7 Tips for Better Sleep in Midlife
For many women, once we hit midlife, sleeping through the night starts to feel like a pipe dream. Nearly half of women ages 40 to 65 say they’re suffering from poor sleep quality, according to a study published in the Journal of Clinical Sleep Medicine.
As we approach menopause, our levels of estrogen and progesterone—hormones that help us fall and stay asleep—begin to fluctuate, says Tara Scott, M.D., a board-certified ob/gyn in Fairlawn, Ohio. As a result, we’re more prone to lighter sleep. In midlife, we’re also at greater risk of developing health conditions linked with disrupted zzz’s, such as sleep apnea or restless legs syndrome.
Then there’s the same old culprit: “Stress is a big factor,” says Scott. Many women have so much to balance—for example, a career, financial struggles, caring for adult children and aging parents, not to mention the emotional toll of menopause. And higher levels of cortisol (the so-called stress hormone) can suppress your body’s production of melatonin (the so-called sleep hormone), priming you for a vicious cycle of sleepless nights and stressed-out mornings.
But how do we fix this problem? Good sleep hygiene can help. Curbing alcohol use can help. Alcohol may bring sleep more quickly, but it may still cause late-night wakeups. Try avoiding alcohol, smoking, and caffeine in the evening. Sleep in a cool, dark, quiet room and wear light clothing to bed. Put away your phone and turn off the TV (or use night mode and blue light-blocking glasses) for at least 30 minutes prior to bedtime. Find ways to relax. Try to sleep at the same time and wake up at the same time every day. Taking simple steps like these may not help everyone, though. In that case, here are some other things to try.
1. Hormone Therapy
If you’re waking often at night, Scott recommends having your hormone levels tested by a healthcare provider, such as an integrative gynecologist or functional medicine specialist. Underlying imbalances may cause symptoms, such as hot flashes and night sweats, that interfere with sleep, says Scott. Additionally, decreased levels of progesterone may lead to obstructive sleep apnea, which can manifest as irregular breathing, gasping, or even choking during sleep. Hormone therapy (HT) with estrogen and/or progesterone may help ease those symptoms, according to The North American Menopause Society.
Staci Greason, a 57-year-old living in Los Angeles who tried acupuncture, heart-pounding cardio workouts, and wine to cope with wide-awake nights, says using an estrogen patch and taking a progesterone pill, along with cutting out alcohol, made for a winning combination.
But—important note—HT is associated with an increased risk of stroke, blood clots, and breast cancer, so talk to your doctor about the pros and cons to find out if HT is right for you.
2. Essential Oils
The sweet scent of lavender is found in just about every aromatherapy product out there for good reason: Smelling the scent of lavender oil could help ease anxiety and relax your body, some studies suggest. “Using essential oils via diffuser or application to a pillow are both great ideas to try for help falling back asleep,” says Scott. Essential oils may lead to increased production of the happiness hormone dopamine and the feel-good hormone serotonin, which can help people feel calmer and more relaxed. Serotonin is needed to make melatonin, the hormone that makes you feel sleepy. Lavender is a common essential oil. Not only do some people find it helps them fall asleep, but it may also increase the amount of deep sleep they get.
Yvonne Westover, 48, an Ontario-based flight attendant and art teacher, says she’s been waking up between 3 a.m. and 5 a.m. about four times a week for the past six years. To quiet her busy brain, she runs a diffuser with a few drops of a mix of calming oils, including lavender, magnolia, neroli, copaiba, rosemary, and a few others. No diffuser? No problem: Annie Collins, 57, a Melbourne-based editor and author, recommends rubbing a blend of lavender, frankincense, clary sage, and ylang ylang oils right onto your pillow. You can also directly apply it to your skin. Be sure to try a small amount first to make sure there are no allergic reactions to the oils.
Lisa Roney, a 61-year-old university professor living with Type 1 diabetes, was no stranger to disrupted sleep due to symptoms of her condition and nights spent worrying about her blood sugar taking nosedives. Menopause paired with a stressful job made her eyes pop right open at 3 a.m. If it’s anxiety that’s keeping you up at night, put pen to paper, she suggests.
“Sometimes, it does me a lot of good just to make a to-do list for the next day and tell myself I will worry about it tomorrow,” she says.
4. Light Entertainment
If you are finding yourself not being able to fall asleep after 20 to 30 minutes, some light entertainment may be better than just tossing and turning in bed anxiously trying to fall asleep. Light entertainment can include reading books, journaling, or doing calming exercises. For Roney’s part, reading a book or watching easy TV often helps her fall back asleep. Collins says listening to the calming podcast Nothing Much Happens also helps.
“It works for me because the stories don’t have any tension in them—they’re contemplative vignettes—and the narrator has a soothing voice.” Whatever helps you zone out is worth a try.
5. Get Creative
“When I’m really restless and don’t fall back asleep within 45 minutes, I resort to drawing,” says Westover. A certified Zentangle drawing teacher, she started using the drawing method after she was told by friends that it helped them deal with disrupted sleep at night. Featuring flowing patterns within structured boundaries, Zentangle drawing, like other forms of art-making, may help reduce anxiety. It typically helps Westover fall back asleep in about half an hour. Zentangle is a form of meditative drawing that has no template and is defined by constant repetition and concentrated drawing. It may relieve stress and anxiety, but any form of drawing may be beneficial.
6. Breathing Exercises
When Ann Petrus Baker, 57, of Evanston, Illinois, entered perimenopause, she found herself in an exhausting cycle of hot flashes, racing thoughts, and stress over lost sleep. Her fix: Paced breathing, an exercise that mindfulness researchers believe helps promote relaxation via the parasympathetic nervous system and vagus nerve by slowing your heart rate and “shutting off” your stress response. To do this, remember the simple formula 4-7-8: Inhale through the nose for a count of four seconds, hold for seven, then exhale through the mouth for eight making a whooshing sound. “I’d practice this for about five minutes then allow my breath to calm on its own,” says Baker.
7. Sleep Aids
There are a slew of options to consider when it comes to sleep-supportive medications and supplements. Following her doctor’s advice, Westover started taking magnesium supplements, which she felt helped her symptoms. Another over-the-counter supplement you might try is melatonin; it’s the hormone that regulates your circadian rhythm and makes you sleepy at night. As you age, melatonin levels may decrease.
Of course, consult with a medical professional before hitting the supplements aisle, as nutritional supplements are not a proven method of treating menopause symptoms. And if you’ve tried a handful of solutions on your own, don’t hesitate to make an appointment with a sleep specialist. You may need a sleep study to find out what is really going on.
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