Menopause and insomnia

Sleep onset insomnia (trouble getting to sleep) and sleep maintenance insomnia (trouble staying asleep) commonly increase during perimenopause and menopause. The International Classification of Sleep Disorders includes premenstrual insomnia and premenstrual hypersomnia under the category of menstrual-associated sleep disorder. Scientists still don’t totally understand the effect of estrogen on the circadian rhythm and somatic thermoregulation. It used to be common for doctors to prescribe estrogen supplements for older women, but the general use of estrogen replacement has largely been eliminated.

Surveys indicate that women consider insomnia among the most irritating of menopausal symptoms. “Hot flashes” (due to fluctuation in estrogen and progesterone levels) are another common symptom, and many times, the reason for insomnia is due to the body’s inability to maintain a consistent temperature. A hot flash includes a surge of adrenaline, which tends to awaken sleepers. Many women experience night sweats. Both these sweats and the tiredness resulting from insomnia can have a large negative effect on subjective “quality of life”. The International Classification of Sleep Disorders (ICSD) includes premenstrual insomnia and premenstrual hypersomnia within the category of menstrual-associated sleep disorder.

Like insomnia from other causes, this insomnia can be a challenge to live with and to treat. The first line of action for the insomniac is making sure sleep hygiene is practiced, including a comfortable dark room and a regular sleep schedule.

In bad cases some doctors prescribe medicines, including nonbenzodiazapines. Researchers are looking into phytoestrogens and other estrogenic substances for control of many symptoms related to menopause and this may eventually result in some treatment in the future.

A recent study showed that Zolpidem was effective in treating insomnia in menopausal women, and of course there are many over-the-counter and prescription sleep aids.

Related: insomnia in pregnancy

Sleep disorders in women

Sleep Disorders

Dyssomnias

Parsomnias

"It’s been a hard day’s night
I’ve been workin´ like a dog
It’s been a hard day’s night
And I’ll be sleepin´ like a log…. "

(John Lennon and Paul McCartney)