It is true that women face distinct sleep issues throughout their lives due predominantly to hormonal changes besides various other factors. That is, these challenges can crop up even at menarche (onset of menstruation).
As such, during perimenopause and menopause transition, fluctuating hormones can take a toll on our physical and mental health. Adding poor sleep to the mix: Nah, definitely not good!
In fact, this is like adding oil to the fire because sleep is quintessential for the synchronization of hormone synthesis and secretion, which are heavily dependent on and share a bidirectional relationship with the circadian rhythm.
In this article, we have broken down the science behind sleep and the reasons why sleep deprivation during midlife can wreak havoc on different aspects of your health when left unaddressed. However, with timely intervention and conscious steps toward regaining sleep health, you can manage several of the associated symptoms during (peri)menopause and lower the risk of lifestyle diseases and mental health issues in the post-menopausal years.
Why is sleep crucial?
Emerging evidence indicates that the essential role of sleep is to help maintain the brain cells, especially by repairing DNA and removing toxins, which can be performed efficiently only when the brain cells are inactive. No wonder our brain is sluggish after a sleepless night!
According to the latest research, 7 hours of sleep is ideal in middle and old age for good cognitive and mental health. This is essential for the brain to gradually relax and enter the REM or slow-wave sleep stage, commonly referred to as “deep sleep”, for the toxin cleanup process to happen. Both poor and excessive sleep routines seem to cause changes in specific regions of the brain.
Due to this impact at the cellular level, adhering to the circadian rhythm i.e. a consistent sleep-wake cycle is highly important for basic metabolic functions, including but not limited to maintaining hormonal cycles, appetite/ feeding patterns, and glucose and fat metabolism.
All in all, good sleep is precious for physical and mental wellness!
Through this blog, we intend to convince you that it is wise to embrace a good sleep routine. Read on to check out the different aspects of your body functions that can be impaired by unresolved sleep disruptions.
The big picture
With inadequate or disrupted sleep, the levels of cortisol (stress hormone) shoot up, directing the nervous system into panic mode, commonly referred to as “fight and flight”. In this state, the brain channels the energy into body functions that are necessary when faced with a threat or danger. Therefore, much of the housekeeping, restorative, and repair mechanisms take a back seat. When such a metabolic condition prevails for an extended time period, the body is stressed overall due to lack of rest and undergoes a lot of inflammatory changes. Existing health conditions can worsen, and there are high chances of developing lifestyle diseases and associated conditions.
Short-term/ visible changes
If you notice or experience the symptoms or changes, it is time for you to think from the sleep perspective and take action if necessary.
1. Weight gain
Sleep disrupts the rhythm of two vital hunger hormones: ghrelin (which induces hunger) and leptin (which makes one feel full/ satiated). High ghrelin and low leptin are indeed a ‘double blow’ as the person ends up being ‘ever hungry’ and tends to overeat, thus gaining extra pounds.
Wait, that’s not all! The high cortisol levels caused by poor sleep trigger a distinct fat storage pattern around your midsection for your vital organs to function and be protected when you are threatened (Remember? High cortisol signals the brain to stay in survival mode).
Fluctuations in reproductive hormones can cause digestive problems (bloating, bowel habit changes or acidity around menstruation) and VICE VERSA! Did you know? The gut microbes help convert estrogen to its active form. This is why it is believed there is a rise in gut problems in (peri)menopausal women. However, the story is not complete without the sleep aspect among others. Especially, irritable bowel syndrome (IBS), which is usually strongly linked to sleep, also seems to be more prevalent in midlife.
Sleep deprivation due to hormonal depletion can magnify the disruptive effects on the gastrointestinal (GI) aka digestive system, playing a ‘double whammy’. For instance, poor sleep habits can disturb meal timings and the sleep hormone melatonin, which controls intestinal mobility, thus driving the GI system crazy and leading to the untimely release of digestive enzymes (acid reflux/ GERD, gas formation, etc.).
In women, sleep deprivation and disruptions influence the fertility hormones greatly (and vice versa), thereby directly impacting fertility and libido. Besides, impaired melatonin cycles, which influence the secretion of leutinizing hormone (this triggers ovulation/ regulates the menstrual cycle), add on to the problem. Mood problems associated with poor sleep can further bring down the chances of impregnation.
4. Bone health
When it comes to bones, the protective shield of estrogen wears off during the menopause transition, which is reason enough to lose bone density (up to a whopping 20% in 5-7 years following menopause). In this phase, the initial symptoms may just be fatigue and low energy; however, the long-term effects can be debilitating.
There is emerging proof that gender-biased bone health deterioration in the 50s can be exacerbated by sleep disruptions both in the pre- and post-menopausal phases, thereby disproportionately increasing osteoporosis risk in older women than men. A possible explanation is that bone remodeling, which happens during sleep, is impaired.
This effect has been observed in women of different ethnicities/ BMI, and sleeping longer than 7 hours does not seem to have make things better either. While the exact mechanism is unknown, the one way you can minimize the effects during this life transition is by maintaining good bone density through your adulthood and postpartum through a clean diet, lifestyle, and bone-strengthening fitness routine. Not to forget- 7 hours of beauty sleep!
Since melatonin helps keep the core body temperature low, melatonin supplementation is being considered as an adjuvant therapy to improve hot flashes, psychological symptoms, and bone deterioration during the menopause transition.
How are your bones doing? Are you at risk for Osteoporosis? Do this simple test and find out. The OsteoTest | home from Osteolabs is easy, quick, and safe because it determines the calcium ratios in the bones using a urine sample.
This list is far from comprehensive. More articles on the other benefits of sleep are in the works.
To be continued.....
Please consult your physician for personalized medical advice. Always seek the advice of a physician or other qualified healthcare provider with any questions regarding a medical condition.
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This article is written by Ayshwarya Ravichandran
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