I could barely sleep four hours a night my hot flushes were so bad – until I made a few surprising changes
BETWEEN the hot sweats and anxiety, it’s no wonder over half of women going through menopause struggle to sleep.
The Sun’s Fabulous Menopause Matters survey found that 54 per cent of women in menopause have difficulty sleeping or insomnia, while 62 per cent suffer from night sweats.
But a good night’s shut-eye is vital for our all-round health.
Sleep expert Dr Sarah Gilchrist (gilchristperformance.co.uk) says menopausal women must try to improve their sleep as long-term, poor sleep can have a negative effect on both your physical and mental wellbeing.
“Poor sleep health has been associated with certain diseases such as diabetes, Alzheimer’s and cardiovascular disease,” she says.
“Mental health can suffer too through increased propensity for anxiety, depression, irritability and mood swings.
“Daily life is hard if you suffer poor sleep, especially over a long period of time.
“Given the peri-menopause and menopause process can take ten-12 years, with poor sleep a common symptom, it is important that women seek help in relation to sleep before it takes its toll on daily life and long-term health conditions ensue (from high blood pressure to diabetes).”
Katie Love hadn’t had a period for over a year but only began to suffer symptoms of menopause eight months in. Sleep is now her biggest issue.
“I thought I’d got away with menopause lightly as I hadn’t really suffered any symptoms I’d associate with menopause,” explains Katie, 48, a foster carer from Wolverhampton.
“But over three or four months, it started with a vengeance. I’m getting hot flushes at all hours of the day and night.
“I started to feel irritable during the day. I was getting easily confused and suffering brain fog.
“I began feeling really disorganised which is really unlike me. I’m usually a very organised person.”
Katie believes many of her symptoms would improve if she could get more than her usual four hours sleep a night.
“I had always been a good sleeper,” she says. “I began to think that a lot of what I was feeling might be down to the fact that I really wasn’t sleeping very well at all.
“I struggle to get off to sleep and I’ve been waking frequently. I lie awake clock-watching for one or two hours when I get into bed, unable to drop off even though I feel both physically and mentally exhausted.”
Sarah has agreed to change up her sleep regime – as advised by our expert – and keep a diary for seven days to see if she can improve her symptoms. Here’s her seven day sleep diary:
DAY 1
I am a very busy lady. My partner Andy and I have four grown-up children aged 18 to 24, we’re foster carers to a three-year-old, run our own tour company and I’m a charity trustee.
You’d think after a busy day my head would hit the pillow and I’d fall fast asleep, but that’s not the case.
The sleep expert has given me a list of steps I can take to try and improve my sleep.
First I’m going to cut out caffeine. Usually, the first thing I do when I wake is reach for the coffee.
I feel I need caffeine when I get up especially if I haven’t slept well so this is a big change for me.
I sometimes drink seven cups a day. I bought herbal teas instead and managed to get through the first day without any caffeine at all.
The sleep expert advised I buy cotton pyjamas and keep a spare pair by the bed in case I suffer night sweats and need to change them.
I have never been a big pyjama fan but I am finding these incredibly comfortable.
One of the biggest problems is that I get extremely hot at night. I throw off all the covers to cool myself down. That wakes me up and I struggle to get back to sleep again. Then I wake up again feeling cold.
I hope the pyjamas will prevent me messing around with the covers all night.
Another tip the expert gave me was to sleep with just one pillow. I really like my two pillows so I’m not sure how I’ll get on, but I’m going to give it a try.
I also have an air cooler fan by the bed. I never feel hot as I go to sleep but I often wake feeling hot in the night so hopefully this will keep the room at a nice temperature.
It does give off a bit of a humming noise which might get on my nerves.
DAY 2
I didn’t notice a massive difference in my sleep last night.
The pyjamas are a revelation. I loved the comfort of them and definitely felt less sweaty so I’m going to keep wearing those.
I did throw my covers off but as I was wearing pyjamas I didn’t wake up again feeling cold.
I tried sleeping with just one pillow but couldn’t get comfortable so half way through the night I grabbed my second pillow.
The expert also advises going to bed and waking up at around the same time every day.
For me, that is usually around 10.30pm and I get up about 6.30am. For the eight hours in bed, I probably only sleep for half of that.
It was the same last night and I got up several times for a sip of drink or to use the toilet.
The fan noise wasn’t as bad as I’d expected. I moved it to the end of the bed and barely noticed it at all.
Apparently food with soya can help you sleep so I went shopping today and bought some ingredients to make some meals with tofu to see if that makes a difference.
I have had tofu before. I can’t say it’s my favourite but I’ve been looking up recipes to see if I can find something I might enjoy.
I also bought Tempeh, a Japanese food made with soybeans, to try.
