Summary
Menopause is the stage in a women's life when her ovaries
stop producing the hormones estrogen and progesterone and
she stops having her monthly menstrual cycle (her period).
This is a normal part of aging and marks the end of a
woman's reproductive years. Menopause usually occurs in a
woman's late 40's to early 50's. It can also lead to sleep
problems.
According to the National Sleep Foundation,
approximately 61% of menopausal women have sleep problems.
Approximately 75-85% of menopausal women experience hot
flashes, which can last for five years. Hot flashes and
sweating can make it difficult to sleep. Hot flashes that
occur during sleep have the ability to affect the quality of
sleep adversely by bringing women from a deeper, more
restful stage of sleep to a lighter, less restful and
restorative stage.
Many women during the menopausal transition (perimenopause,
menopause, post-menopause) complain of sleep disturbances
that are attributed to vasomotor symptoms (e.g., hot flashes
and night sweats) rather than to menopausal status.
Estimates of self-reported menopausal-related Insomnia range
from 33% to 51%, but the actual prevalence of sleep
disturbances in midlife women, particularly as a function of
race, ethnicity, and body size is not well defined.
The traditional treatment for the symptoms related to
menopause has been hormone replacement therapy (HRT). HRT
consists of estrogen given as a pill, patch, or vaginal
cream, either alone or combined with progesterone (for women
who still have their uterus). However, results from a large
study, the Women's Health Initiative, showed that long term
use of estrogen-progesterone combination therapy caused an
increased risk of breast cancer, heart disease, blood clots,
and stroke. Estrogen alone did not increase breast cancer or
heart disease, but the study also found that therapy with
estrogen alone increases the risk of blood clots and stroke.
Some studies have reported that estrogen replacement therapy
(ERT) is associated with better sleep quality, while others
have shown no difference or poor sleep quality.
In pre-menopausal women, the incidence of sleep-disordered
breathing (including snoring and sleep apnea, a condition in
which breathing starts and stops while asleep) is quite
small, but it appears to increase dramatically (to 9% of the
population) after menopause.
Actions that may ease sleep problems include the
following:
- Keep a regular bedtime schedule, including going to bed at
the same time every night.
- Don't consume a lot of caffeine (coffee, soft drinks,
etc.)
- Avoid naps during the day, which can prevent you from
sleeping well at night.
- Exercise regularly but not right before sleep.
- Discuss with your doctor the prescription medications that
can help you sleep.
