Poor Sleep Quality

Long before my sleep sabotage in perimenopause started, my sleep quality started to deteriorate in university. My regular sleep schedule was impacted by late night studying, cheap draught beer, parties, euchre tournaments, and the occasional night where I would worry about not doing well. I view that occasional late-night worry as the birth of my anxiety, which had been brewing deep

within for some time.

My sleep-wake cycle got so messed up, by the time I reached my late twenties I was diagnosed with primary, chronic insomnia which is classified as a sleep disorder. My doctor referred me to a sleep clinic where I ‘went to school’ once a week to learn how to sleep again. Or maybe unlearn some of the habits I created in university.

A Common Sleep Disorder

According to the Mayo Clinic, insomnia is a common sleep disorder that can make it hard to get to sleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. It’s considered ‘primary’ when it happens without an apparent cause. If it’s a symptom of another condition or circumstance, it’s call secondary insomnia.

Sidebar: I suspect I was misdiagnosed, and that my insomnia was secondary and caused by my creeping anxiety.

The criteria for chronic (or long-term) insomnia is three months or more of struggling to get to sleep or stay asleep three nights a week. Otherwise trouble sleeping is considered acute or short term.

Addressing Sleep Problems In My Twenties

What was revolutionary to me back then are common recommendations in most Google searches and medical offices now. The following helped me learn to sleep again:

Don’t Look At The Clock

Being stressed about not being able to sleep will negatively affect sleep. Simple. Not looking at the clock; not so simple. It took me forever to learn to not give in to the temptation to look at the clock. Once I did, it significantly improved my sleep quality.

Sleep Diary

Tracking your sleep can help you understand what is causing your sleep disturbance. I learned that keeping a regular sleep-wake cycle improved my ability to fall asleep. I also determined that on the days I got exercise, I had an easier time getting to sleep. And spending time with friends made a huge difference to my ability to sleep. Tracking my sleep patterns and linking them to my daily activities was very eye opening.

Relaxation Techniques

Whether it’s exercise, getting outside, breathing exercises, meditation, or cognitive behavioral therapy, anything to combat stress is going to help improve sleep disorders like insomnia. Exercise, getting outside, and talking to a psychologist did wonders for my mental health and my ability to address my sleep symptoms.

A Good Bedtime Routine

Having a good bedtime routine leads to relaxation and let’s your body know it’s time to wind down. I started doing things in the same order every night and, when possible, going to bed at the same time. Limiting screens and bright lights before bed, and avoiding stressful activities like work all helped me get better sleep.

Limit Caffeine And Alcohol

Both of these substances can cause sleep issues. Caffeine can impact your ability to fall asleep and alcohol can impact your ability to stay asleep. I quickly figured out that caffeine after 12 pm was a bad idea for me. While alcohol didn’t impact my ability to fall asleep, I suspect it did however disrupt sleep.

Something Missing?

I was able to overcome my sleep problems and built a toolkit that has served me well over the years. That said, there was nothing about how food may impact our sleep. And the program definitely did not address perimenopause, despite all of my classmates being older than I was and mostly female. While I didn’t need that information back then, it would have been game changing when my menopausal symptoms started creeping in a decade ago.

Babies – The Mother Of All Sleep Disturbances

I was sleeping well. I had the occasional night where I struggled to get to sleep, but that was usually because of circumstance, like a job interview or relationship challenge.

Then I had children in my late thirties. No one slept for 3 years. Parents out there know: it can be a gong show. Once my second child was a year old, we were all sleeping well most nights. And I thought I was good. Until I suddenly was not.

Perimenopause Insomnia

Shortly after I turned 42, my sleep problems returned. But they were different this time. I could get to sleep without issue, but I started waking up at 2 am. It was like I had been plugged into an electrical socket, and I usually could not get back to sleep.

My toolkit no longer worked as it once did, and I could not figure out what was going on. You can read more that experience here.

I eventually figured out that fluctuating estrogen and progesterone were triggering this new type of insomnia for me – night waking. Or what I like to refer to as sleep sabotage in perimenopause.

A Lot of Menopausal Women Aren’t Sleeping

Current data show that between 40% and 50% of women experience sleep disturbance. That number increases to as much as 60% for postmenopausal women. That’s a lot of menopausal women not sleeping. And when you don’t get the sleep you need, nothing works as it should.

I have spent the last eight years working on my sleep. First it was just trying to figure out what in the hell was going on. It wasn’t until recently that a doctor actually said that perimenopause could be sabotaging my sleep. While I knew this to be true, the validation was healing.

