of serotonin, which converts to melatonin and can help you sleep more soundly. Eating foods that are rich in magnesium can also help to decrease our stress hormone, cortisol, increase melatonin and help regulate the central nervous system; edamame, spinach, black beans, almonds, pumkin seeds and cashews are a few examples of magnesium-rich foods..

Avoid foods that can interfere with your sleep: Alcohol might make you feel sleepy because it depresses the nervous system, but it can also disrupt sleep cycles, leave you feeling dehydrated and thirsty during the night or even trigger hot flashes. It was the post-wine dehydration that led me to start questioning my relationship with a night cap. You can read more about alcohol and perimenopause here. If you notice that caffeine, spicy foods or alcohol trigger hot flashes, this is something to be aware of and experiment with. Spicy and fatty foods can also lead to indigestion and can keep you tossing and turning.

It's always a good idea to talk to your doctor if you suspect you may have conditions like undiagnosed sleep apnea, anxiety or depression that could be affecting your sleep. Your medical doctor can help you to assess the benefits and risks of hormone replacement therapy. A naturopath can also help with dietary suggestions and prescribing supplements that can decrease symptoms by regulating hormones. Please don't accept that sleep is going to be terrible during this stage of life.  I encourage you to explore these options and find the ones that work for you. 

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