I’ve suffered with a terrible headache today and I’ve had to take paracetamol, probably because of the caffeine withdrawal.
I found it hard when I got to a work meeting as the first thing I was offered was coffee but I took my herbal teas and had one of those instead.
DAY 3
I’m supposed to be giving up alcohol as part of this experiment but last night I went to an awards night.
I broke the rules and had a couple of glasses of wine with dinner.
I did put on my cotton pyjamas and turned on the fan, but it was a very late night by the time I got to bed.
My sleep was a little better. I slept for a solid four hours, which is quite unusual for me and I feel brighter this morning as a result.
I’m hoping removing caffeine from my diet and the other things I’m doing are starting to make a difference.
I’m going to give up alcohol for the remainder of the experiment.
It’s not uncommon for me to have a glass of wine while working in the evening so this will be a big change for me.
We’re having a Sunday roast today as my daughter is home from university but I’m keen to try the tofu recipes tomorrow.
The expert recommends a warm, milky drink before bed so I made a warm soya milk hot chocolate to help me drift off, which I really enjoyed.
I got into bed just after 9pm with my book and played some relaxing sleep music to help me drift off too.
WHY MENOPAUSE AFFECTS SLEEP
Dr Sarah Gilchrist explains: Common symptoms of menopause include hot flushes and night sweats, an interrupted sleep pattern, mood swings, anxiety, irritability, weight gain, headaches, hair loss, urinary incontinence, loss of libido and vaginal dryness.
All of these can affect the quality of life for a significant proportion of women.
In particular, hot flushes, as a result of falling oestrogen levels, are very common and can make sleep difficult.
The theory being the decrease in oestrogen somehow tricks the brain into thinking the body is overheating.
To get rid of excess heat, blood vessels dilate and blood flow increases to the skin, causing a flushed and sweaty feeling.
Given perimenopause typically starts in a woman’s 40s and menopause itself isn’t until around the age of 50, the process can last anywhere between two to ten years.
For many women, the effects of menopause on sleep can be chronic and life debilitating.
Sleep is a very individual process and what works for one person may not work for you. Don’t persevere with a change if it is keeping you awake, causing more stress and ultimately perpetuating poor sleep.
DAY 4
I’ve just dropped our three-year-old at nursery and usually I’d head straight to Starbucks to grab a coffee and catch up on some work.
I did go, but I ordered a mint tea instead. I think the caffeine withdrawal is better.
I no longer have a headache and I feel quite fresh this morning. I still woke up three times last night.
It’s common for me to wake up for no reason and then I can’t get back to sleep.
I do think the quality of my sleep might be improving even though I’m not actually sleeping for longer.
I felt more refreshed when I woke up today and didn’t crave the caffeine as much as usual.
The soya hot chocolate worked. I didn’t feel as though I was lying there mulling things over for hours as I usually do.
When I did wake in the night, I didn’t feel as uncomfortable, fidgety or hot.
I tried my first tofu recipe – tofu kedgeree – a rice dish with tofu and eggs. I enjoyed it.
I’m still not a big fan of the texture but I guess it’s something you have to get used to.
Today I was also meant to try and switch off all screens and technology for two hours before bed at 8.30pm.
I think I will struggle with this the most as I often work late into the evenings and at the weekends, I like watching TV to wind down and I love Strictly.
I managed to switch off at 8.45pm, so a little later than planned but that gave me an hour and 45 minutes before bed which I spent doing a few jobs around the house and then I read a book.
I left my phone on charge away from me so I wasn’t tempted to check it when I heard the pings.
I have a nasty headache before bed so I’m not sure it bodes well for tonight but we’ll just have to wait and see.
DAY 5
I still haven’t had any caffeine and feel much better day and night as a result.
I’m trying to eat healthily too and have made a greek salad for dinner. I’ve had a really chilled day.
I had a bit of a pamper day getting my hair done at the salon so I felt more relaxed than usual.
I also had a nice walk with my dogs and my little boy so I’m feeling refreshed.
I’m going to be stricter with my sleep regime tonight and make sure I shut everything down by 8.30pm.
The TV went off at 8pm and I resisted the urge to turn on my laptop. I had an earlier night and went up to bed with my hot chocolate to read.
Sometimes I read texts for work but tonight I chose a novel which was definitely more relaxing.
I’ve also started putting on some soothing sleep music to help me drift off quickly and that seems to be helping.
DAY 6
I woke up this morning feeling like I’d had a real breakthrough.
For the first time in as long as I can remember, I had a solid five hours of sleep.
It might not sound like a lot to most people but that is the most sleep I’ve had in a block for a very long time.
It didn’t take me long to drift off. I played the sleep music again and I didn’t hear it shut off so I must have fallen asleep within the hour.