Sleep Sabotage In Perimenopause

Poor sleep for me in perimenopause is about night waking. I believe that my fluctuating hormone levels are causing the night waking. I am also now a lot more sensitive, to everything. Could this sensitivity be part of the never-ending list of menopausal symptoms? Or is this sensitivity part of aging? Regardless, my toolkit has now changed as follows or sleep sabotage ensues:

No Caffeine

That’s right. I now only consume decaffeinated beverages. Even one cup in the morning was having a negative impact on my sleep. Yes, stopping the caffeine was brutal. But not as brutal as starting the day at 2 am.

No Red Wine

Red wine and I are no longer friends. Even one glass can disrupt sleep. I now drink tequila, which does not seem to have the same effect. And on a special occasion I may indulge and know that it will likely cause a restless sleep. So I pick my spots.

What And When I Eat Matters

Sleep school in my twenties didn’t talk about food. Maybe it’s perimenopause or maybe it is ageing, but what and when I eat now definitely impacts my sleep.

For example cow dairy, especially if mixed with gluten, will now rob me of a good night’s sleep. So if I am going to have cow dairy, I am careful about how much and try to avoid my other triggers. Here is a great example of one of my sleep sabotage meals: red wine, lasagna,  and cheese cake. And if I consume those items late in the evening, the sleep issues will be epic.

Not Enough Carbs

I have tried Keto to see how it would affect me and the biggest impact, other than losing water weight was trouble sleeping. I have since discovered that if I don’t get enough healthy carbs (no lasagna) in a day, it will cause sleep disturbances.

Sleeping Alone

I love my partner. We have a great relationship (which by the way does not mean smooth and conflict free, but that’s another post). And most nights I need to sleep alone. My partner now breathes, never mind snores, and I am awake. Sharing a bed now causes sleep disruption, and once I am up it’s likely that a good sleep is no longer in the cards.

Sleep Quality in Perimenopause

My toolkit needed to be tweaked and there are a lot of things that I need to do and manage so that my sleep difficulties don’t return.

The most important piece of advice when building your toolkit is don’t undertake everything at once. Start small. Celebrate the little wins. And move on to the next thing you will try to improve your health. Baby steps. This is key for managing the menopausal transition.

Hormone Therapy

This can be a scary, and often controversial topic. And it is a topic all menopausal women should understand. It is not right for everybody and every body is different. However, it is important to talk to your medical practitioner about whether hormone therapy could help you with sleep.

I take 300 mg of a pharmaceutical oral micronized progesterone (bio-identical) nightly and I can’t overstate how much it has helped to reduce the frequency of the night waking. I still need to be mindful of those things that cause my sleep sabotage, but the progesterone has been a life saver.

The progesterone is also helping to manage my other ghastly premenstrual symptoms like mood swings, anxiety, bouts of depression, and extreme abdominal pain.

Natural Supplements

There are supplements that are said to promote sleep. Some have studies to support these claims, others do not.

I have had success with melatonin and CBD/THC oil, but neither worked long term for me. I do use magnesium, which I have found to be beneficial as part of my toolkit, but as my menopause transition has progressed, it no longer had the same impact. I now need the progesterone to get a good sleep.

Alternative Treatments

Anything that will help you relax will help you get better sleep. I struggle with meditation, but I have struggled enough to recognized that when it is part of my daily routine, it helps.

Massage therapy, acupuncture, and cognitive behavioral therapy have all been part of my toolkit. These have worked for me, but they are time consuming and expensive. I work them in when I can and am grateful for the extra boost to my toolkit when they happen.

Sleep Disorders

There are many reasons for poor sleep and you will want to have your doctor rule out sleep disorders, like sleep apnea. The risk of sleep apnea increases significantly for women after menopause.

Avoid Sleep Sabotage

Your medical provider can also help you understand the root cause of your sleep problems. Are night sweats and body temperature the trigger? Are you suffering with mental health challenges like anxiety? Are fluctuating estrogen and progesterone causing you to wake up and not be able to get back to sleep? Is it menopause related insomnia? Is the anxiety causing the sleep problems? Or is the poor sleep quality causing the anxiety? You may need more than one appointment to sort through what is going on.

A qualified medical professional can help you determine if your sleeplessness is related to menopause and/or if there are other issues at play.

The Hero Bit

No one thing is going to solve your sleep issues. Get professional medical advice and start building your toolkit. Remember to start slow, regularly seek expert advice, and know that what is working today will likely need some tweaking tomorrow. You’ve got this.