I’m a doctor, specializing in care of women at midlife. You can best believe that one of the biggest complaints I hear from my patients navigating this path is their struggle with sleeplessness. Are you wrestling with midlife insomnia or nights where you sleep a little, then wake up for no reason, and can’t get back to sleep? You’re not dreaming this up—although you probably wish you were.
I know what’s going on. You’ve tossed and turned, fluffed your pillows 1,000 different ways, tried sleep aids, aromatics, meditation, herbal remedies, and nothing seems to work. You have unfortunately now probably joined The Club. The Club of some 70 million Americans who will struggle to fall or stay asleep tonight. Most of us hitting midlife (yes, I’m right there with you, ladies), will experience various degrees of sleep disturbances ranging from difficulty falling asleep, to waking up frequently, to tossing and turning, and also flat out waking up feeling exhausted. Sadly, this is only likely to get worse as we enter midlife, so figuring out ways to deal with this is important. So here’s my best advice on how to put your sleepless nights behind you.
Get Those Hormones Checked
Your hormone levels begin to gently decrease at the age of about 35, and usually decline more rapidly in your 40s until you hit Menopause. Menopause generally occurs at about the age of 51, when hormone production is at its lowest. This of course isn’t set in stone, and we all take our own journeys to and through menopause, so use these numbers as a guideline. When menopause occurs, progesterone levels decline dramatically and can be the culprit when it comes to your poor sleep.
What to do? Get thee to your doctor! Schedule an appointment with your Gynecologist to have your hormonal levels checked ASAP. I’m biased on this front, but working with a physician who specializes in caring for women at midlife can be pretty helpful, as their practices are focused on exactly the stage you are in your life, so they are on the front lines of midlife care.
Your discussion with your physician of hormonal options should be comprehensive and include a variety of options, including traditional FDA approved hormones, bioidentical FDA and non-FDA approved hormones, which are typically formulated in a compound pharmacy.
The purpose of counseling is to provide you with the hormonal replacement options available to you, the differences in those options, and an overview of the risks, benefits, and alternatives associated with each, so that you can make an informed decision as to what is best for you, based on your own individual history and circumstances.
I find in my own practice, where I prescribe a variety of hormones including bioidentical hormones in patients that have low levels of progesterone, that replacing the progesterone in a slow release capsule at night between 25-125mg seems to help my patients obtain improved sleep in most patients and have dramatic differences in sleep for many. Of course, every patient is unique, and there is absolutely no one-size-fits-all solution when it comes to hormone therapy. You may have to work with your doctor and try different things as you work toward a resolution of your sleeplessness, but if you hang in there, you’ll get there. There is hope! Here are some things to get you started:
Let the Sun In
Get outside! Spending 30 minutes a day minutes in natural sunlight helps to raise your Vitamin D levels and improves your circadian rhythm, which plays a big role in how well we sleep. Even on a cold, wintry day, a brisk walk will get the blood flowing and the fresh air and sunshine will do you good. Be sure to apply sunscreen, even on cloudy days, and protect your skin.
Identifying Triggering Factors—and Fixing Them
In addition to hormonal imbalances, there are many things that can contribute to an inability to sleep—and they’re not the same for everyone. For instance, I absolutely, positively, cannot sleep when there is light in the room or if there is noise I can’t control. Those are my triggers. Knowing what those triggers are allows me to put solutions in place that mitigate those things. Your triggers might be completely different and/or there might be other factors getting in the way of good sleep. Let’s explore.
Setting The Stage for Sleep—Creating The Right Environment
Some contributing factors might be a poor sleep environment, with lighting and/or noise that either precludes sleep entirely or gets in the way of uninterrupted sleep. As I mentioned, this gets me every time. It could also be that your bedroom is too hot, or too cold. These are things you can fix! Once you identify the things that make for a perfect night’s sleep, you can create an environment that promotes sleep. Make your room quiet and dark, even if that means investing in an eye mask or new drapes. Make it cool in there (let’s be serious, what woman at midlife is ever too cold?), and invest in a ceiling fan if you don’t already have one. A sound machine can help block noise if you live in an urban area or can’t control noise around you and can be remarkably soothing once you get accustomed to it.
Medications May Have an Impact
Review your medication list, as common medications can cause insomnia. Blood pressure medication, heart medication, thyroid medication, and cold and allergy medications are all frequent culprits when it comes to sleep disruption. Talk with your doctor about the medications you’re taking and discuss what can be modified to promote better sleeping.
Health Conditions That Might Need Attention
Addressing any health conditions that can affect one’s sleep is important as part of this process, too. Things like as sleep apnea, pain, restless leg syndrome, anxiety, and depression that can also be contributing to sleepless nights. Always be sure to talk with your doctor about these things and work together to try and find a solution. If you’re dealing with mental health issues, there’s no shame in seeing a therapist for help working through them. The more anxiety, stress, and stressors you can either remove or reduce from your life, the better your sleep—and your whole quality of live—will be.
If you’re a shift worker or a frequent traveler navigating different time zones, that can also have an effect on your sleep. There are things you can do to take these variables into account and still get good sleep, so do some research, or talk with your doctor, and come up with a plan that you can put in place.
Resolve to Develop a Sleep Regimen
If your goal is a good night’s sleep, one of the best things you can do is to develop a sleep regimen—get yourself on a schedule, develop a routine, and stick with it. Begin preparing for sleep early in your day, being mindful to not consume caffeine after 12 Noon. Do your strenuous exercise in the morning instead of later in the day, as intense exercise will make you feel more alert. Set a bedtime in your mind, and create an intention to stick to that bedtime.
At least two hours before you plan to go to bed, allow your body to enter a relaxed state. If you need help getting there, climb into some soft PJs, put on soft music, light a candle or two, and maybe pour a glass of wine or fix some chamomile tea. Preparing a warm bath with essential oils such as lavender and Epsom salts for muscle relaxation can also help the body enter a relaxed state.
Bring down the stress of the day by shutting off electronics, cell phones, and plan some quiet time with family, or meditate, reflecting on the day and your many blessings. Adjust your thermostat to about 65 degrees.
When preparing for bed, draw the drapes and darken the room, omitting any outside noises or light. Lastly, there are some herbal remedies that have been used for many years and have been shown to help promote a good night’s rest. Melatonin lets the body know it’s time for sleep, and taking 1 to 3 mg an hour before bedtime is usually what is recommended. Other herbs to consider if you have trouble staying asleep would be Valerian and lemon balm.
Not Sleeping is Not Okay
Insomnia is a relatively common sleeping disorder affecting about one third of the adult population, with some 70 million Americans suffering through sleepless nights. The quality of sleep decreases in midlife and as we age into our elder years. Ten to 20 percent of adults with insomnia will have severe sleeplessness. There are serious consequences to chronic severe insomnia, including decreased performance, increased stress, contributing to chronic illness such as diabetes, obesity, depression, and cancer. Insomnia is also a major factor in sleep- related road crashes that cause countless injuries and fatalities. Botton line, not sleeping is not okay! If you’re suffering from insomnia, you can rest assured it is greatly impacting your health and well-being and should be addressed with your doctor immediately. Work with your doctor to put a treatment plan in place and forcus on getting yourself back to sleeping like a baby. It can happen, and it will!