Episode 8: Women and Sleep during perimenopause and menopause

Today we explore another significant transition stage for women that is probably not talked about as often as it should : perimenopause and menopause. In a general aspect we look into how sleep is altered due to the biological changes happening in our bodies and how to go about it. 
#womenshealth #menopause #perimenopause #sleep

Transcript

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Hello everyone and welcome to yet another episode on Sleep Lab Stories podcast. If you're new here, thanks for choosing to spend this time with me. And if you've been here before, welcome back and thanks for your consistent support. Today's episode is more of a continuation of the conversation we had in the last two episodes where the focus was on sleeping women. Though today's episode delves into more of one of the phases, which is uh perimenopause and menopause, I'm just trying to uh dig deeper into this topic and look into the individual challenges that come along with this also very important transition in our lives as women. Sleep changes during midlife are incredibly and inevitably common, yet, many women are probably not so getting the support they could be needing to navigate this phase. What actually goes on hormonally and neurologically during this period, and what can actually help? Those are very important questions that we need to think about in order to understand what what's happening actually in your body, in your sleep, and in your general um you know mental capacity. Perimenopause is the transition phase leading to menopause, and it can begin years before periods stop completely. I was actually taken aback to learn this, which is actually also very interesting. That I feel like some of such information are not so on the surface, or you have to actually be there to get to know it. But um, speaking from a very individual point of view, maybe some people are more informed about it, but uh, these are some things that I feel like are not so talked about, are not so like a common day-to-day conversations. During this time of perimenopause, hormone levels fluctuate unpredictably, and one of the earliest symptoms for many is disrupted sleep, the night sweats, the infamous 3 a.m. wake, feeling exhausted despite spending a substantial amount of time asleep. Some women have trouble falling asleep, others wake up repeatedly throughout the night, some wake too early and can't drift back to sleep, and many report feeling like they sleep lightly and not deeply. What's important to understand is that sleep disruption during perimenal pose isn't all in your head, it's a real biological process that results from the different hormone-level fluctuations, which in turn affect sleep quality and mood. It's so funny how this is a very like a vicious cycle. One thing affects the other, the other affects the other. So your if your sleep is already disrupted, you end up having mood changes. If your mood already not so stable for whichever reason, stress or all day responsibilities, you end up having a disrupted sleep because your brain won't shut during sleep. The good news though is there are ways to improve sleep, and understanding the root cause is the first step. Let's talk about the legendary wake up between 2 and 4 am. This is also quite common among women in perimenopause. Sometimes it's caused by a hot flush or night sweat. Actually, even small rise in body temperature can disrupt sleep deep sleep, and knowing that can already be a step into finding out how to deal with that. The body may partially wake up to cool itself down, other times one might wake up with racing thoughts, anxiety, or a pounding heart. Chronologically, this time is seems to be significant, or the time that these awakenings are remembered or happening, because it's also biologically the time that a lot of hormones are the like hormonal levels in our body fluctuate, the hormones that also affect our sleep. So, what can help? Cooling bedroom temperature can already be a first step. If you're sleeping in an area where you probably use a heating system or you use maybe heavy things for sleeping, using comfortable breathable beddings can help in making sure that um the temperature of the room are sustained to a level that uh even if the rise in body temperature happens at around the 3 a.m. time, it will not really disrupt your sleep. Also, layering blankets instead of using one heavy duvet or blanket can help because I mean when we are sleeping and are not aware of what's happening around us, if you already had a heavy blanket, your instinct will not kick in to put it aside, but your body will wake you up like on a survival mode. Also, reducing alcohol intake before bedtime because alcohol typically also already disrupts or changes their sleep architecture. So when already we are going through a transition like this, the later into the evening you take it, it feels good and it calms at times for some people. Alcohol has a calming effect, but also taking it too late into the evening or time before bed can increase in impact in the sleep disruption. And another interesting thing that it's almost obvious but also worth mentioning is reducing caffeine intake in the late late afternoon because apparently the sensitivity of caffeine increases during perimenopause. I found this an interesting thing to note, though against things like caffeine impact on people differently, but at this time I think uh the body is very sensitive to uh products like uh caffeine or caffeinated beverages, so it would be advisable to not take them quite late or late afternoon to evenings to reduce their impact also on the sleep. Stress management also becomes essential because another system that feels constantly on alert has a harder time entering deep sleep. One important tip if you wake during the night, try not to look at the clock immediately. The clock at times actually the fact that you'd be noticing that every time you wake up at the same time and every day the clock is showing you the same time, this at times causes a stress, and uh alone knowing that or seeing that oh my again I have woken up at three, struggling back to get to sleep can be an issue, or rather trying to to soothe yourself into sleep. Next I would like to mention uh sleep and emotional health during perimenopause and menopause. Many women notice increased anxiety, irritability, low mood or emotional sensitivity. Especially like I already mentioned, it's like a vicious cycle when sleep is already affected. So we have a scenario where the hormonal changes which is na natural process affects sleep, the poor sleep which in turn makes the quality of sleep poor. This poor sleep quality affects mood. This mood escalates into stress and anxiety, which worsen sleep further because if you're anxious and feel stressed, it's hard to fall asleep or to to stay asleep or to fall into deep sleep. A situation mostly described by many as wired but exhausted. So it's it's quite um like the brain is tired but won't settle and uh that's like a a fight among two bodies but they existing within one, I mean the two organs existing within the body. The brain is tired but the moods and the whole other system in the body is not actually settled or relaxed to help the brain power up. I I I talked about the significance of what sleep does to our brain in one of my earliest episodes. If you didn't catch that, you can check it out where I um I was exploring why what happens actually to our brains during sleep. So this is why support for sleep during perimenopause is not just about feeling rested but also protecting mental health, and I I find it also interesting that anything around mental health is usually associated with so much shame and stigma, but it's and I feel like that's also one of the reasons a lot