When I woke up I was up for an hour and after that I felt like I dozed and didn’t really go back into a deep sleep, but I still feel a lot better than usual.
It’s amazing what a difference it makes to your day. Some days it feels a real effort to get out of bed but I haven’t had that this morning.
The brain fog was gone and I was really on the ball. I achieved a lot.
Turning off technology earlier is definitely helping me get to sleep faster and usually I’d only get about an hour to 90 minutes sleep before waking up, so five hours is a real win.
Then it would take me another hour to get back off before waking up. That pattern of sleep is definitely starting to get better.
DAY 7
Just when I thought I was getting somewhere, I had a bad night last night.
I still had two hours before waking for the first time, which is better than my sleep would have been before this experiment, but I still woke up several times and found it hard to get back to sleep again.
I fell asleep quickly and I think switching my brain off a bit earlier is definitely having a positive effect.
I’m not sure what made me stir but once I was awake it took me an hour to get back to sleep again.
I lay there tossing and turning and as usual I ended up feeling frustrated and annoyed that I couldn’t get back to sleep.
I worry about disturbing my partner Andy too as I fidget a lot. He tends to sleep through it but there are nights when we are both up because of my disturbed sleep. He snores but I don’t think that disturbs me.
Often I start worrying about all the things I’ve got to do the next day and how tired I’ll be.
A lot of the tips have really eased my hot flushes during the day and at night, which is fantastic.
But when it comes to my sleep issues, it’s not just the hot flushes keeping me awake.
I think stress plays a part so going forwards I’m going to try and find ways of reducing my stress levels, maybe with some exercise or time spent outdoors.
KATIE’S VERDICT:
Getting so little sleep, it’s no wonder I feel run down at times so I was really keen to try and improve my sleep regime.
I’m exhausted and could do with getting more than four hours of sleep a night.
I’m sure that will resonate with many women my age who have kids, a house to run and a career.
You’re knackered but you have to keep going. Because of this, implementing some of these changes has been hard.
Overall, my sleep has improved. I still get restless nights and can find it difficult to drop off, but I tend to sleep for longer spells and feel like my sleep quality once I am asleep is much better.
I don’t wake up still feeling exhausted which is a great development.
Switching off the computer early feels alien to me but I do feel it made a difference and going forwards, I’m going to make a conscious effort to turn things off earlier.
If you feel better during the day you do get things done more quickly and perhaps I wouldn’t have so much to get on top of in the evening.
It’s not always possible to shut things down for two hours before bed, but even half an hour could make a difference and I’m going to give myself the odd evening off where I do something more relaxing.
The fan has been brilliant and the pyjamas were a revelation. I definitely feel more comfortable in bed.
I’m going to have the odd coffee as a treat but going without it has made me realise that I don’t really need it. I feel better for not having it and have cut down on spicy food.
I am considering HRT to help with my sleep issues but right now, I’m going to continue with the lifestyle changes to try and make myself healthier and look after myself a little better.
I will speak to my GP if there is little improvement in a few months, but if there are alternatives, I’d rather try that first. This is a marathon, not a sprint.
With something like this, it’s the little tweaks you make in the short-term that will have an impact long-term.
WHAT YOU CAN DO TO EASE SLEEP
Here are Dr Sarah Gilchrist’s top sleep tips:
- Have a regular sleep routine. This means going to bed and getting up at around the same time every day.
- Wear breathable clothing to bed such as light cotton pyjamas and consider keeping a spare set near your bed so you can change if you become too damp or sweaty.
- Make sure your duvet is the right tog for the season. Use cool cotton sheets.
- Use a fan to cool the bedroom temperature. Ideally it should be 18-20C before sleep.
- Have a cool bag by the bed with ice packs, cold drinks, ice cubes and a cold flannel to help with night sweats.
- If you overheat in the night, try lying on a cool bathroom floor to cool off before getting back into bed.
- Eat healthily. Avoid large meals for around two hours before bedtime. Spicy or acidic foods may trigger hot flushes, so avoid those. Try foods rich in soy as they might minimise hot flushes.
- Avoid nicotine, caffeine and alcohol, especially before bedtime.
- Your body needs to be in alignment from a musculo-skeletal point of view. Use only one pillow so that your neck is aligned with your spine.
- Try black out blinds or use an eye mask if your bedroom is too light and ear plugs if you live in a noisy area.
- Avoid devices, including television, for two hours before bed.
- Enjoy a warm, milky drink before bed.
If you are experiencing insomnia in relation to menopause, you should seek medical advice and you may want to talk to your GP about HRT if peri-menopause/menopause is negatively impacting your life.
If poor sleep health symptoms persist for more than three months, seek medical advice.