Sleep Disturbances

     Some women experience sleep disturbances (insomnia) around menopause, especially if hormone changes provoke hot flashes during the night.

     Sleep is adequate when one can function in an alert state during desired waking hours.

     Most adults require 6 to 9 hours of sleep each night.

     Treatment of sleep disturbances should first focus on improving sleep routine with good sleep hygiene. This includes avoiding heavy meals in the evening and adjusting levels  of light, noise, and temperature in the bedroom.

     Avoiding alcohol, caffeine, and nicotine throughout the entire day, not just during the evening, can help increase sleep efficiency and total sleep time.

     Daily exercise can also help ease insomnia, but exercising close to bedtime may have  the opposite effect.

     Maintaining a sleep-conducive environment (quiet, cool, dark) can also help. The bedroom should be used only for sleep and sexual activities. Those who do not fall asleep within 15 minutes should get up, leave the bedroom to engage in relaxing activities elsewhere, and return to bed when drowsy. This may be repeated as necessary.

     A regular sleep schedule is important. Choose a consistent time to get up, regardless of bedtime, even on weekends.

    When lifestyle changes fail to alleviate sleep disturbances, I should  be consulted to discuss other options and to rule out sleep disorders, such as thyroid abnormalities, allergies, anemia, restless leg, depression, or sleep apnea (breathing problems).

    Although estrogen is not government approved for treatment of insomnia, research suggests that it may improve sleep in some women around menopause, likely by reducing hot flashes and night sweats.

    A few herbal supplements have been found to improve sleep after 2 weeks of use; no substantial side effects have been noted with standard doses.

    Prescription sleeping pills may be used to break a cycle of insomnia but are only a short-term solution.