Tips for beating insomnia related to menopause.
Sleep always sidestepped Nancy Wurtzel, 55, of Westlake Village, Calif. But when menopause hit four years ago, slumber became a distant memory. “By 2 a.m., I’d know I wasn’t getting to sleep,” Wurtzel says.
For Julie Rominger, 56, of Wilmington, Del., tossing and turning became her new hobby four years ago: “I called 3 a.m. ‘the witching hour.’”
Who can sleep with hot flashes and night sweats, the NoDoz of menopause? For at least 40 percent of women, menopause becomes an alarm clock that accompanies estrogen decline. And 75 percent of women get hot flashes, sleep robbers that also arrive with falling hormone levels.
But other less obvious thieves are at work on menopausal sleep. Estrogen production is driven by the pituitary gland, which in turn is ruled by the hypothalamus, part of the brain that lies close to its sleep center. “As the ovaries poop out, the hypothalamus drives the ovaries to produce more estrogen,” explains Dr. Mary Jane Minkin, Yale University medical professor and author of A Woman’s Guide to Menopause and Perimenopause. “That’s like a factory whistle going off near the sleep center.”
For Wurtzel, sleep finally came after three sessions of hypnosis. Rominger now wakes only three nights a week instead of every night, primarily because she exercises every day and meditates for five to 10 minutes before bed. If she wakes, she drinks a tea containing the herbal relaxant valerian root. Of these remedies, exercise and valerian are the only ones backed by research. Minkin’s response to the others? “If they work, terrific.”
Recording when you go to sleep, when you wake, which remedies you try and what works can be useful, says sleep researcher Dr. Mary Jane Minkin. “People feel better just knowing they have a consistent pattern.”
Yale’s Dr. Mary Jane Minkin particularly likes RemiFemin Good Night, calling this product the best-regulated, most effective black cohosh formula. Black cohosh is an herb noted for relief of hot flashes. She also recommends Benadryl, a sleep-inducing antihistamine, as well as “PM” products like Tylenol PM. Prescription sleep aids like zolpidem (Ambien) can also be helpful, she says. But don’t rely on prescription sleep aids every night, or you may not be able to sleep without them.
Chucking the bedclothes
“Going to sleep with the barest minimum on does help,” Julie Rominger says. Keep a change next to the bed, Minkin says: “If you wake up sweating, you can put on something clean and dry.”
Several studies have indicated that valerian improves sleep, Minkin says. Valerian is available as an extract, a tea or in capsule form. Follow dosage directions on the package.
“It can be very effective for hot flashes,” says Dr. Nicholas Rummo of the Center for Sleep Medicine at Northern Westchester Hospital in Mount Kisco, N.Y. “Taking it for a year or two is not associated with cancer risk, but you don’t want to use it for 10 years.”