of people would rather suffer in silence than seek help. But I would like to encourage you that you should not feel shame in seeking professional help, especially if your feelings or even your observation is that it's already like some of these symptoms are severe, the tiredness, the mood, or the sleep um disruptions get encouraged to seek professional help because you deserve it. At times there are some approaches like um medication which can be helpful too, but the downside of most medication are not just the side the side effects that come along at also organ on an organ level, but I don't even know how to describe it too because this also addiction or the long-term reliance also is more on something that is coming from internal, so that makes medication not address the underlying hormonal and nervous system, but be like a short-term solution. So the best approach actually is often a layered one, like lifestyle support, stress regulation, sleep habits, uh optimization, and medical evaluation when needed, which will eventually lead to um individualized treatment. As you can see, a phase like this, a transition like this already calls for already has a lot of layers layering. There are already a lot of things going on in the background, mentally, um physiologically, hormonally. So, also the best way to treat with to treat or to deal with that is also approaching it on an interdisciplinary interdisciplinary level. I think for today I've come to the end of um of our conversation. It's more of it was more of an expounding of what I feel happens more or less differently, but it's still like uh in a women's sleep, a lot of what affects our sleep are on hormone levels, but which again affect our moods and affect when our moods are affected, uh the quality of our sleep also gets compromised. In the next episode, I will explore a bit of more into practical uh strategies that could help because um that's also a bit of a long conversation or a bit of a few things that I feel need in a bit more expounding. So if I talk about that today, I I don't want to make it such a long episode. I try to stay within some time in these conversations, and I encourage you to tune in next for the next uh episode that I'll upload, and I also encourage interactions and opinions and ideas because these things a lot of the times a lot of information that's on the textbooks are quite let me say old, they don't match up to especially the lifestyle or the life the technology we have. In fact, recently we're talking about with my colleagues how a lot of the information that is on textbook right now are 20 years behind, and for those who've lived that long, you know how much different things or how much life was a different, like there was already a lot of difference 20 years ago that you can't match up with now. So I would like to always hear from people who have current maybe research or information on what's going on, or those also involved deeply. I'm approaching most of these conversations from a very personal point of view, and also I try to bring in my experience as a sleep specialist or having worked in a sleep lab or being in a sleep lab for over the past one decade, and I'm trying to encourage the such kind of conversations so that actually from the point of many people coming to the lab or I get to interact with, don't really know at times where to get information. So, my hope is that some of this information get out there and reach the right people. So, in conclusion, just a reminder that just because perimenopause and menopause is closely associated with sleep problems doesn't mean one has to suffer through it in silence. These are biological reasons behind the changes and tools that can help and are also not just tools, but they are also specialists nowadays going going into like really really finer things that can offer support. Instead of thinking what's wrong with me, try approaching yourself with curiosity, like what's my body wanting or asking for right now. Sometimes the answer could be simple, it could be rest or stress reduction or management, because for some people stress reduction would sound like reducing a part of their life, which is at times impractical. So at times I I I call I consider that stress management, medical support, sometimes it's boundaries we need to enhance or grow anew, or actually, boundaries are um here. I don't even need to expound on that because most of the time we we find ourselves into situation because of lack of boundaries. So if you found you analyze the situation you're in, and you see that it's maybe lack of boundaries or boundaries that have been missing, please go ahead and create some. Sometimes what our body could be needing could be simply acknowledging that it's going through transition because these transitions or or at times not being in denial also brings a bit of internal conflict that makes it hard to approach anything from a point of knowledge. So a lot of things are approached from a point of resistance, and this also makes some of the things that could work, like seeking professional help or seeking uh support not really effective. So consider that or at least um thinking about it as yeah, acknowledging this is something we are going through or the body is going through, and it needs the support that it deserves. You deserve good sleep, good quality sleep, you deserve care, and most importantly, you deserve to be heard. This should be an encouragement to anyone going through this, uh going through this phase that you're not alone and you're not crazy and you're not uh building things up. Some of these things could be happening, and interestingly, even with age, it's usually I feel like a lot of things, information also on the textbooks are not so precise, and also let me say not reliable, considering these are information that were so long ago, like put down a long ago. They are already new information, but not yet translated or not yet implemented. So some of the information out here could not be accurate, and what you could be needing could just be yeah, sleep, restorative sleep, and being hard, which means whatever how you express yourself or what you go to say must not necessarily match the description of a certain thing, and this is I think one thing that needs to be emphasized more and more. We are individuals, and most of the times how we experience things and even the stage or rather the age or the time which we go through certain things could vary, it could happen to some people earlier, it could happen to some people later, and some people might not even experience any of this symptom till till much later. The chosen ones, or yeah, the lucky ones. Thank you for choosing to spend this time again with me. And feel free to share whatever resonated with you from this episode with a friend, a sister, a colleague, a partner, or even your mom. Conversations like these help reduce stigma and empower us women and individuals to self-advocate where necessary and also to speak up for ourselves and also stand on what is happening to us and not be in doubt when when maybe we are told that can't be or that's not true, or when it's belittled or when it's look like yeah, that's something small you can you can manage because I feel like we we we have lived through a lot of times where some things are supposed to be managed, like just live through it or endure actually. Manage is not the word I was looking for, endured, but thankfully we live again in an age where there is help, there are tools, there is support. So don't be ashamed to reach out when need be or to get to to your physician or to talk about these things from a point of confidence until next time take care and I hope this has helped someone else or has reached out there and will bring out some change or will spark this conversation to continue. Bye