Sara Robl Sara Robl

What to do when Perimenopause Hijacks Your Sleep

Insomnia and sleep disturbances is one of the most difficult and debilitating symptoms women complain of during perimenopause.

There is nothing worse than lying in bed wide awake at 3 am, staring at the ceiling, while you worry about the fact that you have a super busy workday ahead of you and won’t be rested. Your hormones have hijacked you again and you’re left feeling frustrated and exhausted.

Lack of sleep makes you feel grumpy, slow thinking and unmotivated. Overtime, chronic sleep deprivation can promote serious long term health concerns including weight gain, high blood pressure, diabetes, depression and suppressed immune function.

Many factors can contribute to insomnia and sleep disturbances. We will cover a few of these today.

  1. Low Progesterone. Progesterone is nature’s valium. It helps us feel calm and balances estrogen. Progesterone is the first hormone to start to decline in perimenopause. In fact, progesterone deficiency may affect 1/2 of all women by age 35. It drops 75-80% from the 30’s through menopause.

  2. High Cortisol. Cortisol is our survival hormone. It helps us kickstart our energy and metabolism in the morning, survive stressful times, run from our lives when we are in danger and acts as an anti-inflammatory molecule in our body. Ideally, we have a healthy surge of cortisol first thing in the morning to get us moving for our day then drops off to allow us to fall asleep at night. When we are under a lot of stress, our cortisol pattern can become dysregulated and cause insomnia. It may also cause us to wake between 2-4 am. High cortisol can cause feelings of anxiety, heart palpitations, mind racing or even panic attacks. For some women, our cortisol can start to RISE when it’s time to go to bed, resulting in the dreaded feeling of “tired but wired”. It is impossible to fall asleep when we have high cortisol.

  3. Hot flashes. Hot flashes can be caused by sudden changes in estrogen, low progesterone, and/or high or low cortisol, imbalanced blood sugars, adrenalin surges, side effects of some medications, excessive vitamin D intake, histamine overload and endocrine disrupting chemical such as phthalates.

    Ways to Balance Cortisol Naturally

    1. Establish a calming sleep time ritual. This may include drinking a calming tea like chamomile. My favorite ritual is taking an Epsom salt bath. Epsom salt is naturally high in magnesium, which is a calming mineral that is absorbed through your skin. Add some relaxing music and a few drops of lavender essential oils and you are well on your way to a home spa treat.

    2. Practice saying NO! We often overcommit and spread ourselves too thin. Learning to say no is a superpower and an invaluable form of self-care.

    3. Getting off of all screens an hour before bed is essential, this stimulates our brain and makes it think it is time to be up and energized. It also interferes with melatonin production, which is our bodies natural hormone to induce sleep.

    4. Avoid alcohol and caffeine. Alcohol may help us fall asleep but once it’s metabolized, it can cause us to wake up. Both alcohol and caffeine can raise cortisol and promote hot flashes.

    5. Practice some mindful breathing, meditation or gentle stretching before bed. Avoid aggressive exercise too close to bed as it can raise cortisol.

    6. Journal out your to do list for the next day. If you can write your tasks and worries out before hand, it will help get them off your mind prior to sleep.

    Stay tuned for our next blog post where I will discuss some supplements that may help you to fall and stay asleep.

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