The Hormone Sleep Connection

How menopause affects your sleep

Here's a hot flash:

Hormones could be zapping your Zzzzs. Falling levels of female hormones estrogen and progesterone are linked to insomnia.

Progesterone, which drops during perimenopause, is a natural sleeping pill, triggering neurotransmitters in the brain that reduce middle-of-the-night awakenings. Hot flashes- a symptom of drops in estrogen at that time of life- may wake up women. Estrogen also boosts the feel-good neurotransmitter serotonin that helps us unwind- and is converted into melatonin, the brain chemical that promotes shut-eye. Thinner and more irritated bladder tissues may boost overnight bathroom urges. Pain, arthritis, and other health problems during this time can also disrupt sleep.

Approaches to consider

Hormone replacement: “Some women get a response with replacement therapy at low levels,” says Englewood Hospital and Medical Center sleep specialist Jeffrey Salizzoni, M.D. Consult your doctor about estrogen/progesterone pills or patches in the year or two before and after your last period. Some research shows that Prometrium, a plant-derived progesterone-only pill, also helps women sleep more deeply and with fewer interruptions.

Herbal remedies:

Alas, the record isn't promising for most over-the-counter herbals, Dr. Salizzoni says. An exception is melatonin, a natural substance our brain secretes at sunset to make us sleepy. The ideal amount is 150 to 300 micrograms taken three to five hours before bed.

Prescription drugs:

While over-the-counter meds (generally containing antihistimines) backfire because they cause lingering drowsiness, Ambien, Lunesta and shorter-acting Sonata can help you fall asleep. “These are a last resort,” says Susan Zafarlotfi, Ph.D., clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center. “Don't take them for more than three weeks and don't take them nightly. They're habituating, so you form a tolerance, leading you to increase dosages with less benefit.”

Keeping cool

You can short-circuit a hot flash by placing an ice pack under your pillow. Turn over the pillow for instant chill. A cool pre-bed shower also drops core temperature. During the night, open-weave bamboo and non-clingy natural fabrics can wick away moisture. Brands include Select Comfort Lyocell sheets and CoolSets, Cool Nights and DryDreams nighties. Avoid synthetics, silk or wool, which retain water.

Related Read: Menopause? No Sweat!