“You need your beauty sleep … An hour before midnight is worth two after … You should sleep for 8 hours a night … Sleep deprivation can cause heart disease!!!” Arghhhh!
These are the sorts of messages we hear, internalise and then regurgitate repeatedly to ourselves when we wake in the early hours. No wonder we can’t get back to sleep! There is no doubt that sleep is important for resting and restoring our bodies, but worrying ourselves over not getting sufficient sleep is unhelpful and likely to exacerbate the issue, making sleep evermore elusive.
Years ago I attended a course on coping with insomnia as I’d always had trouble sleeping. I gained many useful tips from this course, but the one thing that really resonated with me was this:
“STOP worrying about not getting enough sleep! Your body will get the sleep it needs over time, and when you wake up during the night, don’t lie awake for hours on end. If you haven’t gone back to sleep within 20 minutes, get up and do something; either a relaxation technique – yoga, meditation, breathing – or simply do the ironing! Then go back to bed afterwards, if you feel like it, and when you wake up, your ironing will be done – bingo!”
Well, I didn’t do the ironing in the early hours, but I did internalise this metaphor and it certainly worked for me, helping me to stop worrying about something I felt I had little control over. I adapted my night-time routine and gave up tossing and turning from 3 o’clock onwards and when I did wake up, and couldn’t get back off again, I got up. Sometimes I pottered around, and on a few occasions, I did some yoga. This proved far better than lying awake for hours on end, and I discovered that it stopped the wandering, worrying mind and prevented those – what my friend calls – “dark nights of the soul” episodes. Eventually, my sleep pattern did improve and I managed to break the habit and establish better sleep patterns. And then … just when sleep issues were something I didn’t have to consider anymore, along came Menopause, and with it, that old friend – sleep deprivation! Great!
61% of menopausal women (peri- and post-) report frequent episodes of insomnia, according to the National Sleep Foundation, and whilst this can be due to hormonal changes relating to menopause, it can also be because of other age-related health conditions.
We all know that we pee more frequently as we get older, and this is what often wakes us up! Peeing more could be due to hormone changes or it could be because of a weakened pelvic floor. However, there may be other medical reasons, so it’s best to get checked out if your usual peeing habits have changed significantly. We all know it’s important for all sorts of reasons to drink plenty of fluids throughout the day and the NHS recommends 1.2 litres for women which equates to about 6-8 glasses. Water is, of course, a good first choice of fluid, because it hydrates you without adding extra calories or harming teeth. I now limit how much I drink in the evenings to try and reduce the number of times I wake up to pee during the night.
Aches and pains may be another reason for waking during the night. These may seem to be synonymous with aging, but again if there is a significant change for you, talk to your GP. There’s a difference between common aches and pains and those niggling pains which we can’t quite explain. Joint pain can be another menopausal symptom, but also may be an indication of something else, so, finding out what the underlying cause is, is important.
Menopausal symptoms such as hot flushes, itching, and anxiety could also be a reason for poor sleep patterns.
Checking in with your GP to find out if indeed your sleep disturbance is a symptom of menopause, should be first on your list.
Hot flushes affect many women during menopause, particularly during peri-menopause, and are caused by changes in hormone levels which can affect the body’s temperature control. Severe hot flushes and night sweats can be upsetting, and exhausting, especially when night-clothes and/or bed-linen have to be changed time and time again. There are, however, solutions to these.
I have decided not to go down the HRT route, having weighed up the pros and cons for me personally. However, many women find HRT is the best treatment for reducing or stopping hot flushes and night sweats, which can then solve the insomnia issue, as well as alleviating other debilitating menopausal symptoms. It is important to make a well-informed decision about whether to take HRT or not, so speak to your GP and read information from trusted sources (not the harum-scarum articles in the media!). Kathy Abernethy’s book, ‘Menopause: The One-stop Guide’ is an excellent source of information. Kathy is a specialist menopause nurse and the chair of the British Menopause Society. ‘The Wisdom of Menopause’ by Dr. Christiane Northrup is another excellent read and dip-into book, full of – yep, you’ve guessed it – wisdom worth listening to. It suggests that this time of a woman’s life, when the veil of oestrogen is lifted and when we see things differently from before, is a time to analyse and confront those important issues we have pushed under the carpet for too long; for example – is there something on your mind when you wake up night after night that you aren’t addressing, but need to? Another book I would recommend is Deborah Garlick’s ‘Menopause: The Change for the Better’. It is a user-friendly, trusted source of information with helpful tips, and solutions. Deborah Garlick is the Director of Henpicked and supports women with menopause in the workplace. And sleep deprivation is, of course, a huge issue if you’re a working menopausal woman. Here is the link to the Henpicked website.
There are plenty of alternative solutions to HRT and all three of these books address this. I am currently trying ‘Menopause Support’ a supplement by A.Vogel. It is a formulation of isoflavones from soy, magnesium, and hibiscus. You may like to read more about it and other remedies on their website here. Holland and Barrett stocks remedies ranging from herbal and flower to vitamins and minerals, and Helios in Tunbridge Wells stocks homeopathic remedies and offers Homeopathic consultations.
