Archive for sleep habits

Oct
20

Why Sleeping Is so Important to Menopausal women

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Your may have read some headlines recently, discussing how lack of sleep can cause you to gain weight. You may even have experienced this first hand. I know when I do not sleep well, I usually overeat the next day. I had assumed this was my bodies way of getting much needed extra energy. I assumed it was something that specific to me, not necessarily driven by any known biological mechanism of action.

It turns out there is a biological reason that we eat more when we have not slept. Through knowledge gained from research studies on why sleep is so important, it has been shown that many important functions occur while we sleep. The body and brain repairs itself while we sleep. Most of us have always assumed this, but many of us would never imagine that lack of sleep can make us fat!

Sleep deprivation, even if only for a few days; can wreck havoc on our hormone system. It can cause cortisol to rise in the evening, when it should be declining. This rise in cortisol can contribute to diabetes and obesity as it promotes fat storage. Thyroid function can also be affected by lack of sleep.

But how can sleep actually make us fat? In addition to the cortisol rise mentioned above, sleep deprivation affects the appetite regulatory hormones leptin and ghrelin. These hormones play an important role in helping to regulate our appetite through signalling when we are full and when we are hungry. Lack if sleep causes them to rise and fall inappropriately, encouraging you to consume more calories than you actually require.

Additionally, lack of sleep has been shown to also decrease glucose sensitivity by almost 30%. This means  that the food you eat will not be utilized as efficiently and will be more likely to be stored as fat. Such a response implies that chronic sleep deprivation may cause an increased chance of developing diabetes and obesity.

Menopausal sleep deprivation can not only add to the weight gain and fatigue of menopause, it can also increase your risk of diabetes and heart disease. If you are being told by your medical provider that your glucose, cholesterol and blood pressure are becoming higher than normal; your sleep patterns as well as diet may be the reason.

It is important to work on your sleep habits in order to minimize the effect menopause may be having on your health. Work on getting plenty of exercise, decrease caffeine, learn to relax and maybe meditate to decrease stress. Talk to your provider about help with sleep and any medical conditions other than menopause which may be contributing to lack of sleep.

Most importantly, set a schedule for sleep and stick to it! Work on not allowing the phone, your computer, or TV watching interfere with your bedtime.

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Feb
09

What happened to Your Sleep during Menopause

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Anne discusses sleep and sleep disturbances during menopause. Why do women in menopause have trouble sleeping?  How can you improve your sleep during peri-menopause and menopause?  Watch this 5 minute video and then leave your comments and questions below. Thanks!

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Categories : Menopause Symptoms
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Nov
23

SLEEP-ZZZZZ What Happened?

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Insomnia during MenopauseOh for the days when we laid our head down at night and the next thing we knew, the sun was up and the birds were chirping. Are those nights gone forever? Will I have a roving bedroom forever? Well not necessarily, but like everything else, it has morphed into a different version.

The causes for sleep disturbance during menopause can be related to several factors and it is important to identify what is causing your sleeplessness, so you and your medical provider can treat and manage the problem. Reasons for sleep disturbance can include hot flashes and night sweats, development of obstructive sleep apnea(OSA), restless leg syndrome(RLS), depression, and/or the development and continuation of poor sleep habits. I will talk about the different causes and possible solutions in this article.

For most women who have not had sleep problems prior to menopause, the change in sleep pattern most likely occurs because of

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a spike in body temperature during the night. This can cause the sleep stage to shift from the deeper restorative stage to a lighter stage where awakening can occur more easily. This is believed to occur because of lower progesterone and other hormonal changes. Then, after the temperature spike, you get the hot flash- sounds familiar doesn’t it?

Most of this cause of sleep disturbance happens more in the early or transition stages of menopause when hormonal fluctuations are greatest.

Later in menopause, a different pattern emerges, one of early morning awakening. This is felt to be due to changes in breathing patterns (you mean I snore?!!) and possible sleep apnea from weight gain and changes in muscle tone in neck and throat area.

So for causes from temperature issues, it is important to sleep in lighter clothing than you may have used in past, perhaps keep a fan near your bedside or use ceiling fan if you have one. A low dose aspirin before bed (if you have no stomach sensitivity to aspirin or not allergic to aspirin) will help keep body temperature down; and lastly, HRT (hormone replacement therapy)  is very helpful at restoring hormonal balance so you can sleep. Some women are more progesterone sensitive and when levels fall during peri-menopause, this can trigger sleep disturbance.

