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The Perimenopause Night Club: A Practical Guide for Insomnia

The prevalence of sleep disorders, especially insomnia, is up to 2 times higher in women than men. Particularly, a majority of these women are reportedly from the perimenopausal age bracket!


Midlife women are super busy caring for their children and the elderly, taking additional responsibilities at work, and supporting family members physically, emotionally and financially. The stress of life and anxiety levels at this phase is reason enough to drive one crazy and lead to a poor sleep routine. Add menopausal symptoms like hot flashes and cold sweats, sleep can fly out of the window for many women. This hugely impacts daily life and opens a Pandora’s box of new health concerns. These women may start to feel out of control and overwhelmed. 


This article intends to equip you with the right information and some strategies for coping with sleep disturbances during the menopausal transition.



 

Imagine yourself lying wide awake surrounded by the stillness of the night. Your mind is in hyperactive mode with turbulent thoughts bouncing everywhere. The worries, regrets, and anxieties choose this moment to surface as various aches make their presence felt loud. Funnily, it is in this state where you can hear the pin drop. Your sense of hearing is heightened. A large part of the night passes in tossing and turning.


Now imagine going through this day after day. This is the reality of countless women battling insomnia.


How Do You Know If You Have It?


According to NHLBI, insomnia is a common sleep disorder involving difficulties in falling asleep or staying asleep or both. 


In addition to the above, insomniacs may also experience daytime fatigue, irritability, or difficulty concentrating. 


This condition can be detected based on the systematic observation of sleep patterns and their influence on the daily functioning of a person, if the symptoms persist for several weeks. 


The best person to diagnose this condition is a sleep specialist. Insomnia needs a comprehensive assessment of medical history and sleep patterns as individual symptoms vary from person to person. Sleep studies (polysomnography) are commonly conducted to confirm the condition. Insomnia sufferers usually need a customized treatment plan. 


What keeps an insomniac awake at night?  


The most common contributing factors to insomnia are stress and anxiety, physical ailments, and (or) hormonal imbalance. 


Stressors can be individual-specific. Some people tend to overthink or worry about facing certain situations. These individuals are more likely to suffer from insomnia as they often cannot calm their racing minds when they hit the bed.


Women invariably suffer from hormonal imbalances for half of their life. Menopause is the stage when insomnia is most likely to surface due to decreasing estrogen levels. Other inflammatory conditions can also be triggered or worsened during this phase. For instance, a relative of mine suffering from fibromyalgia, which causes chronic pain and persistent discomfort, would constantly try to shift her position for pain relief but rarely settle down.  


Substance abuse and certain medications can also contribute to insomnia. Caffeine is known to block the adenosine receptors, causing sleep disruption. In current times, light exposure from excessive screen time - phones, laptops, and TV is also contributing to the disruption of our sleep cycle.




Why is it necessary to take action? 



Perimenopausal sleep issues are not only indicators of anxiety and depression but also risk factors for developing depression later in life.


Navigating the Path to Better Sleep


Though I am not a sleep specialist, I have found the following ways helpful in easing insomnia issues.


Sleep management. Maintain a consistent sleep schedule by hitting the bed at the same time every night. Keep the room well-ventilated and at a comfortable temperature. Draw the curtains to block external lights; use blackout curtains if necessary. If your other half snores sleep in a separate room if possible


  • Physical activity. At any age, staying physically active throughout the day is beneficial for good sleep. However, reduce physical activity by late evening. Going to the gym at 8 PM may not be the best idea for an insomniac. 


  • Managing screen time. Many people have the habit of watching TV or streaming shows after dinner. But this is not for you if sleep is a problem; reduce your exposure to laptops, and smartphones by dinner. You can set your phone to DND mode to avoid getting notifications. 


  • Breathwork/ Meditation. Taking deep breaths, sitting calmly in Padmasana (or any way), and letting your thoughts settle down reduces stress levels. You might prefer to burn some incense sticks or light a scented candle if that helps you calm down. I was a skeptic till I intentionally meditated and now I do it often when my mind is racing.


  • Low GI food and meal timing. Research shows that foods high in glycemic index i.e. easy to digest (processed carbohydrates and sweets) cause sharp blood glucose (and insulin) levels to peak and drop steeply, which can lead to sleep disturbances.  Therefore, plan your dinner early and try to incorporate a balanced meal plate that is low in glycemic index. Keep the meal portion small to medium.


  • If insomnia persists, it’s time to see a sleep specialist. Now, are you thinking what can a specialist do? 


Is Insomnia Treatable? 


Insomnia is treatable. Medical research suggests that therapy options like Cognitive-Behavioral Therapy for Insomnia (CBT-I) effectively tackle persistent sleep problems.


While insomnia can wax and wane due to various factors, medications are available to alleviate acute symptoms. As stated previously in this post, the advice of specialists is crucial to ensure you have the right prescription and dosage.


Some people also opt for complementary and alternative therapies, including acupuncture and yoga, which have been reported to show promising results in managing insomnia. Remember, with the right support and approach, sound sleep is within reach.




In quest of restful nights


Insomnia is treatable but only when you know you have it. You need to figure out the root cause. If you have any symptoms discussed earlier in the post, the easiest thing to do is keep a journal. Note down your observations for 60-90 days and simultaneously try our suggestions to improve your sleep challenges. 


If the condition persists, visit a sleep specialist with your journal. Problem solving such as insomnia is a collaborative effort. The more inputs you give to the specialist, the more equipped they will be to come up with the right diagnosis and give you evidence-based treatments. 


A restful night's sleep is vital for your overall well-being.  


 

This article was edited by Ayshwarya Ravichandran PhD 


About the author


Dr. Ipshita Basu Guha is a twin entrepreneur who is passionate about women's health and mental health in general. It is incredible that she not only took a step toward her personal health but also talked her women's tribe into this and drove the campaign on the ground.





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