A couple of years ago, I visited a nutrition consultant. She was extremely helpful in identifying the root cause of the extreme fatigue I was experiencing at the time. She gave me advice about the tests I needed, analysed the results afterwards and then offered suggestions about how to rectify the situation. The root cause was a significant Vitamin D deficiency which I quickly managed to get under control with supplements and sunshine! As our diets may be lacking in certain nutrients, vitamins, and minerals necessary for sustained and good health during and after menopause, a nutrition consultation could be another route to combating fatigue and resolving sleep problems.
Try changing a few habits to see if that will help …
- cut out or reduce coffee and tea
I enjoy my cup of tea, first thing in the morning, and at other times during the day, and therefore didn’t want to cut tea out altogether. I have, however, cut out a nighttime drink and this has helped reduce trips to the loo!
- stop smoking
I smoked a bit as a teenager, and I hate to admit that I continued to have the odd one during my twenties. As reliable and abundant research increasingly prooves links with all manner of ghastly diseases, including cancer and heart disease, I choose not to smoke at all now and haven’t done so for many years. However, it is addictive and may be difficult to quit. Here is a link to the NHS website and ’10 self-help tips to stop smoking’. An old habit can take a long time to break but a new habit only takes about 66 days to form! Try taking up a new healthy hobby or pastime, or join an exercise class or gym. I find I sleep better after exercising regularly.
- keep the bedroom as cool as you are!
I usually have the radiator turned off in my bedroom. Having a thermostat fitted on the radiator and turning the temperature down to low is a good alternative if you like it cool but not cold.
- use a fan, spray your face with cool water (not great when in bed!) or use a cold gel pack (available from pharmacies)
Most of the time, I throw the covers off or stick a leg out! One woman whom I met and chatted to on the train to London recently told me she used to take two ‘cold’ water bottles to bed with her. She filled them up each morning and kept them in the fridge all day. She then slept with one cold water bottle on her chest and one between her knees during the night. She had severe hot flushes and night sweats and said that this trick worked wonders. She also slept on a towel to avoid having to change the bed-linen during the night. Ingenious!
- wear cotton or silk pyjamas
I do not have silk PJs so cotton it is, or nothing! But I would advise against synthetic materials; they make me itch! You have to find what’s most comfortable for you. (By the way, itching is another whole, future blog! I am currently reading Jane Lewis’s ‘Me and My Menopausal Vagina’ which is enlightening! Itching anywhere on the body wakes you up and keeps you awake. Look out for my future Vagina-Blog!)
- have layers – sheets and blankets – rather than a duvet
My husband loves a duvet and it is so much easier to make the bed when you haven’t got sheets and blankets to faff about with, so it’s either a compromise – thin duvet over a sheet, bedspread over that, (because my temperature fluctuates between hot and cold during the night) or sleep in separate beds for a while. If you have a partner you like, I would not advise the latter as a permanent solution! Those hugs, and sex if you want it and can have it, are good for you. (‘Sex during Menopause’ – now there’s yet another future blog!)
- cut down on alcohol
Personally, I like a small glass of wine two or three times a week, especially to accompany a good meal; I find it relaxing. However, more than one glass, and it has the opposite effect on me! I go off to sleep like a light after I’ve had more than a couple, but then at about 2 or 3 in the morning, I am wide awake and consequently, feel absolutely dreadful for the duration of the next day. I have now accepted that my body can no longer process alcohol like it used to, and nor do I want it to! ‘Click here for the Drinkaware’ website, which has research, facts, and advice on alcohol and related issues.
- sip cold or iced drinks*
I keep a glass of water on the bedside table, as I get very thirsty during the night. I try to sip though, rather than gulp, to alleviate that dry mouth and quench that thirst, thus avoiding more frequent trips to the loo!
- take a lukewarm shower or bath
These days, I don’t ever have the bath water too hot and I don’t have a bath directly before bedtime either so that I completely cool down beforehand. I have been known to get up in the night and take a luke-warm shower on a few occasions, which has been refreshing and has helped me to sleep better. If you are already wide awake, so why not if it helps?
You may like to try a short Yoga routine before bedtime. I love ‘Yoga with Adriene’ on Youtube (thank you daughter Dilys for introducing me to her!). Try to learn a routine, or do your own relaxation stretches rather than staring at the screen though. There is a lot of research telling us that our gadgets are keeping us awake! Apparently, the blue light suppresses melatonin, the hormone which controls our sleep /wake patterns. It’s also wise to check out whether Yoga is right for you, either with a Yoga teacher or your GP before you start. You may prefer to join a Yoga class with guided support, if you are a beginner, to avoid injury. Yoga classes differ hugely, so look into this carefully and be well-informed.
I love Pilates for core and back strength, and balance. Exercise definitely makes me feel good and I sleep better when I exercise regularly – mostly! Other benefits include weight control, muscle toning, cardio health, and bone strengthening and because our bodies release endorphins when we exercise – which trigger a positive feeling in the body – exercise can lift your mood and help with depression. Don’t think about it, ‘Just do it’ … so ‘they’ say!
