Do you wake up several times a night with a sudden flash of heat in your face and chest? Have you noticed feeling more depressed and that you’ve lost interest in doing things that normally brought you joy? Have there been shifts in family dynamics, such as your kids headed off to college or aging parents needing more help? These are a few factors why midlife women struggle with sleep more than younger women. Keep reading to find out how they play a role in causing insomnia for women in midlife.

Changes in reproductive hormones 

The average age of perimenopause in the US is 47 and fluctuating hormones during this time can cause a laundry list of physical and psychological concerns. Difficulties with sleep is high on this list. Data from the Study of Women’s Health Across the Nation (SWAN) found that the most common sleep concern was frequently waking up at night. Hot flashes and night sweats are a big reason for this. However, not all women who have insomnia suffer from hot flashes. 

Low levels of estrogen are also seen in women with poor quality sleep in perimenopause. Women who have had their ovaries surgically removed report worse sleep than those who go through natural menopause. This is likely due to the abrupt decline of estrogen levels without having ovaries.¹

Changes in mental health

With age and the inevitable state of perimenopause, women are more vulnerable to be diagnosed with depression and anxiety than in adolescence or young adulthood.²  When we don’t sleep well and are exhausted, our desire to do things that normally give us pleasure and enjoyment is very low. This is when depression can set in, and insomnia is a symptom of depression. 

Excessive worry and anxiety can also disrupt our sleep, thus leading to insomnia. People who have anxiety can have a heightened arousal system that negatively impacts our ability to fall asleep at night. Just like with depression, when we don’t get adequate sleep and rest, our anxiety worsens. If we are unable to get our anxiety under wraps, it can lead to an endless cycle of poor sleep, insomnia, and consequently, leave us feeling exhausted during the day.  

Changes in your family and personal life

Let’s face it: in many cultures, women are the caregivers for their family and sometimes even extended family. When we enter perimenopause, it tends to clash with the same time period where our parents are aging and possibly developing health problems, and our kids are becoming teenagers or flying the coop. Similarly, you may be at the height of your career, feeling burned out, or retirement may be on the brain.

As our bodies transition to the end of the reproductive phase, our families, careers, and friendships may also be transitioning. For some, this can lead to excess stress, ruminating thoughts, disrupted sleep, and subsequently, insomnia.

When should you seek help?

We all have difficulty falling and staying asleep from time to time — however, that doesn’t mean we all have insomnia. If you have trouble falling or staying asleep at least three times a week and this has been occurring for more than three months, and you feel unwell during the day, it’s time to speak with your doctor. You can go over treatment options together. 

On the other hand, if you already know you’re an insomniac, and your insomnia is debilitating and you’re experiencing alarming symptoms such as suicidal thoughts, psychosis, or falling asleep while driving, please seek out professional help immediately. Any sleep difficulties that cause negative effects on work, your relationships, or health should also be addressed. 

You can search the Society of Behavioral Sleep Medicine’s directory to find a licensed sleep therapist in your state, just follow this website: https://www.behavioralsleep.org.

Please visit www.sleephoria.health for sleep education and more information about how to end exhaustion through better sleep. 

References:

1. Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep. 2018;10:73-95. Published 2018 Feb 9. doi:10.2147/NSS.S125807
2. Stephanie Mulhall, Ross Andel, Kaarin J. Anstey, Variation in symptoms of depression and anxiety in midlife women by menopausal status, Maturitas, Volume 108, 2018, Pages 7-12, ISSN 0378-5122, https://doi.org/10.1016/j.maturitas.2017.11.005.