Anxiety and poor sleep in perimenopause and menopause
Do you find when you go to bed that you're tossing and turning? Perhaps, you just can't relax physically or don't feel comfortable no matter what position you're in. Do you find that you're lying in bed worrying? You're anxious. Your brain's going 20 to the dozen. You're worrying about things that maybe you did or didn't do during the day, and you're worrying about things you've got to do tomorrow. And these thoughts just go on and on. And you find that it's really impossible to calm your mind and switch off.
Anxiety is very common. It's probably the second most common menopause symptom during perimenopause and menopause, in our experience. And anxiety itself has a huge impact on sleep.
Poor sleep is also another really common menopause and perimenopause symptom. Most women will experience some kind of sleep disturbance at some point along the way.
So, let’s take a closer look at how they impact each other.
When your oestrogen is starting to fall in menopause, or when it's fluctuating in perimenopause, this can affect your ability to drop off to sleep quickly. And it can also prevent you from staying asleep and getting into a deep sleep stage.
Now, going into a deep sleep stage or the dream stage (called REM sleep) is really important for our well-being, both physical and emotional. So, if you're not getting that stage of sleep, that can have a huge impact on you the next day, and will make you more vulnerable to anxiety and stress.
If you're going to bed anxious after a really stressful day, or you're getting general anxiety, that's going to compound the problem as well. Not only has your body got to deal with the daytime anxiety, but when it prevents you from falling asleep, you get more and more anxious and wound up, compounding the problem and making getting to sleep and staying asleep even more of a struggle.
You may find too that you might eventually get off to sleep but stress and anxiety will make you more prone to waking up. And low oestrogen causes this too. If you don't get into that deep sleep, then noises and movement will wake you up much more regularly. The low oestrogen will make you much more prone to things like night sweats and flushes during the night, which can also wake you up!
The causes
So, the reason that this happens is, as I've mentioned before, is that your oestrogen starts to fall, and this affects your ability to fall asleep and stay asleep.
Also, as your hormones are fluctuating all over the place, this can impact your nervous system. Lastly, your body can be put under a lot of pressure physically, with all these hormonal changes going on.
The impact on the nervous system makes you much more sensitive to everything else that's going on around you. So, you can end up getting stuck in flight or fight mode. Then, if you've had anxiety during the day, your nervous system is going to be revved up.
When you're in a state of flight or fight, it's your body's way of protecting yourself from danger. Now, when you're trying to get to sleep, if you're in flight or fight mode, you won't sleep because your brain is wired to keep you awake so that you can check for danger all over the place.
You might find that your heart is racing a little bit as well, so you've got all this to contend with when trying to get to sleep, making it practically impossible.
And I know some of you tell me that you're lying awake for maybe three or four hours a night before getting off to sleep, and then you're waking up. So, you're maybe not even getting three or four hours sleep in any one given night, which will compound all your other symptoms as well.
It can be a vicious cycle - if you're getting lots of anxiety during the day, it's going to affect your sleep; and if you don't sleep well, you're going to be anxious the next day. And if this goes on, you're literally in a downward spiral of anxiety and poor sleep; and then comes the fatigue, and the low mood, and everything else that goes with that too.
Tips to help calm night-time anxiety and promote better sleep
So, what can you do to help yourself here?
A good sleep pattern: You need to look at maintaining a regular sleeping pattern. Try to go to bed at the same time every night.
What I found was that, as I like to go to bed early and get up early, I’d go to bed at 10:00 and I'd be lying awake with my brain going round and round in circles until 11:00. So, I thought, right, instead of lying in bed for that hour getting more and more wound up because I can't sleep, I'll stay up an hour later and see if that makes a difference. And that really helped me just to get back into a reasonably good sleeping pattern.
Relax before bed: Try and relax before you go to bed if you can. So, for the last hour, they do say no TV, and things like adventure books. I mean, that's me - I like adventure and crime books! And it's the worst thing you can do before bed, because you're excited, you're revved up, even sometimes you can feel your heart going. And it's the same if you're watching thrilling or scary TV programs.
So, try and cut these out. Do relaxing things instead. Some women tell me they like to knit, sew, or do something very calming before bed. And that can sometimes make a huge difference.
Watch what you eat and drink in the evening: After your last meal, keep off sugar and salty foods, and caffeine, because they will all rev your nervous system up as well.
Do some deep breathing: I can't emphasise enough how deep breathing can make a huge difference to so many different menopause symptoms; so, just get into the habit, because if you do deep, slow breathing, your nervous system calms down and it then can't rev up.
It's impossible for your nervous system to be revving up and calm at the same time. It can only be one or the other. So, getting your nervous system used to being in that calm state with the deep structured breathing can make a huge amount of difference.
Write down your anxieties: So many of you tell me that you do a night-time journal, writing down what's been going on during the day that's worrying you, and then letting it go. I mentioned this in my previous blog about overthinking. And a lot of you came back saying that you do it or you've done it and you found it so helpful. So, five minutes just before you jump into bed, quickly write things down.
Make your sleeping environment as stress-free as possible: I think red is probably the worst colour to have in the bedroom because it's a sign of energy and it can be a sign of anger too. So, try to go for more muted colours.
Make sure your bed is comfy, and that your mattress isn't 10, or 15 years old, especially if you're getting a bit of joint or muscle aches and pains - a good mattress is really important. The right type of pillow will help as well. And if you're getting night sweats, and especially if the weather's really hot, you want to be thinking about the tog of your duvet to make sure that you're not trying to get to sleep when you are too hot.
Try a herbal helper: Look at calming herbs such as valerian and hops. These are in our licensed sleep remedy Dormeasan Sleep.
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The flower essences can be absolutely wonderful as well for shutting off the chattering mind. And I know, for me, the Relaxing Essence was a really helpful one because it helped switch off my brain when it was going 25 to the dozen.
Do some exercise: Get yourself tired before you go to bed, but don’t go mad. We don't want you doing mad stuff that's going to rev up your nervous system; but something like 10 minutes of stretching such as yoga in the evening can be really great. YouTube's fantastic for that. Some of the videos are only five minutes. And if you're really tired, then five minutes is all you need. Stretching yourself, limbering yourself up, can help your muscles to relax that little bit more easily as well.
Try a weighted blanket: Some of you have said that you find weighted blankets really helpful. These are special blankets that are weighted. They are very comforting. They ground you. They hold you into your bed. That can also help you to get off to sleep and have a better night's sleep.
So, I hope you found that helpful. And please, if you have found things have worked really well for you, be it remedies or just things you've done or not done in the evening before bed you have found have really helped your sleep, then please share your stories with us.
Until next time, take care.
You may also find these topics helpful:
Types of anxiety in menopause & what can help
5 menopause symptoms that can impact your sleep
Signs your nervous system is struggling & how to support it better during menopause
