Just lying there awake ... is it menopause insomnia?
Sleepless at midlife? Menopause insomnia may not be to blame
Sometimes sleepless nights at midlife have nothing to do with menopause insomnia, hot flushes or anything hormonal. We're just awake and that's it.
Sometimes our heads are buzzing with repetitive thoughts that trundle through our fevered minds like hamsters stuck on their wheels. Sometimes we’ve a few aches and pains or even restless legs that we can't stop moving around.
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At other times though, there are no repetitive thoughts, no anxiety, no aches and pains, no nothing.
We're just awake.
Lying there awake, waiting for morning and wondering how much of a dead duck we will be when we try and fulfill our full agenda the next day.
Like menopause, sleep is one of the great mysteries of our time, so mix the two mysteries together and you get a double whammy: menopause insomnia – two for the price of one!
Menopause Insomnia – companions in upheaval
For many women at midlife there are stresses, strains and life changes that cause sleepless nights. The midlife transition can be a difficult time emotionally as we face up to a number of upheavals and also begin to come to terms with our own mortality.
Researchers Nancy Woods and Ellen Mitchell studied data on 286 women who participated in the Seattle Midlife Women's Health Study in the 1990s. They wanted to try and find out more about menopause insomnia(1).
They found that although sleep problems in midlife women were associated with hot flashes, they were also linked with women's general health.
Women who were anxious, depressed, had joint pains or back ache, who were suffering from stress or had suffered from sexual abuse were more likely to have sleep problems.
If women perceived their health to be good then sleep problems tended to be fewer, though it's likely that if women sleep well they also feel that they are healthier.
But some women (and men too) suffer from insomnia throughout their lives. The latest scientific thinking on this is that these people may have an inherited tendency to insomnia which is linked to the way they handle stress(2).
What causes insomnia?
Finding balance to help sleeplessness
Since our stress and distress levels play such an important role in our sleep patterns, body mind practices such as yoga, meditation and mindfulness can be an invaluable help.
Amidst all the buzz and flurry of middle aged women's busy lives it is also essential to seek out regular opportunities for reflective solitud or quiet companionship with a close friend.
And once again the wonderful "cure-all", regular physical activity, can play a key role in getting us back into a stable sleep habit.
It is good to establish what's known as: good sleep hygiene: this means mainly common sense practices such as:
- trying to keep to a regular time for going to bed
- sleeping in a dark, quiet room
- getting up if you are tossing and turning for too long.
- don't drink caffeine too late in the day, or drink too much alcohol or eat a heavy meal too close to bedtime.
- although regular exercise is essential, you shouldn't work out too close to bedtime.
It's also important not to stress alone about this problem. So many other people are also lying in bed awake in the wee small hours – we shouldn't be afraid or embarrassed to talk about this problem with our close friends.
When things get really tough
Your doctor can help if you are getting so exhausted you can't cope, though the solutions are usually only advised for short term problems:
Hormone treatment – if you have very bad hot flushes and night sweats your doctor may prescribe hormone treatment which sometimes improves insomnia in perimenopausal women. But hormone treatment is not without its problems and it's not usually a good idea to take it either for too long or only for insomnia.
Sleeping pills such as benzodiazepines and other tranquilizers - these have the disadvantage of creating dependency and your doctor will most likely not encourage you to take them for too long.
Antihistamine tablets - these are available from chemists over the counter in many countries, but should only be taken for a short time to help a mild and temporary sleep problem.
Insomnia and menopause – more research needed!
Although a definite causative link between insomnia and menopause has not been proven, there's no doubt that we need to know much, much more about the psychophysiology of sleep problems during our midlife journey.
Until more is known about sleep, not only women but men too will continue to have sleepless nights as they age.
The best way that we can improve our sleep is to keep healthy and fit, eat sensibly, not overdo the alcohol and to work on our body mind balance so that we can remain calm and detached in the crazy maelstrom of 21st century living!
- Woods NF, Mitchell ES. Sleep symptoms during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Sleep. 2010 Apr 1;33(4):539-549.
- Bonnet MH, Arand DL. Hyperarousal and insomnia: state of the science. Sleep Med Rev. 2010 Feb;14(1):9-15.
Published January 2012.
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