Many women who reach midlife encounter new, often unwanted changes in their wellbeing. This blog looks at why you may wake in the early hours, feeling wired or needing the toilet or even starting the day at 4 am.  Let’s dive a bit deeper into Perimenopause and sleep disturbance.

Oestrogen & Progesterone

When we hit our forties, oestrogen is on the decline. A gradual reduction of this hormone doesn’t tend to cause severe deficits in sleep, it’s the erratic peaks and troughs though, that can. Oestrogen decline causes us to become more sensitive to temperature change, whilst progesterone impacts sleep quality and remaining asleep.

Cortisol

Cortisol, one of our stress hormones, may peak between 3 and 5 am during perimenopause, causing a feeling of anxiety, being wired or just simply wide awake. Our circadian rhythm may also change during these years with lighter sleep experienced in the later hours of the sleep cycle.

Neurotransmitters such as serotonin and GABA are also impacted by a reduction of oestrogen. This is the aspect that triggers racing thoughts, running through what you did or didn’t say or do, or planning for the next day’s meeting or event.

Blood sugar

Blood sugar balance plays a role in our circadian rhythm and sleep quality too. Sugar spikes after eating late at night can cause crashes in blood sugar in the early hours, waking us up for this biological & physiological ‘Witching Hour’.

Alcohol

Alcohol metabolism peaks around 4-6 hours after your last drink. When blood alcohol levels wear off, cortisol and adrenaline are released, waking us up. The perimenopausal brain, lower in oestrogen is already sensitive to cortisol levels, making alcohol more of a triggering factor for night sweats & sleep disturbance. Read more about alcohol and menopause in my article here.

10 Things that help sleep quality during perimenopause.

1.       L-theanine or passionflower supplementation to support calming of the mind

2.       Consistent bedtime routines & no clock checking on waking

3.       Temperature control – layers that can be removed or added easily

4.       Reduction in caffeine and none after 3 pm

5.       No late-night sugary snacks – choose complex carbs, protein and healthy fats if you must snack before bed

6.       Magnesium supplementation and a general multi vitamin & mineral if you have a poor, restricted or vegan diet

7.       No alcohol after 7 pm & drink with food

8.       Avoid high intensity workouts after 6 pm

9.       Journal or capture your thoughts and plans in writing to clear your mind before sleep

10.  Consider body identical HRT if sleep disturbance is severe and the above doesn’t improve quality of life as much as you’d like.