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Menopause

Effects of Menopause on Sleep

Summary & Participants

While menopause is a natural change for all women, it can cause a variety of symptoms that feel anything but natural. One of the most common complaints is the occurrence of hot flashes which can be not only uncomfortable, but cause endless nights of interrupted sleep. Discover what the experts advise women about turning tossing and turning into peaceful rest.

Medically Reviewed On: May 08, 2008

Webcast Transcript

ANNOUNCER: While women today have the option to lead many different kinds of lives, there's one thing they will all eventually share in common: menopause. And those changing hormone levels can cause a variety of difficulties.

CHARLES REYNOLDS, MD: Menopause, perimenopause affects sleep, typically in women in their early to mid-fifties, with changing hormonal levels, dropping hormonal levels and with the occurrence of symptoms like hot flashes. It can be a very disabling symptom. The disruptions in sleep continuity that are associated with hot flashes, waking up with a sense of drenching sweats and feeling very, very hot.

ANNOUNCER: Hot flashes are a direct consequence of those changing hormone levels.

CHARLES REYNOLDS, MD: The falloff in estrogen levels and in the metabolites of estrogen have been implicated in causing sleep disturbance in perimenopausal and postmenopausal women. The physiological effect of these hormones and their loss in bringing about hot flashes and sleep disruption is a key factor.

ANNOUNCER: During menopause, the incidence of some sleep disorders may increase.

CHARLES REYNOLDS, MD: Once women have gone through the menopause, there is some medical evidence that the frequency of sleep disordered breathing increases, so that may also be a factor, particularly in the postmenopausal women.

ANNOUNCER: Waning hormones can also mean psychological adjustments.

BROOKE JUDD, MD: There may also be an increase in depression and anxiety that's associated with menopause, and anxiety and depression can themselves cause some sleeping problems.

ANNOUNCER: Since sleep requirements don't change as women enter menopause, those sleepless nights can often mean daytime problems.

CHARLES REYNOLDS, MD: A perimenopausal woman who is getting poor sleep will often complain of multiple awakenings during the night, not feeling well rested during the day, feeling tired or even sleepy, perhaps a sad or lower mood than usual, less energy, less sense of well-being, less ability to engage in major life roles.

BROOKE JUDD, MD: It's time to seek professional help when you feel that your sleep disorder is really impairing the quality of your life, because it can be treated.

ANNOUNCER: Gaining back good sleep might mean paying attention to what you do at bedtime.

CHARLES REYNOLDS, MD: A good doctor will recommend attention to lifestyle issues, particularly stability of sleep-wake schedule, not spending too much time in bed.

BROOKE JUDD, MD: If you find that you're in bed, you're not falling asleep, then you should get out of bed, pursue a relaxing activity. That would not be things like using the computer, because the light is activating, doing the checkbook, doing housework, doing work.

Another component is sleep restriction, and the idea is to make your sleep as efficient as possible and not to spend excessive amount of time in bed not sleeping. A final component of behavioral therapy is relaxation techniques. And that can vary from person to person. Some people do progressive muscle relaxation. Some people like to listen to relaxation tapes.

ANNOUNCER: Although long-term hormone replacement therapy may pose risks, some doctors might recommend hormone replacement therapy on the short-term in order to deal with the hormone changes that may be affecting patients' lives.

BROOKE JUDD, MD: There's a lot of controversy now about hormone replacement therapy, but estrogen replacement in patients with significant hot flashes can help decrease the hot flashes and improve, improve sleep quality.

ANNOUNCER: There are over-the-counter as well as prescription sleep medications that can help women on their way back to good sleep. Prescription medications fall into two categories.

CHARLES REYNOLDS, MD: There are basically two safe classes of sleeping pills currently appropriate and available in the US market: the traditional benzodiazepine sleeping pills and the newer types of non-benzodiazepine sleeping pills.

ANNOUNCER: While the symptoms of menopause are not permanent, sometimes the poor sleep it causes can become just that.

BROOKE JUDD, MD: So even when the menopausal symptoms pass, patients can still end up with the bad sleeping habits, waking up frequently even though they're not having hot flashes.

ANNOUNCER: Whatever the nature of the sleep problem, addressing it can make a very positive change in a woman's life.

CHARLES REYNOLDS, MD: If sleep problems are addressed, it generally means a much better quality of life, much better sense of daytime well-being, energy, mood and a chance at aging successfully.