You Can't Solve Sleep Issues Overnight
How to sleep better in perimenopause and beyond
Are you up Googling? I purposely scheduled this newsletter to be sent to my subscribers at 3 a.m. assuming that many were up at that hour. If you’re here for the same reason, I want you to know that you're not alone in this struggle.
How to Sleep Better during Perimenopause
Sleep issues in perimenopausal women are not due to a lack of awareness that sleep is important. We know, we know ALL about it. It would be insulting to your intelligence if I used our time together to talk about why sleep is important. But if you want a refresher, please read naturopathic sleep doctor Dr. Catherine Darley’s article “Why Sleep?”
As with anything perimenopause-related, there are so many reasons why sleep escapes us, and each body is going to be different. I’m like you; I wish it was a one-size-fits-all type of thing, but that’s not how our human biology works with everything.
We need to be our own mystery shoppers, carefully picking up and looking at each reason we can’t sleep to see if it applies to us. Inspect it closely and be honest with your assessment. Are you a 5-star midnight snacker 🍕? Do you jump on your phone the moment you wake up during the night? Are you lying in bed ruminating over something that happened?
Once you determine the cause or causes which I’ll discuss in a minute, you can begin to work on habits one at a time that will bring better sleep into your life. I’ll stress here one at a time because if you try to take on too many fixes at once, you’ll overwhelm yourself and you won’t know which one(s) is helping you.
Let’s Sleep On It
First, let’s talk about what makes good sleep. I’ll share some facts about sleep that are important to know in order to help yourself from developing “sleep performance anxiety.”1
We all want great sleep, but when we don’t get it, we feel lagging, tired, and foggy. I believe that the creation of Oura rings (and other sleep-tracking devices) is fueling our sleep performance anxiety. We’ve never had this much data about our sleep before. I do not own one of these devices for this reason. I would make myself crazy trying to chase the perfect zzzz’s.
“The healthiest body is one you listen to.”2 - Dr. Lindsey Berkson
I love this quote by hormone specialist, Dr. Lindsey Berkson “The healthiest body is one you listen to.” Your body will send you signals, but you’ll have to pay attention and teach your body to trust that you’ll listen and act on it. For example, if you constantly ignore the signal that you need to use the bathroom your body will speak back in ways you don’t want to have to deal with.
Here’s what a good night should look like:
One full sleep cycle is 3 non-REM movement stages and 1 REM (dream) stage. Each cycle lasts about 70 – 120 minutes with later in the evening cycles typically lasting longer. “A person will typically go through 4 - 6 sleep cycles per night, although the duration of each stage may vary.”3
Some say that most brain/body cleaning and maintenance activities happen between 10 p.m. – 2 a.m. The European Heart Journal research says that going to bed between 10 – 11 has shown a reduced risk of heart and circulatory diseases.4
You may wake naturally several times a night during these cycles, usually at the end of a sleep cycle. You may drift back to sleep without realizing it or it may wake you up enough to use the bathroom.5
·You can wake up to use the bathroom once a night without the medical world wanting to label it. Peeing more than once a night becomes a medical term called “nocturia” and peeing a large amount of urine (volume in mL) is called “polyuria.”6 If this is happening, I suggest you visit your primary care doctor or if you have one, your urologist. Stress can cause frequent urination and polyuria, I’ve experienced it myself, but so can other things. Best to get it checked.
“Your body's internal clocks are in sync with certain cues in the environment. Light, darkness, and other cues help determine when you feel awake and when you feel drowsy. Artificial light and caffeine can disrupt this process by giving your body false wakefulness cues.”7
Everyone needs their own “perfect” amount of sleep. Experiment and see where your sweet spot is. For me, I have to get to bed by 10 p.m., and I need 6 – 8 hours of sleep cumulatively. If I miss this plan once, I’m fine, but I can’t do this for multiple days at a time without consequences (increase in frain bog 😁, cranky patties, hungry horrors). Also, if I go to bed too early, I’ll be up at 2 a.m. wide awake. When I go to bed before/around 10, I can usually sleep through until 5 a.m. before I have to get up to use the bathroom.
