For many women, menopause becomes the ultimate sleep challenge. And that loss of sleep can leave you feeling fatigued, confused and mighty irritable the next day, raising your risk of injuries and certain health conditions like high blood pressure, heart disease, diabetes and even obesity, according to the Mayo Clinic.
In his book, Sleep for Success, James Maas reports that 66 percent of women around menopause complain of difficulty falling asleep and staying asleep. But there are some things women can do to help themselves sleep better.
During sleep, hot flashes can create intense sweating, known as night sweats. While they decline over time, they can linger for 10 years or more—although on the average, they last for three to five years, according to the North American Menopause Society.
To Sleep Better: Your temperature may be rising, but dressing light in moisture-wicking fabrics can help you beat the heat. Dressing in layers may be an option for women whose body temperature unpredictably fluctuates, says Harvard Health Publications. Keeping your bedroom cool (between 65 and 68 degrees F.) and well-ventilated can go a long way toward keeping your cool during that sudden heat surge. Another tip: Become buddies with bedding that breathes, like Lyocell pillowcases.
You wake multiple times each night with a loud snort or choking sound. Your breathing pauses or becomes shallow, sending you in and out of deep sleep. The North American Menopause Society reports that sleep apnea is more likely to occur midlife in women.
To Sleep Better: If you’re dragging in the morning, or your partner confides that you’ve been making some strange and disturbing sounds during the night, sleep apnea may be a culprit. Consider a sleep study, the only test that can diagnose the problem.
Your frayed nerves can easily lead to insomnia, and it’s not uncommon during menopause to suffer from mood disorders, especially depression and anxiety, as reported in a study published in the Journal of Clinical Sleep Medicine.
To Sleep Better: Before bed, relax and unwind with some yoga or meditation. Or ask your partner for a massage, which can be a nice sleep-enhancer. A small study in the Journal of Holistic Nursing found that just three minutes of a slow back massage helped women get an extra 36 minutes of sleep compared to women who didn’t get the hand’s-on treatment. Hormone replacement therapy has also been used to treat insomnia in menopausal women.
Women might wake up to use the bathroom more frequently, especially during menopause, according to the Cleveland Clinic. Nocturia, which becomes more common with aging and menopause, makes it difficult to have a normal sleep cycle, notes the clinic.
To Sleep Better: Empty your bladder before you turn in for the night. In the evening, limit your consumption of liquids, especially alcohol, coffee and any other caffeinated beverages.
With these tips, menopause may not have to mean saying goodbye to a good night’s sleep.
Is it better to get fewer hours of uninterrupted sleep or more hours of interrupted sleep?
When it comes to your mood, the former is actually better. Recent research from Johns Hopkins University published in the journal Sleep has shown that people who get interrupted sleep end up in a much worse mood than those who get less, but uninterrupted, sleep and those who get a good amount of sleep.
Researchers randomly assigned 62 men and women to one of three groups for three days. An interrupted sleep group was forced to wake up several times throughout the night by nurses during the course of 8 hours. A delayed bedtime group was allowed to sleep uninterrupted for 3 hours. Subjects in the normal sleep group got to sleep uninterrupted for 8 hours.
Everyone who participated in the study was asked to take a mood survey before and after the sleep trial, which asked them to rate how much they felt a variety of positive and negative emotions.
After the first night, those who were forced to wake up often showed similar levels of positive and negative moods to the group of people who went to bed later. But after the second and third nights, the forced awakening group reported a 31 percent reduction in positive mood (including feelings of sympathy and friendliness), while the delayed bedtime group reported a 12 percent reduction in positive mood. Researchers also found that the group who had interrupted sleep experienced shorter cycles of deep slow-wave sleep, which is the non-dreaming phase of sleep important for body repair and memory consolidation.
“When your sleep is disrupted throughout the night, you don’t have the opportunity to progress through the sleep stages to get the amount of slow-wave sleep that is key to the feeling of restoration,” says the study’s lead author, Patrick Finan, in a press release.
Dr. Morrie Nille, a sleep psychologist based in Maryland, says that he sees this in real life with his patients.
“When you frequently wake, your body never gets the chance to go into the deep sleep that your body needs to feel well rested and then you get cranky,” he says.
For the average sleeper, this means it’s probably better to stay up to finish studying rather than waking several times in the night and working. Try to avoid on-call work if possible. If you’re a parent to a newborn, see if your partner can take turns taking care of the baby. Eliminate distractions from your bedroom that might wake you in the middle of the night.
Given the choice, the research shows that you should probably opt for shorter, uninterrupted sleep rather than longer, interrupted sleep.
Your friends and family may thank you for it.
Breathing is the foundation of human life, yet so many of us breathe incorrectly. Poor posture, too much sitting and a cultural tendency to hold our breath all contribute to shallow “neck breathing,” which can be detrimental to sleep and, therefore, overall health.
Neck breathing is characterized by short, shallow breaths—you may notice your chest, not your abdomen, rising or expanding. The problem is that this breathing pattern inhibits the diaphragm, the sheet of skeletal muscle that makes room for your lungs to expand with oxygen, and then contract, expiring carbon dioxide.
Neck breathing can also cause unnecessary stress by triggering the body’s fight-or-flight response. In his book, Deskbound: Standing up to a Sitting World, Dr. Kelly Starrett explains how short, shallow breathing increases tension and alertness, neither of which will help with a good night’s sleep.
