Why insomnia with menopause

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Abstract The menopausal transition is associated with an increased frequency of sleep disturbances. Publication types Review. Here's what you need to know to get the rest you need.

Insomnia and sleep disturbances caused by hot flashes leave many menopausal women tossing and turning or waking up drenched in sweat. The next day, irritability, anxiousness, fatigue, and trouble concentrating are common.

If menopause symptoms continually keep you up at night, make an appointment to see your doctor. And in the meantime, try these lifestyle changes and smart sleep strategies to rest easy. Sleep disturbances are extremely prevalent and a challenging problem for midlife women, says Steven Goldstein, MD, professor of obstetrics and gynecology at New York University School of Medicine and president of the board of the North American Menopause Society.

In fact, according to the National Sleep Foundation, 61 percent of perimenopausal and postmenopausal women report frequent bouts of insomnia. He explains that sometimes the cause is hormonal changes related to menopause, and sometimes the problem is another age-related health condition such as incontinence or joint pain.

Midlife stresses such as anxiety over work and family can also interfere with sleep. One cause of menopause-related sleeplessness is hot flashes. Fluctuating levels of estrogen and progesterone that occur during perimenopause and menopause can cause hot flashes in about 85 percent of American women.

When they strike during the night, they can wreak havoc on sleep, explains Michael Decker, PhD, RN, an associate professor of nursing and a sleep disorder specialist at Georgia State University in Atlanta. If menopause symptoms such as hot flashes are waking you up night after night, turning down the heat can restore your sleep, Goldstein says. Hormone replacement therapy HRT remains the gold standard in treating moderate to severe hot flashes and other menopause symptoms, but not everyone is a candidate for it.

Women who are at high risk for breast cancer or have a history of blood clots and certain other medical conditions should not take HRT.