I believe the important bit is not to berate yourself when you slip up with something, just learn from it and then get on with having another go. (After you’ve had a duvet day in order to feel a bit sorry for yourself, licked your wounds and had a good cry watching several romantic comedies of course!)
- eating healthily
Yes, I know, we all love chocolate! But what I also know is, that if I over-indulge, especially in the evenings, my sleep suffers as a result. Chocolate like tea, coffee, and alcohol, is a stimulant. I always try to eat healthily, but usually, have one day in the week when I let my hair down! I buy organic whenever I can too. I’m not suggesting that organic food aids sleep (however, there’s an interesting research piece right there!), just that having a healthy attitude to food and nutrition is, in my opinion, a good thing, at any stage of your life, standing you in good stead for long-term health and well-being. As a general rule, I try to eat fresh, plant-based food and I steer clear of sugary drinks and too many carbs. I don’t hold with dieting personally. Balancing calories in with calories out and remembering that ‘you are what you eat’, makes sense to me. Of course, I indulge from time to time. Lindt’s ‘Excellence, Dark, Touch of Sea Salt’ is my favourite chocolate choice! Just one square after a meal. (sometimes two – oops!) I’ve adopted a mantra for 2019 – “balance” and I am trying hard to be mindful about it. But, I sometimes forget this mantra, and that’s ok! I believe the important bit is not to berate yourself when you slip up with something, just learn from it and then get on with having another go. (After you’ve had a duvet day in order to feel a bit sorry for yourself, licked your wounds and had a good cry watching several romantic comedies of course!) . Just do the best you can for YOU and ask for help when you need it.
Here’s an article from the Telegraph, “Chocolate: 10 convincing health reasons you should eat more of the stuff”. I haven’t done the research on this one, but it makes good reading! Everything in moderation … well, maybe not everything!
I’ve never been one for having a massage … but many women find it extremely relaxing and helpful for inducing sleep. It is important to drink plenty of water afterwards to rid the body of any toxins that have been released through the process. N.B. Always choose your masseur carefully.
- meditation, mantras, breathing and positive thinking
There are many, many, many thousands of self-help books which can be useful, but there is also a good number which you may find to be just a load of old tosh! Find ones which work for you. Or you may prefer to search through some apps, there are many. But again, don’t look at your screens before bedtime, whatever you do, and leave your phone/laptop etc., out of the bedroom! It makes a big difference to me.
Short daily meditations and readings can help to keep you calm and fully in the present, which is particularly helpful at night-time when thoughts can race in the dark silence and set you off on a downward, sleepless trajectory. Everything seems worse at night-time, doesn’t it?
I like to read Eckhart Tolle’s ‘The Power of Now’ or ‘Stillness Speaks’ and I read daily quotes from The Power of Now every night before I turn off the light and have done so since beginning peri-menopause. This helps to reinforce positive thoughts and focus on the ‘now’.
- and breathe
Following the breath is also helpful, bringing the mind back to the breath when it insists on going for a wander in the middle of the night! There are lots of breathing exercises which simultaneously relax the body and help induce sleep, found in good books, trusted websites, and some good apps (read the reviews first).
- bedtime stories!
My favourite bedtime stories are my recipe books! Healthy ones, I hasten to add! I used to read novels at night but found they were too stimulating and my brain would get busy. So I keep copies of Nigella’s ‘How to Eat’, Ella Woodward’s ‘Deliciously Ella’, Yotam Ottolenghi’s ‘Plenty’ and anything of Rose Elliot’s close at hand. (Yes, I have piles! Now they would keep me awake). If you don’t like cooking, reading recipe books is not a good choice!
And the list goes on … reflexology and acupuncture apparently, (I did have reflexology once and enjoyed it, despite not usually liking having my feet touched! I don’t like needles!) If you decide to try these out – make sure you go to a properly qualified and experienced practitioner.
What is important is finding out what works best for you.
Adopt a routine that suits. Stay in ‘the now’ when you wake in the early hours and remember you’re not alone. There are millions of other menopausal women awake at the same time. Years ago, when I was breastfeeding my children in the middle of the night, I used to consciously call to mind all the other mothers who would be doing the same as me. Connecting in this virtual, and empathetic way can be reassuring and reminds us that we are not alone, even though it may feel like it at 3 in the morning.
Talk to people if lack of sleep (or anything else for that matter) is getting you down, or if your mood is low. Either talk to a sympathetic friend or family member, Visit your GP or speak to a nurse at your GP surgery. You could also seek out a specialist menopausal nurse (Click here to find a menopause specialist via the British Menopause Society website. There are NICE guidelines your GP should follow when diagnosing menopausal symptoms and they will then hopefully be able to support you appropriately, but it helps to do a bit of your own research first.
Remember, nothing lasts forever, and your sleep patterns will improve eventually. It just feels like forever when you’re in it doesn’t it?
Here’s a little mantra for you to try next time you wake and can’t switch your brain off …
“Try a little experiment: Close your eyes and say to yourself, ‘I wonder what my next thought is going to be.’ Then become very alert and wait for the next thought. Be like a cat watching a mouse hole. What thought is going to come out of the mouse hole? Try it now.”
From ‘The Power of Now 50 Inspiration Cards’. Eckhart Tolle