Uncategorized Sleep


Waking up is hard to do

 When women talk about the most difficult and impactful challenges at midlife, sleep is usually in the top 3!  If exhaustion, fatigue, and interrupted sleep are something you’re dealing with, you are not alone! The impact of reduced sleep is profound, leading to irritability, brain fog, depression, and even an increased appetite for carbs. Yes, you’re not imagining that, lack of sleep can absolutely lead to weight gain. This is not just something to put up with try to get by as best you can. There’s a lot you can do to get more sleep, reclaim your energy and get back to enjoying your life.


My patient Kelsey had always been a great sleeper, that is until menopause arrived, and with it, several bothersome tumultuous changes in her life. Besides drenching night sweats, she was much more anxious, had trouble recalling words, and noticed that her irritability was impacting her family. She had a sleep study, tried guided meditation, chamomile tea, hot baths, and eating more bananas for the tryptophan. She tried numerous over-the-counter sleep aids, but no matter what she tried, she only slept 3 hours, woke up, and couldn’t go back to sleep for at least 2 more hours and by then, it was time to get up and start her busy day. Does that sound familiar?


When we talked, she told me that she felt like she was a different person…and really she was a different person after 3 years of fragmented and reduced sleep. 


What is Good Sleep? 

Here’s how to tell if you’re getting enough good, restorative sleep:

– You fall asleep easily within 10-20 minutes

– You stay asleep throughout the night without waking up completely

– If you do wake up or go to the bathroom, you’re able to fall back asleep easily within 10 minutes

– You wake up after 6 – 9 hours 

– You feel refreshed and recharged, ready for your day, or at least can get on track with a cup of coffee or tea 


With smartwatches, apps, and rings that monitor sleep, many more of us are able to see our sleep patterns. While there is a lot of ongoing research and we’re learning more about sleep every day and every night, Let me try to simplify and summarize what we do know about sleep.


Sleep cycles

Throughout the night, when we go to sleep, we have sleep cycles that progress through stages from light to deep non REM Sleep, which is the restorative stage, when our brains are busy repairing and restoring our neurons and removing toxins and the proteins known as beta-amyloids (which are associated with memory loss and Alzheimer’s). After the deep restorative non-REM sleep, we move into the REM or (rapid eye movement sleep) which is when dreaming occurs. Each sleep cycle takes about 1.5 to 2 hours, and as the night progresses, the deep restorative phases of sleep get longer.  This deep restorative sleep can be disrupted by a loud noise, a partner’s snoring, a pet in the room, and of course night sweats. And new research is showing that even women who aren’t having noticeable night sweats are still having disruptions in deep sleep. 


How Menopause Impacts Sleep

It turns out that as our estrogen levels drop at midlife, our brain’s internal thermostat goes a little haywire, leading to bizarre hot flashes, feelings of warmth throughout the day and night. These temperature changes are triggered by the release of “fight or flight” stress hormones, specifically norepinephrine. Even at night, while we’re trying to sleep, our brains are also dealing with small or large releases of those “fight or flight” stress hormones. If the amount released is big enough, we wake up feeling sweaty or warm. And if the amount is smaller, it disrupts our sleep cycles, leading to what’s known as sleep fragmentation and reduced time in deep restorative, non-Rem sleep. 


This is why we feel so fatigued, and start to notice: 

  • An increased appetite and food cravings, especially for carbs
  • Weight gain from a slower metabolism. Reduced sleep leads to our metabolism slowing down meaning we don’t burn calories as quickly or efficiently
  • Irritability and feeling jittery or on edge 
  • Worsening depression and/or anxiety
  • Trouble concentrating and remembering. It’s also harder to stay focused, leading to brain fog
  • Less sexual satisfaction! We’re just too tired. If it’s a choice between sex and sleep, Sleep wins every time!


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Many women have improved sleep high on their list of goals with Menopause Coaching. If you’re ready to work on improving your sleep, and other goals, click here to get started with Menopause Coaching.

Nurse Barb

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Disclaimer: The information provided on this site is intended solely to serve as a guide to Perimenopause and Menopause and to provide basic evidence-based information about the symptoms, long and short-term impact to health, the causes, as well as the risks and benefits of various treatment options.

This site does not claim to prevent, cure or treat any medical disorder or disease. It is designed to inform and support decisions that should be made with your own personal licensed healthcare provider. It is not intended as a substitute, nor should you use this as a substitute for the medical advice and/or gynecologic care given by your own licensed healthcare professional. It is your exclusive responsibility to seek medical care as needed. No pharmaceutical or medical device companies contribute to the content or the cost of providing this education.

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