If you’re in the perimenopause, the years leading up to menopause, or post-menopause, the time after you’ve not had a period for one year, you may have started to experience problems with sleeping. You may have trouble falling asleep or find that you are waking in the night and find it hard to get back to sleep again. This can have a huge impact on general health and wellbeing. Poor sleep is associated with weight gain due to increased food intake. When we are tired, we are more likely to reach for high calorie foods to keep us going. Our hunger hormone (ghrelin) increases and our satiety hormone (leptin) decreases making us more likely to overeat. In addition, we lack energy so are less likely to feel like doing any exercise. Chronic loss of sleep increases our risk of developing type 2 diabetes, impaired glucose tolerance, cardiovascular disease, and poor mental health.
So why is this happening? There are many possible contributing factors. Firstly, lower levels of Oestrogen and progesterone cause hot flushes and night sweats in about 80% of women going through the menopause. These symptoms can severely disrupt sleep, causing night-time waking. Nocturnal breathing disorders such as sleep apnoea are very common during menopause, causing sufferers to wake several times a night. Stress, depression and anxiety are more prevalent during menopause and play havoc with getting to sleep and maintaining sleep. All these factors can create a never-ending cycle of poor sleep leading to development of symptoms which make sleep even more elusive.
Improvements can be made to sleep quality and quantity with a change in diet and lifestyle. A recent meta-analysis and systematic review of 59 scientific studies on nutritional interventions and sleep, showed that isoflavones given at doses of 25mg daily or obtained from consumption of soy and soybeans, had a beneficial effect on sleep. Isoflavones are a type of phytoestrogen found in plants that have an oestrogen-like effect on the body, although their effect is weaker than human oestrogen. Research has shown that isoflavones can be effective in reducing hot flushes and night sweats when consumed in sufficient quantities and on a daily basis.
The most well-known dietary component thought to improve sleep is magnesium. One study showed that taking 500mg of magnesium daily improved sleep duration and efficiency when compared to those taking a placebo. However, other studies have shown inconsistent results and many of the studies are observational studies so a causal link cannot be assumed. What we do know is that magnesium may have a relaxant and anti-depressant effect and may increase melatonin levels (the sleep hormone). More recent research has shown that magnesium regulates energy balance and our circadian rhythm and therefore seems to play a key role in sleep regulation. In terms of getting sufficient magnesium in the diet, I would always recommend trying to get it from food first. We require 270mg-300mg of magnesium per day and rich sources of magnesium include nuts, seeds, wholegrains (e.g. brown rice), legumes (beans and pulses), avocado, spinach, soy, and oats. Eating a varied diet containing plenty of fruit and vegetables and plant sources of protein will ensure adequate amounts are consumed. If you choose to take a supplement, choose magnesium citrate (200-400mg per day) over magnesium oxide, as it can cause bloating and diarrhoea. Magnesium bisglycinate chelate is also available as a supplement to aid sleep and recommended by some sleep experts.
Other supplements that may be effective include melatonin and black cohosh. A meta-analysis of 24 studies found that melatonin supplements improve subjective sleep quality in menopausal women, however, these are not available to buy over-the-counter in the UK. Black cohosh, a plant from the buttercup family, has been found to be effective in improving sleep. However, other research into its effectiveness have been inconclusive and, in some cases, have shown adverse effects on the liver. Bear in mind that supplements are likely to be less well absorbed than dietary sources because the food matrix and interaction of components within foods helps with the absorption of nutrients. Always seek medical advice when considering taking a supplement as they can interact with medications.
Another important nutrient for sleep regulation is the amino acid tryptophan. Tryptophan is converted into the neurotransmitter serotonin which in turn is converted into melatonin. Foods that are good dietary sources of tryptophan include beef, pork, lamb, poultry, and dairy as well as nuts, seeds, whole grains, tofu, and legumes. I would recommend obtaining tryptophan from plant sources to reduce levels of saturated fat in the diet, which is associated with increased risk of heart disease and type 2 diabetes, both of which are more prevalent during this life stage.
Whilst there are plenty of foods that can aid sleep, there are some that can be detrimental and should be limited if you are struggling to sleep. Caffeine is a well-known stimulant and has varying effects on ability to sleep from person to person. Drinks containing caffeine such as tea, coffee and cola should be consumed earlier in the day. A recent systematic review and meta-analysis of 24 studies found that caffeine when consumed 8-9 hours before bedtime had little or no effect on sleep. Alcohol also has a detrimental effect on sleep. Whilst it has a sedative effect such that you have no trouble falling asleep, it usually affects sleep later on in the sleep cycle causing wakefulness later in the night. Limiting alcohol and having several alcohol-free days a week will have a huge positive impact on your sleep quality. Spicy and high-fat foods increase the chance of night sweats and also cause indigestion, both of which can disturb sleep. These should be eaten earlier in the day or several hours before bed-time where possible.
In addition to dietary changes, there are a number of lifestyle changes that can improve sleep quality. A recent meta-analysis and systematic review of 16 randomised control trials (the gold standard of scientific studies) showed that cognitive behavioural therapy, physical activity, and mindfulness and relaxation techniques improved sleep outcomes. Yoga has also been found to be a very effective way to improve sleep as it includes both physical activity and relaxation techniques. Establishing a regular sleep routine helps to improve sleep. Make sure you go to bed at roughly the same time each night and start winding down about an hour before bedtime. Winding down includes avoiding use of electronic devices as the blue light from these devices has been shown to affect sleep. You could try having a relaxing bath, reading a book, or listening to music. If you find that anxiety and stress are hindering your sleep, then try talking to someone about your worries or writing it down in a journal. If you are worrying about all the things you need to do the next day, it can help to write a to-do list before going to sleep. Creating the right sleep environment is important as it makes falling asleep a lot easier. Making sure your bedroom is dark, quiet, and cool is usually the most conducive sleep environment.
Managing sleep problems during menopause can feel challenging, but with the right approach, it's possible to regain restful nights and improve your overall quality of life. By making thoughtful food choices, considering beneficial supplements, and adopting healthy sleep habits, you can mitigate the impact of menopause on your sleep. Remember that each person's journey is unique, so it's important to be patient with yourself and seek professional guidance when needed. I hope these tips help you find a path to better sleep and renewed energy. If you found this blog useful, please share it with others who may benefit from these insights and subscribe to my email list by downloading my free eBook for more advice on health and wellness.
If you would like to have a chat to discuss how I can help you with your health and wellbeing in peri-menopause and menopause then please book an appointment for a complimentary health and energy review by clicking this link https://calendly.com/juliet-nutritionist/30min.
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