Understanding how menopause affects sleep quality and patterns is crucial for any woman. Menopause is a natural biological ageing process which results in a variety of hormonal changes and generally affects women between the ages of 45- 55 years. A woman is considered to be in menopause when she does not experience menstruation for 12 months in a row.
The National Health Service informed that this period of transition from pre-menopause to menopause is characterised by different symptoms like hot flushes, nighttime perspiration, palpitations, confusion, irritation, and sleep disturbances. This is because of the numerous hormonal changes that occur when a woman enters the menopausal state.
While the symptoms of menopause are already tough to deal with, the sleep disturbances that occur alongside make this transition tougher. To understand how menopause causes sleep disturbances and ways to navigate this symptom, the Onlymyhealth team spoke to Dr Sibasish Dey, Head of Medical Affairs, South Asia, ResMed.
How Does Menopause Cause Sleep Disturbances?
“Various hormonal changes occur as a woman transitions from pre-menopause to menopause. There is a gradual depletion of estrogen and progesterone, so the protective effects of both these hormones wane,” said Dr Dey. He underscored that this is an important cause of various sleep disorders like insomnia and sleep apnea.
But how does this happen? Dr Dey gave two examples as reasons:
- The shortage of estrogen makes the brain more susceptible to changes in temperature, which could interfere with neurotransmitters that are involved in mood regulation and may influence the sleep-wake cycle.
- Low estrogen and progesterone levels may contribute to weight gain, which may result in snoring or sleep disorders like sleep apnea.
Types Of Sleep Disorders Caused By Insomnia
“Around 35-65% of women in their early stage of menopause experience different types of sleep disorders. The predominant ones being sleep apnea and insomnia,” said Dr Dey.
Insomnia
The National Heart, Lung, and Blood Institute defines insomnia as difficulty in falling asleep, or maintaining sleep or is associated with a feeling that sleep is nonrestorative with daytime symptoms.
Insomnia during this transition phase is characterised by hot flushes, and nighttime sweating and there is also a strong association with anxiety and depression, shared Dr Dey.
Sleep Apnea
Dr Dey shared, “In post-menopausal women, there is a 3.5 times increase in sleep apnea in comparison to pre-menopausal women.” He shared how this happens:
- This is primarily due to the loss of the protective effect of estrogen and progesterone.
- Additionally, there is an increase in body weight, reduction of muscle tone due to ageing and altered chemoreceptor sensitivity.
Dr Dey explained, “Due to reduced levels of female hormones, the tone of the upper airways decreases making it more collapsible while an individual is sleeping. As the upper airway collapses, less air enters the lungs and subsequently the brain gets activated leading to micro-awakenings. As this phenomenon may happen many times at night multiple micro-awakenings lead to sleep fragmentation. This results in various symptoms such as fatigue, irritability, depression, and daytime sleepiness.”
Also Read: Diagnosed With PCOS And Sleep Apnea? Expert Shares Why You Should Not Ignore This Sleep Disorder
Side Effects Of Sleep Disturbances
Dr Dey commented, “Due to menopause, it is less likely for one to experience a good night’s sleep and it can lead to women feeling tired during the day, impair their cognitive abilities, cause mood changes, result in weight gain, decrease immune function, among other things, which can impact the overall quality of life.”
Sleep deprivation has both short-term and long-term consequences. As per Dr Dey, the short-term consequences are more neuro-cognitive like fatigue, inability to balance home and workplace activities, and depression. Whereas, long-term effects impact the cardio-metabolic system. Associations have been found with type 2 diabetes mellitus, hypertension, heart failure, and irregular cardiac rhythm.
Treating Poor Sleep Due To Menopause
Six to eight hours of uninterrupted, high-quality sleep each night is what is considered ‘good’ sleep, underscored Dr Dey. He listed a few tips for women with menopause who have trouble sleeping:
- Optimise your sleep environment: It is essential to keep the bedroom cool, dark, and quiet before sleeping. To further improve sleep quality, keep the bedroom clean and use it only for sleeping. According to the ResMed Sleep Survey 2024, 25% of Indian participants reported that screens and other electronic devices kept them awake at night. This underscores the critical need to attempt to put electronics away at least an hour before bed.
- Stick to a sleep schedule: While it may be tempting for people to stay up late during the workweek and then make up for lost sleep on the weekends, the menopause transition impacts circadian rhythms. It is crucial to maintain a consistent sleep schedule each night to obtain good sleep. Developing a consistent sleep schedule can help individuals get more restorative sleep including the quantity and the quality of their sleep.
- Maintain cool body temperatures: Adjust the temperature in the bedroom to a low, comfortable level to avoid hot flashes and night sweats. Choose cotton sheets over synthetic ones and dress in breathable cotton sleepwear. Consider having a cool shower before going to bed.
- Diagnosing sleep disorders: A wide range of indications can be present for sleep disorders, which are more common in women going through menopause. Based on the signs, sleep history, and indicators, a sleep specialist may assess sleep health. Women's symptoms differ from men's symptoms, so PAP therapy for them needs a customised algorithm, which means that the available treatment options can change.
Dr Dey concluded that it has been demonstrated that getting enough sleep is linked to good health and well-being. Sleep deprivation can lead to heart disease, high blood pressure, and other long-term medical conditions. It also has an impact on job performance, safety, and overall quality of life. If a person exhibits signs of fatigue or excessive daytime sleepiness, they should consult a healthcare professional.