Help, I Can't Sleep!

Next to hot flashes, insomnia is one of the most common complaints of peri– and post menopausal women. More than just a complaint associated with menopause, insomnia can have many detrimental affects on our bodies. Insufficient sleep increases our levels of corticosteroids and catecholamines - stress hormones. This increase in stress hormones can throw off overall hormonal balance, depress the immune system and increase our feelings of anxiety. For optimal health, it is important to get an adequate amount of sleep each night. So, we must look for the cause of the insomnia so that it can be treated appropriately.

Most women assume that their insomnia will disappear once hormone therapy begins. While this does occur for some women, many others find that insomnia persists despite hormone therapy. The type of hormone replacement therapy and strength can make significant differences in the incidence of insomnia. Researchers have found that women on synthetic hormones often have sleep problems. A study of sleep patterns in women receiving Premarin plus Provera or Premarin plus natural progesterone showed a significant increase in sleep efficiency in the group receiving natural progesterone. Insomnia can be a symptom of excess estrogen and/or deficiency of progesterone. Estrogen and synthetic progestins (like Provera) increase brain excitability while natural progesterone has a calming affect on the brain. Switching to natural hormones or adjusting dosages maybe helpful. If hormone levels are fine but insomnia still persists, then other issues need to be evaluated.

Insomnia can result from a wide variety of other causes, including low blood sugar, muscle aches, indigestion, breathing problems, anxiety, stress, grief, depression, jet lag or caffeine. Many medications can cause insomnia such as decongestants, appetite suppressants, most antidepressants, thyroid medications and others. Check with your physician or pharmacist about your prescription and over the counter medications.

Once medications and hormonal imbalance have been ruled out as causes of insomnia, then emotional issues may come into play. Emotions are the biggest reasons for insomnia. Are you worried, anxious, sad? Are you upset about your relationships or career? These issues may need to be resolved in order to beat the insomnia. Still don't think that emotions could be affecting you. Physicians report that women with trouble falling asleep, who have light, fitful sleep and disturbing dreams may have anxiety. Alternatively, women who fall asleep easily, but awaken during the early morning hours and can't get back to sleep are likely to be depressed. You may need to take an honest inventory of what's on your mind before you can get past the insomnia.

Whatever the reason for your insomnia, you may find one or more of the following helpful.
• Magnesium chelates 200-400 mg 1 hour prior to bedtime.
• Melatonin 1.5-6 mg 1 hour prior to bedtime.
• 5-hydroxytryptophan (5HTP) 300 mg at bedtime. Do not take with medications that affect serotonin like Paxil, Zoloft, Prozac and others.
• Avoid caffeine containing beverages after lunch.
• Avoid alcohol. While alcohol may help you fall asleep, it actually disrupts the sleep mechanism causing rebound insomnia.
• Avoid tobacco. Nicotine stimulants the brain and can cause sleep problems.
• Do not take naps. You may not be sleepy later.
• Exercise regularly. Regular exercise helps you sleep better, but don't exercise an hour or two before bed.
• Go to bed and get up at the same time every day. Maintaining a schedule will train your brain and body to sleep soundly.
• Avoid eating late. Eating foods that increase insulin levels can result in sleep disturbances.
• Develop a sleep routine. Read, listen to music, meditate prior to bedtime nightly.
• Avoid stress one hour prior to bedtime. Try to wind down about an hour before turning off the lights. Paying bills or family discussions just prior to sleep will not result in a restful night.
• Create a bedroom environment that encourages sleep. Don't use your bed for activities other than sleep or sex. Keep the room dark and at a comfortable temperature. A cold room is better than a warm room for sleep.
• Improve your sleeping surface. Beds don't last forever, it may be time for a new bed.
• Check your partner's sleep habits. Does he snore? Is he restless? Do you harbor resentment against this person? You may need to sleep in another room until your sleep problems resolve.

Disclaimer

The viewpoints expressed in this newsletter are based upon scientific research, and the personal and professional experience of the authors. They are not intended as a substitute for consulting with your physician or other health care provider. You should consult with your healthcare practitioner prior to starting any vitamin, herbal or other therapies.

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