Betty came to visit me last winter. She was a funny patient with a serious problem.
"When I wake up at night with one of my 'power surges,' I feel like I could heat a small country. And I am having a hard time sleeping because my husband's teeth are chattering so loudly from my keeping the window open. Doc, it's December, but my body thinks it's July."
Not all women experience symptoms prior to or following menopause, which is defined as the time when a woman has naturally ceased having menstrual periods for one year. If menopausal symptoms occur, they may include hot flashes, night sweats, pain during intercourse due to vaginal dryness, and increased anxiety or irritability.
Welcome to the signs of approaching menopause. In addition to hot flashesand mood swings, many of my patients report difficulty sleeping. Although some 40% of premenopausal women report sleep problems, this percentage can double from the onset of perimenopause (the transition into menopause, beginning as early as the late 30s for some women) through postmenopause. That's a lot of women missing out on a good night's sleep.
During this transitional time, the ovaries gradually decrease production of estrogen and progesterone (a sleep-promoting hormone). Hot flashes, typically accompanied by a surge of adrenaline, can result. And when they happen in the middle of the night, a woman may find it very hard to settle back into slumberland.
How can women like Betty improve the quality of their shut-eye? Consider some of these simple solutions to minimize the impact of sleep-marauding hormones.
Stay cool. Keep a damp cloth or a bucket of water nearby to cool yourself quickly if you wake up feeling hot and sweaty.
Consult your doctor. If you have difficulty sleeping after age 35 because of hot flashes, night sweats, or other symptoms of perimenopause, ask about the possibility of taking a low-dose birth control pill to stabilize estrogen fluctuations. Your doctor may also consider short-term use of hormone replacement therapy (HRT) to help relieve menopause-related symptoms. Note that HRT is not for everyone; ask your doctor if it's right for you. To see if your sleep improves, your doctor may also suggest a prescription sleeping pill for a short period of time.
Prevent pain. If aches and pains prevent you from sleeping, try taking a mild, over-the-counter pain reliever or analgesic before going to bed. Just be sure it doesn't contain any stimulants.
Ban Fido and Kitty. Your pet's movements -- or your allergiesto animals -- could be disturbing your sleep. Animals can also give off a tremendous amount of heat.
If you have trouble sleeping for more than a few weeks, or if sleep problems interfere with your daily life, speak with your doctor or contact a board-certified sleep specialist.
SOURCES: Kryger, Meir et al, editors: Principles and
Practice of Sleep Medicine. Fourth Edition. Elsevier. 2005: pp 1287- 1296.
Kryger, Meir, et al, editors Sleep Medicine, Third Edition, Elsevier
2000. WebMD Medical News: "Plant Estrogen Pill Gets Menopause Test Results
Similar to Fake Pill"; Timing, Ingredients May Need More Study." Bonnet
MH, Arand DL. We are chronically sleep deprived. Sleep ,1995; vol 18:
pp 908-11. Jewett ME, Dijk DJ, Kronauer RE, Dinges DF. "Dose-response
relationship between sleep duration and human psychomotor vigilance and
subjective alertness," Sleep, 1999; vol 22: pp 171-9. LUNESTA,
"Perimenopause-Menopause Study Shows Improvement for Women Suffering from
Insomnia," Sepracor news release. July 18, 2005.