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Menopause And Insomnia: How Hormones And Hot Flashes Affect Sleep

Menopause And Insomnia

First Posted: 02/13/11 10:09 AM ET Updated: 05/25/11 07:30 PM ET

If you're within a few years of menopause, you may find yourself channel-surfing at 3 a.m. the morning for the first time in your life. Hormonal ups and downs may have affected your sleep during menstruation and pregnancy, as well, but chances are, that was nothing compared to these fearsome midlife fluctuations.

Hormones Drop; Adrenaline Rises
During menopause your ovaries slowly decrease their production of two hormones, estrogen and progesterone, the latter of which promotes sleep. When those hormone levels drop, it can be very unsettling to your system and make it hard to sleep. A drop in estrogen also leaves you more vulnerable to stress, another disturbance to your slumber.

Hot flashes, which plague up to 85 percent of menopausal women, can jolt you awake too. These flashes are actually caused by a rush of adrenaline that alerts your mind and wakes you up. You won't be able to settle down until the adrenaline subsides, and that could take hours.

When menopause hit Lauren Butler, 52, hot flashes were just a small part of her ensuing insomnia. The main thing keeping her up, she says, was pent-up energy and stress.

Sleep Hygiene And Relaxation Strategies
As a sleep therapist in Sebastian, Fla., Butler runs a monthly support group for insomniacs, talking to patients about sleep hygiene and coping strategies. Unfortunately she had to take her own advice when she suddenly began waking up at 2 a.m. every morning.

"It was just boing, and my eyes were wide open, and that was that," she says. "I could flip-flop in bed for hours, physically tired but wide awake. I remember thinking, 'My gosh, now I know what my poor insomnia patients are going through!'"

As frustrating as it was, Butler forced herself to do the mediation exercises she recommends to her support group. "You concentrate on your breath: five counts in and 10 counts out, walking down a hill, walking on the beach," says Butler. "That's all you focus on. It works, if you do it night after night."

After two months of nightly awakenings, Butler's insomnia disappeared. "The hormones just adjusted, I guess," she says, "but for a while, it was horrible."

More from Health.com:
The 11 Kinds of Insomnia
Can't Sleep? What Not to Do at 3 A.M.
Can Supplements Ease Menopause Symptoms?

What You Can Do, And What To Look Out For
Short of taking replacement hormones or low-dose birth control pills to even out your estrogen levels, there isn't much you can medically do about your shifting hormones. Acupuncture, shiatsu massage and yoga are worth a try; they help some women feel more settled and relaxed.

Besides hormones and hot flashes, there may be other sleep saboteurs at work. In 2007 Wayne State University researchers studied 102 menopausal women overnight in a sleep lab and found that more than half showed signs of sleep apnea, restless legs syndrome or both. Other research suggests that menopause can increase the risk of sleep apnea almost eightfold.

If sleep problems begin to affect your daily activities or if you suspect there might be other factors involved, talk to your doctor to rule out a more chronic cause.

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If you're within a few years of menopause, you may find yourself channel-surfing at 3 a.m. the morning for the first time in your life. Hormonal ups and downs may have affected your sleep during men...
If you're within a few years of menopause, you may find yourself channel-surfing at 3 a.m. the morning for the first time in your life. Hormonal ups and downs may have affected your sleep during men...
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HUFFPOST SUPER USER
deminmo
just looking for answers
03:38 PM on 02/15/2011
I can identify with this. Getting a full nights sleep is
a joke, usually 4-5. I have hot flashes at the weirdest
times. But I don't want any more chemicals in my body.
This too shall pass.
HUFFPOST SUPER USER
jacquelinenh
HuffPo Addict
05:29 PM on 03/04/2011
You don't need to use chemicals to get relief from hot flashes -- even simple diet changes can make a huge difference. Different foods may trigger hot flashes -- eliminate them and your problem may be solved. Read about this here: http://www.huffingtonpost.com/2011/02/13/menopause-and-insomnia-_n_821984.html
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HUFFPOST SUPER USER
RhiannonRings
Childfree and loving it!
11:53 AM on 02/15/2011
I'm starting to get night sweats, but I'm not about to mess around with bioidenticals...I'll get through it on my own.
01:21 AM on 02/15/2011
I'm not aware of any research showing that as hormones drop during the menopausal transition,adrenaline goes up, nor that hot flashes are caused by an adrenaline surge. If that research does exist, I for one would love to know about it!

