By Dr. N. Ramakrishnan
Postmenopausal years & insomnia:
In the years following menopause, sleep grows lighter and more fragmented. It becomes more difficult to maintain long hours of uninterrupted sleep and to maintain long hours of wakefulness during the day.
An increase in daytime fatigue can be one result. Other physical factors can also disturb sleep; arthritis and other painful conditions, chronic lung disease, certain medications, heartburn, and increased frequency of urination.
Some sleep disorders occur frequently in the postmenopausal years. For example, sleep-disordered breathing – uncommon in young women- is much more common in postmenopausal women.
This may be related to falling progesterone levels, since younger women who experience surgical menopause are also at increased risk of developing sleep-disordered breathing. Higher body weight and lower levels of physical activity are also risk factors for this syndrome. Signs of sleep-disordered breathing include loud snoring during sleep and excessive daytime sleepiness.
Other factors that influence the quality of sleep in postmenopausal women are the psychological environment, physical health and emotional state. The connection between worry and insomnia may be obvious, but at times subtle signs and concerns can be less visible in their influence on tension and insomnia.
- To promote better sleep during the postmenopausal years, women should follow these guidelines:
- Maintain a comfortable, safe environment in the bedroom; reduce disturbing noise and extreme temperature.
- Go to bed and get up at the same time every day.
- Avoid staying in bed late in the morning to make up for sleep loss
- Get up early in the morning and maintain structure daily activity.
- Stay away from fatty, spicy foods that are likely to cause indigestion or heartburn.
- Seek medical advice if following these measures do not alleviate excessive daytime sleepiness.
Emotional issues continue to impact sleep in women of all age groups. Two conditions worthy of mention are depression and nocturnal eating syndrome.
Insomnia is one of the most common symptoms of depression at any age. Women who are depressed tend to fall asleep fairly quickly but often awaken in the middle of the night, unable to go back to sleep. Insomnia may be interpreted as the cause of the depression – “If I could just get more sleep I would not feel depressed” – but getting professional help and treatment for the depression can often solve the insomnia problem.
Nocturnal Eating syndrome
Some women wake up in the middle of the night and feel that they are unable to go back to sleep until they eat. Unless there is a medical cause (such as an ulcer), this type of problem is typically associated with dieting during the day.
Occasional disturbances in sleep can happen to anyone, and generally, do not require medical intervention. Serious sleep problems, however, can affect a woman’s daily functioning, her relationships, and her sense of well-being. When a sleep problem results in a disruption in one of these areas, it may be wise to consult with a healthcare provider.
Women are particularly sensitive to sleep difficulties because they are affected by hormonal changes, family stresses and role conflicts, any of which can affect sleep quality.
Guidelines for good sleep:
Following some general guidelines can be helpful in alleviating all types of sleep problems:
- Get up about the same time every day
- Go to bed only when sleepy
- Establish relaxing presleep rituals, such as a warm bath, light bedtime snack, or 10 minutes of reading.
- Exercise regularly. Consult a healthcare provider before beginning an exercise program. Confine vigorous exercise to early hours, at least six hours before bedtime, and do mild exercise – such as simple stretching or walking – at least four hours prior to bedtime.
- Keep a regular schedule. Regular times for meals and other activities help keep the inner clock running smoothly.
- Avoid ingestion of caffeine within six hours of bedtime. Don’t drink alcohol, especially when sleepy. Even a small dose of alcohol can have a potent effect when combined with being tired.
- Avoid smoking close to bedtime.
- Avoid self-medication with sleeping pills.