What Really Helps With Insomnia During Menopause?

 “Insomnia around menopause is a very distressing symptom that also occurs very frequently,” says Dr. Judith Bildau, gynecologist and author of “Out of the Hormone Carousel.” A great many women from premenopause onward suffer from difficulties falling and staying asleep. But what helps against sleep disturbances during menopause?

Sleep Disturbances During Menopause? The Consequences of Sleep Deprivation

As with all symptoms in and around menopause, hormones play a central role, including in sleep problems. Dr. Judith Bildau explains: “The reason for restless nights is the hormonal changes, especially the female sex hormones estrogen and progesterone. Estrogen improves deep and REM sleep, while the breakdown products of progesterone have a calming and sleep-promoting effect. When the levels of these hormones drop, it can naturally have a direct impact on sleep.”

Problems falling or staying asleep can have far-reaching consequences beyond restless nights, which can also be noticeable during the day. Laureen Erichson-Kirst (a doctor in training in gynecology) explains that “sleep deprivation can lead to other symptoms such as concentration difficulties, irritability, and even depressive moods.” Sleep deprivation or sleep problems have a significant impact on women’s daily well-being and work ability.

Treatment of Sleep Problems

“Even though sleep problems in pre-/peri- and postmenopause are one of the most common symptoms of an imbalanced hormone system, this deficiency cannot always be detected in lab values,” explains expert Erichson-Kirst. Before treating hormonally induced sleep problems, other possible causes must be ruled out, such as emotional issues or any pre-existing conditions of the patient that may be robbing her of sleep.

For sleep disturbances, especially in premenopause, Erichson-Kirst recommends “high doses of chaste tree. The plant-based active ingredient helps stabilize hormones. If necessary, melatonin is also a good option to help you fall asleep again. In postmenopause, however, a progesterone preparation can help alleviate sleep problems.” Erichson-Kirst also notes that hormone replacement therapy, which today primarily uses bioidentical hormones, is intended not only to alleviate menopause symptoms but also to reduce secondary diseases caused by hormone deficiency, such as osteoporosis and vascular diseases.

Healthy Sleep Hygiene

It is not only women in menopause who benefit from sleep hygiene. Adequate and healthy sleep is essential for health and quality of life. Above all, a sustainable evening routine, stress-reducing behavior patterns, and herbal remedies help.

Turn off electronic devices with artificial light in the evening, such as tablets, smartphones, computers, TVs, e-readers, or video game consoles. The screens of these devices produce blue light, which in turn disrupts the production of the sleep hormone melatonin and can delay the natural sleep time by up to three hours.

Avoid evening workouts and instead ensure sufficient physical activity during the day, preferably outdoors, gynecologist Judith Bildau also recommends. Strenuous training should take place at least four hours before bedtime—not later. Intense exercise stimulates the cardiovascular system, releases stress hormones like adrenaline, and makes it harder to fall asleep. If time doesn’t allow otherwise, opt for relaxing, gentle workouts like yoga, Pilates, or Tai Chi in the evening, which also reduce stress and thus even promote sleep.

Effectively Combat Sleep Disturbances During Menopause

Try meditation or muscle relaxation exercises to help you fall asleep as part of an evening routine. By sticking to the routine, you send signals to your body to “wind down.” Your body automatically knows that the nightly rest phase is beginning. Help your body by starting the routine at about the same time every evening and getting roughly the same amount of sleep each night (seven to nine hours). Also, avoid heavy meals in the evening, skip high-fat meals, and opt for Mediterranean cuisine instead.

If you suffer from sleep problems, you should avoid consuming caffeine from the afternoon onward. Caffeine can also inhibit melatonin production. According to Dr. Bildau, in addition to herbal preparations from valerian, lemon balm, hops, or passionflower, strategies from cognitive behavioral therapy can also help against chronic sleep problems. This involves analyzing individual sleep disturbances, creating sleep-wake logs, and regulating sleep behavior with timed sleep restrictions.

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