“The ability to recognize stress breathing and react with the appropriate stress hormones is a useful adaptation when you’re chasing dinner prey or defending your babies against lions,” Starrett says. “But just as drinking coffee all day long impairs your ability to wind down and go to sleep, so too does the stress signal that you are sending to your brain throughout the day by neck breathing.”
Alternatively, deep breathing that engages the diaphragm tells the body’s nervous system that no imminent threats are present, and that it’s okay to relax. “Deep abdominal breathing encourages full oxygen exchange—that is, the beneficial trade of incoming oxygen for outgoing carbon dioxide,” according to Harvard Health Publications. “Not surprisingly, this type of breathing slows the heartbeat and can lower or stabilize blood pressure.”
Steps for Effective Breathing
Are you guilty of neck breathing? Starrett recommends using this diaphragmatic breathing exercise to relax before bed and teach yourself to breathe efficiently:
- Lie on your back. This can be done in bed, but the floor or a firm surface is preferable. Bend your knees and place the soles of your feet on the ground in front of your hips.
- Rest your hands on your belly, near your navel.
- Slowly breathe in through your nose. Direct the air into your belly. You should feel your hands rise as your lungs fill with air.
- Exhale slowly through your mouth or nose. Notice how your hands move downward as your diaphragm pushes carbon dioxide out of the lungs.
- Repeat slowly for 5 to 10 minutes. Your hands should continuously rise and fall with your breaths.
While this breathing exercise can help your bedtime routine, you can do it any time you catch yourself breathing shallowly or holding your breath. While lying on your back aids relaxation, diaphragmatic breathing can also be practiced sitting or standing. Just place your hands on your belly and follow steps three through five.
Playing sports takes a toll on athletes’ bodies — and on their sleep.
“Challenges include overcoming stimulation from the excitement and arousal from night games, controlling pain from injuries, reducing accumulation of sleep debt from late night games and early practices, and limiting disruption of circadian rhythm from frequent travel,” explained Dr. Jonathan Saluta, an orthopedic surgeon at Good Samaritan Hospital in Los Angeles. “Sleep along with nutrition are two of the most important factors influencing athletic performance and recovery.”
Every team and individual sport requires both physical prowess and mental focus. In football, for example, poor sleep reduces a player’s ability to adapt quickly to unfolding plays on the field, said Daron Roberts, who spent five years as an assistant coach in the NFL for the Chiefs, Lions and Browns.
“The NFL game really hinges on adjustment, having the awareness to see a formation or play and not just react, but to be able to change between different offenses or defenses between plays,” Roberts said. “If these guys don’t get enough sleep and they’re sluggish, that could cost us a really big play.”
Two things drive sleep, says Hugh Fullagar, a sport science coordinator at the University of Oregon, who studied the effects of going to bed earlier for elite soccer players. One is the body’s need to rest after being awake a long time, and the other is the circadian rhythm, the body’s internal clock, influenced by light exposure. “When athletes encounter disruptions to their environments, circadian rhythms and normal sleep-wake cycles can become de-synchronized,” Fullagar says.
These five factors can interrupt sleep cycles and make it harder to get adequate shut-eye:
- Late night games. Playing games later in the evening can undermine sleep several ways. “The most obvious issue here is that when a player is attempting to sleep, the activity at night itself and post-match activities delay the time at which a player goes to bed,” Fullagar says. “These later bedtimes invariably result in shorter sleep durations.” Physiological reasons play a role too. Peak athletic performance occurs between 5 p.m. and 8 p.m., he says. Playing later raises the heart rate and the body’s core temperature, which might make it harder to fall asleep.
- Nighttime light exposure. Night games also mean bright floodlights on the field, or bright indoor lighting for other sports. Light represses melatonin, the hormone that tells the body to sleep. “Bright light exposure decreases sleepiness, increases alertness, and attenuates the nightly drop in core body temperature,” according to one study published in the journal Sports Medicine. For top-level athletes going to press conferences after games, camera flashes and other lights add to the problem. So does using smartphones and other devices whose light has also been shown to delay melatonin release.
- Travel, jet lag and erratic schedules. Most elite athletes travel for games, and that often means crossing several time zones. Jet lag “generally takes about one day per crossed time zone to adjust completely,” states one study from Sleep Medicine Reviews. That’s not always possible during intense season schedules. The same study noted that traveling eastward can be more difficult to adjust to than traveling westward, though it depends on when games occur. Variation in practice times, game times and time zones also make it hard to maintain a consistent sleep schedule, which is key to good sleep hygiene.
- Game and post-game experience. What happens during or after games matters too. Winning can be so exciting it prohibits sleep. Losing can lead to stress, tension and a bad mood, which can also interfere with sleep. Anxiety before a game might affect some players, Roberts says, and players injured during a game may have trouble sleeping because of pain.
- Lifestyle choices. Of all these reasons, athletes have the most control over lifestyle choices affecting sleep. Caffeine ingested up to 6 hours before bedtime impairs sleep, yet players often chew caffeinated gum or swig energy drinks at halftime. Drinking alcohol in post-game celebrations also disrupts sleep. Though it may be tempting to unwind with a movie or by playing games on a smartphone or tablet, the light exposure and shift in focus make it harder to quiet the mind and begin getting those ZZZs.