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Sleep disordered breathing includes snoring and a more severe form called Obstructive Sleep Apnea. Both occur when an increase in weight causes a slackening of muscles in neck and throat, which support the back area of the roof of the mouth. When a person lays flat, this area can partially collapse over the airway and block air from entering the lung passageway. Some people are more prone to this and it can also occur in men for the same reason-weight gain and age.

The brain does not like lack of oxygen, so it prevents a deeper sleep cycle and causes alot of body movement and change of breathing patterns to increase intake of oxygen.  People awaken often, and awaken in the morning feeling as if they haven’t rested. OSA can have some very serious health consequences involving your heart and lungs.  It is important to find out if this is the cause of your snoring.

A sleep study is the way to identify whether or not your snoring can involve OSA, and there are treatments for this including use of a device called a C-PAP machine or sometimes surgery involving the back of your mouth and throat. There are no pills to treat snoring or OSA, however, weight loss or prevention of weight gain through proper diet and exercise are often the best ways to avoid and help lessen the symptoms of OSA.

Restless leg Syndrome (RLS) is another disorder which interrupts sleep patterns and can occur in both men and women. It is more common as people age and for that reason can be more common in peri and post menopausal women.

It seems to be common within families, the cause is still unknown but several factors seem to predispose a person to this. It is felt that anemia from low iron can cause or make worse the symptoms of RLS. Other triggers include caffeine, tobacco, and alcohol. Most people will describe an unpleasant sensation over the legs and an irresistible urge to move the legs for relief. It can be treated with mediation that was originally developed for Parkinson’s disease, but at lower doses. As you can imagine, the constant need to move your legs because of abnormal sensations would interrupt anyone’s sleep.

Lastly, there is depression, which can also interrupt a normal sleep pattern. Depression can happen in anyone, however the hormonal changes causing mood swings can make this more prevalent in menopause. Some people are more prone to depression, believed due to an inherited lower production of neurotransmitters in the areas of the brain which manage mood control, desire, motivation, emotional energy. Treatment for depression can often restore the sleep cycle to normal.

I am going to briefly mention the sleep medications. There is Melatonin, which is an OTC herbal product which purports to help sleep. Melatonin is produced by the brain at the end of the day and is triggered in part by your natural circadian rhythm (ie. I’ve been awake all day, time to go to sleep), sun setting, slowing of activity level. The problem with Melatonin tablets is that not everyone gets it into the brain where it needs to work. So it is not effective for everyone.

There are the newer sleep medications called Ambien, Sonata and Lunesta. These also work in the brain by blocking the awake part of the brain. They are very effective but can be habit forming and can also have undesirable side effects.

Also used are some of the older antidepressants, such as Trazadone. These can be effective and are not habit forming, however some people experience day time drowsiness with their use.

Lastly, Gabapentin has been shown to be effective for sleep in women who are experiencing hot flashes as a cause of sleep disturbance. Researchers are not sure why, but it is known to help RLS and may diminish hot flashes.

Sleep habits are very important to establish and maintain during this period of time. Avoiding caffeine after noon, not eating a heavy meal or late meal with in several hours of bedtime, and also keeping noise and lights low within 1-2 hours of bedtime. Alcohol can also interfere with sleep even though it seems to help with falling asleep. The alcohol interferes with achieving and maintaining the deeper sleep stages, so it is more easy to be awakened by noise, movement or minor discomforts. Lastly, computer use can interfere with sleepiness as it is felt that the light of the monitor can up regulate the activity of the awake center of the brain.

So, to summarize, there are many causes of sleep disturbance. You and your medical provider can discuss the possible causes contributing to your changes and treat them specifically. As always, it is important to keep that balance we have discussed in other articles, so that you do not feel over whelmed and do not gain too much weight.

It is also important to continue to foster the relationships which enrich and sustain you through your day and week, and that you continue to find time to relax and feed your own soul. This is a time to tend to yourself, and this is not a selfish thing to do. Most women spend much of their adult lives tending to other people and putting themselves last, either due to work, family both immediate and extended, and community or church commitments. It is ok to take some time for yourself, this is when it is most important.

Use this information to discuss these issues with your doctor.  The reading of this material, being a member of this membership site, or leaving comments does not constitute a patient/provider relationship. You should discuss this information with your medical provider.

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