Cortisol, an adrenal hormone associated with stress (especially chronic stress), has been shown to rise during menopause, and can be a cause of some of the sleeplessness and weight gain of menopause. Any woman who has had hot flashes can attest to the fact that emotions and stress can bring them on.

Sleeping in a cool room can help prevent nighttime hot flashes, as can doing some kind of meditation during the day.

Virginia Hopkins
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HUFFPOST COMMUNITY MODERATOR
emlr
"a man of knowledge is free"
02:59 PM on 02/15/2011
You can actually feel the adrenaline rush. I'm not emotional or under any stress but at 72 I still experience flashes day and night.
08:03 PM on 02/14/2011
I'm not aware of any research showing that when hormones drop during menopause, adrenaline rises, or that hot flashes are caused by a rush of adrenaline. If there is such research, please share it here!

Cortisol, which is a hormone released in response to stress does tend to rise during the menopausal transition. Lack of progesterone, causing estrogen dominance can certainly cause stress and can also be related to a rise in cortisol.

Research does show that exercise, sleeping in a cool, dark room, avoiding spicy foods and meditation can all help with hot flashes, but hormone replacement is the only treatment that really does the job. Unlike synthetic HRT, bioidentical hormones, e.g. estradiol and progesterone, in low doses, are safe and effective -- see 10 steps to hormone balance for details -- http://www.virginiahopkinstestkits.com/hormonebalancesteps.html

Virginia Hopkins Health Watch
03:39 PM on 02/14/2011
It is easy and SAFE and in fact,protective to use bioidentical estrogen and progesterone. I would NOT suggest the use of BCP's;not only contraindicated at this age but SYNTHETIC which is bad,bad,bad. Oh,and another thing;be sure your thyroid hormones are in tune as this is another factor in hot flushes (the medical term for hot flashes)
http://kimcrawfordmd.com
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HUFFPOST SUPER USER
organicconnect
10:53 AM on 02/14/2011
You can also try vitamins specially formulated to help sleep: http://sleepvites.com
HSC55
We will be known forever by the tracks we leave
02:40 AM on 02/14/2011
I'm going on my eighth year of this...will the hot flashes never stop? It is 2:30 am right now. Everytime I lay down and start to doze off, WHAM, another hot flash jolts me wide awake. I am going to go back to bed now and try the meditation breathing recommended by this author. I should mention I've tried everything else with no luck.
03:40 PM on 02/14/2011
I understand;it is awful,isn't it? If you haven't tried bio-identical hormones,I would strongly recommend them....they DO work!
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HUFFPOST COMMUNITY MODERATOR
usamade
11:30 PM on 02/13/2011
I can"t recommend enough Natural Progesterone Cream. Keeps the perimenopause weight down and stops all the symptoms. Get Dr. Lee's book "What your doctor didn't tell you about Perimenopause or Menopause".

Saved my life.
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zelda777
transcend the B. S.
10:09 PM on 02/13/2011
Hormones are the first place one should look for a reason/cure for insomnia, especially more mature women. Too often, insomnia is considered a symptom of anxiety and/or depression. Many doctors will prescribe anti-depressants, which only have a side effect of drowsiness - they do not cure the condition. The fast paced, busy, busy life of many Americans leads to having too much adrenalin. A good exercise/yoga program really helps also.
09:25 PM on 02/13/2011
Ah yes, the being awake at 2am and just being so tired but not being able to fall asleep. The relaxation exercises sound like they will work. Makes me wonder if the insomnia that the women who are suffering with Post Tubal Ligation Syndrome is caused from the same thing? Certainly something to research!

http://www.tubal-reversal.net/post_tubal_ligation_syndrome.htm
HUFFPOST SUPER USER
Drewry
11:39 AM on 02/13/2011
From personal experience, I've discovered that when I don't get enough sleep, not only does it accelerate growth of grey hairs, but it also affects weight and mood. And, it leaves me feeling grumpy, and not wanting to talk to people if I don't get enough sleep. I think by not getting enough sleep, not only does it affect my health, but I somewhat feel a drop in hormone levels, such as feeling less ambitious, but more productive somewhat in other areas of my life.

http://www.DrewryNewsNetwork.com/healthcare