Articles on Menopause | Topics: menopause, menopausal
by Jacqueline Vaughn
Sleep disturbances, including insomnia and sleep apnea, are a frequently reported complaint in menopausal women as fluctuating hormone levels and hot flashes may disrupt a woman's sleep. Hot flashes during sleep are caused by widening of the blood vessels near the skin's surface and are associated with decreased levels of estrogen. Some experts estimate that menopausal women may wake up hundreds of times a night because of hot flashes.
A National Sleep Foundation (NSF) poll found that 43 percent of menopausal and postmenopausal women reported waking at night and needing to go to the bathroom either "often" or "always" during the previous month. On average, the women polled reported experiencing hot flashes during sleep three nights a week. In addition, hot flashes caused sleeping difficulties an average of five nights a month.
Insomnia, the most common sleep problem, is more likely to occur with women then men. According to the NSF poll, 53% of women aged 30-60 experience difficulties sleeping often or always: 47% aged 40-49, and 50% aged 50-60. Luckily, there are a number of steps you can take to improve sleep, including exercise, establishing regular bedtimes and wake times, dietary changes (less or no caffeine and alcohol) and improving your sleep environment.
If you think your poor quality sleep is not insomnia, it is important to see your health care provider for a sleep study that can diagnose sleep apnea or other sleep disorders. The treatment of the problem will be based on what is found.
For insomnia, the following measures may be useful:
Make sure the bedroom noise is controlled and temperature is cool. Maintain a fixed schedule to going to bed and getting up -- try not to vary it. Avoid alcohol and exercise within 5-6 hours of bedtime and no caffeine after noon. Do not look at the bedroom clock after you lie down in bed or if you get up at night. Eat a light snack containing protein, especially tryptophan, before bed. This would include milk, cheese, yogurt, cottage cheese, bananas, fish, and turkey. Do not reflect upon the day's events or your "to do" list in the hour or two before bed
| Quote of the Day |
Democracy is the menopause of Western society, the Grand Climacteric of the body social. Fascism is its middle-aged lust.
| —Jean Baudrillard (b. 1929) |
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Also, you can consult your health care provider about taking estrogen therapy (ET) or estrogen plus progestin (HT). ET and HT have been shown to improve menopausal sleep difficulties and lower the incidence of sleep apnea that would be classified as insomnia. Estrogen therapy is a long term rather than a short-term effect. ET often should be at higher levels to prevent both hot flashes and sleep disturbances for surgical menopause especially, and for natural menopause within the first 5 years. Dosage should be reduced later in menopause.
Melatonin and sleeping medication are other non-prescription medical alternatives to treat sleep disturbances. Melatonin, a brain hormone that is secreted according to a person's biorhythm, is low during the day and peaks in the middle of the night. Its secretion is controlled by exposure to light and dark rather than when sleep occurs. It has been well documented to be lower than normal in subjects with insomnia and administration of it may improve sleep problems in some people.
Melatonin levels are lower in menopausal women who have insomnia. You can check your level at home with a home test or have it done by your healthcare professional. A dose of 10 mg a day by mouth is thought to be safe when taken over a 30-day period; however, whether it should be used on a regular basis for insomnia or other sleep disorders has yet to be determined. You can also try skin cream with melatonin, but always consult with your health care provider before starting any treatments.
Short acting sleeping medications are preferred so that there is not a residual daytime sedative effect. Most women who use sedatives report that their sleep is better, but when questioned about symptoms, they seem to have the same amount of symptoms as insomniacs who do not take prescribed medications. Because sleeping medications may produce undesirable side effects, most physicians do not recommend them for long-term treatment. For the same reason, long-term melatonin treatment is not recommended.
There are many treatments available to combat sleeplessness. Make sure you contact your physician to find the best one for you.
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