Sleep and perimenopause: everything you need to know

Sleep Scientist and Psychologist Dr Nicola Barclay explores the relationship between perimenopause and the quality of our sleep

After many years in the shadows as something that is taboo to talk about, society is now finally being more open about women’s menstrual cycles and the onset of the menopause. Growing research into the field is helping to shed new light on the processes involved, how the symptoms can be handled and how routines can be adapted to make perimenopause and the menopause a less challenging experience for women.

There’s some great work being done also in this field by well-known voices such as Davina McCall, who earlier this year presented Davina McCall: Sex, Mind and the Menopause on Channel 4.

In this article for Mammoth, I want to continue the conversation and begin with perimenopause, exploring this transitional stage and how it can impact our sleep quality.

What is perimenopause?

Perimenopause is the menopausal transition – a time of intense physiological change. It is a natural process during which the ovaries gradually stop working. Ovulation may become erratic before eventually stopping, resulting in irregular periods before they eventually end. Symptoms of perimenopause are caused by changing hormone levels in the body.

What are the symptoms of perimenopause?

Many of the symptoms of perimenopause are vasomotor, such as hot flushes and night sweats. Perimenopause can also lead to mental health symptoms such as heightened anxiety and depression, as well as drastic mood changes and trouble concentrating.

As well as this, perimenopause can result in headaches, joint and muscle aches, sweating, having to pee often and changes in sexual desire   

Perimenopause and sleep

Sleep problems are one of the most common symptoms of the perimenopausal stage and beyond. In fact, more than a third of women report more sleep disturbances during menopause compared to pre-menopause, according to the National Institutes of Health.

Hot flushes, night sweats and other symptoms can make perimenopausal women more prone to insomnia, or exacerbate pre-existing insomnia. The fact that ageing and perimenopause often go hand-in-hand can aggravate symptoms even more, as ageing is associated with many of the symptoms involved in perimenopause, including aches and pains, weight gain and an increased need to urinate during the night.

Your hormones during perimenopause

Bodily changes brought on by perimenopause occur as a result of fluctuating hormones. Both oestrogen and progesterone levels drop during the perimenopause, and it is possible that these changes interfere with the neurochemicals controlling the sleep drive.

Studies have found that post-menopausal women have an earlier secretion of melatonin in the evening, impacting the internal body clock and possibly contributing to earlier bedtimes and early morning awakenings.

Oestrogen reduction can also result in hot flushes, which in turn increased night-time awakenings. One study of menopausal women published in the Journal of Clinical Sleep Medicine found that 80% of hot flushes preceded or occurred at the same time as an awakening.

What can you do to improve your sleep

Learning to live with the menopause can be difficult, marking a period of intense change for women. One of the most common treatments available for managing menopausal symptoms is Hormone Replacement Therapy, or HRT. This is designed to manage your body’s oestrogen and progestin levels.

There has also been some research into whether HRT can improve sleep. By managing other menopausal symptoms, HRT can tackle some of the symptoms which may be disturbing your sleep, such as hot flushes.

Cognitive Behavioural Therapy for Insomnia (CBT-I) is another option for treatment, commonly used to reduce insomnia symptoms. Studies, such as those published in the Archives of Internal Medicine in 2004, even found that CBT-I was more successful in treating sleep problems than pharmacological treatment options.

There are also simple lifestyle changes you can make to promote better sleep, such as sticking to a sleep routine, reducing your screen time, following a healthy diet and taking steps to deal with stress and anxiety.

Perimenopause can be challenging, but you don’t have to go through it alone. Conversations about perimenopause and menopause are opening up, with the development of excellent support forums and advice.

The best sleep happens on a high-quality mattress, so check out the Perks range now. You can also explore the rest of our blog for more sleep news and tips.