My husband, on the other hand, can go to bed at 8 p.m. and sleep until 6 a.m. the next morning. Must be nice. I’ve often wanted to kick him awake in his Arctic protection sleep cocoon to join the misery. My name for this is Sleeping Husband Syndrome (or Sleeping Partner Syndrome). I think I’m on the right track, check out Maggie Jon’s podcast called “Why Kicking Someone Improves Your Mental Health.”
When things go awry, sleep problems include:
difficulty falling asleep
difficulty staying asleep
waking up too early, such as 3 am
trouble waking up in the morning
What can disrupt a perimenopausal woman’s sleep?
Plenty! Look through the entire list below and then carefully examine each reason to see if it applies to you.
Once you determine the reason or reasons for not getting a good night’s sleep, you can begin to solve your sleep issues. I’m sure there may be other reasons I haven’t thought of so consider that as well.
Shelby’s Additional Comments on Some Factors:
Fluctuating hormones. I like to call them f**ktuating hormones. We have so many hormones effing up in our body, one or more could be causing our sleep issues. When I was researching Mast Cell Activation Syndrome8, I read from patients that 10pm is when histamine can kick in. Although I did not have MCAS, I know that there was a period of time when if I went to bed at 8pm, I would wake up with a start around 10pm and then have trouble falling back asleep.
Sleep Apnea is a medical condition that should be evaluated by a physician. It’s a common occurrence with perimenopause, even if you’ve never had an issue with it before. Sleep apnea can present itself as snoring or if someone tells you that they can hear you stop breathing while you sleep. Daytime fatigue could be another sign. If you wear a sleep tracker, you may also see dips in your oxygen levels during sleep (depending on the accuracy of your tracker).
If your bed is uncomfortable or old, it needs to be replaced. Different types of bedding have different life spans, so research the suggested life span for your type of bed. A regular innerspring mattress should be replaced every 5 – 10 years. It’s time for me.
There are too many lights in your room. Try to get your room as dark as possible so that your body knows it’s time to sleep. If your eyes see light, your brain will think you’re awake.
Caffeine and chocolate lovers will want to have these goodies earlier in the day. Alcohol and a full stomach can also affect sleep. It should be your goal to go to bed on an empty stomach.
Being on devices too late or too long. The research is mixed on whether it’s the light that affects us, however devices are too stimulating for the evening. And, remember to take device breaks throughout the day too. What you do during the day will affect your sleep.
You have too many things in your bed crowding your space – too many pillows, too many children, too many pets, too many husbands.
We also have to consider that some people are natural night owls or have to work evenings. Please take a look below, by the heart emoji, for a brief explanation of sleep chronotypes.
Excitedness is felt in your body the same way anxiety is.9 Think about the last time you had to catch a morning flight for vacation. How was your sleep? I was so excited to work on this article more today that I was up at 3 a.m. this morning, ready to jump in. I used some of my tips to try to fall back asleep, but I was just too darn excited. I used the time to rest instead of sleep and then got up. It’s now 5:38am.
When I couldn’t fall back asleep, I didn’t berate myself or worry that I wasn’t getting enough quality sleep—that’s the fast ticket to setting off your fight-or-flight response and releasing stress chemicals. I told myself that it was okay and resting was good enough. I closed my eyes and rested. Another positive thing I told myself was that I was asleep during the important hours of 10pm—2 am.
How Can I Improve my Sleep?
Unfortunately, you can’t solve your sleep problems overnight, but you can address them over time. There are simple things that you can do to support yourself, such as getting outside as early as possible so that your body is alerted that it’s starting a new wake/sleep cycle. Sometimes, how we handle our mornings affects that night’s sleep. My advice is always to “get back to the basics.”
“I’m sorry to be the messenger; perimenopause has arrived. We can no longer expect our bodies to behave in the same way as before getting to this stage. We have to help it out a bit. I know you’re smart and capable of doing this. We are women! I’m so proud of us. We have amazing talents and abilities.
Let’s try to redirect some of that energy we put out into the world back on ourselves. This is the time to start.” -Shelby
Now, it’s time to do the work. You’ve completed the first step of identifying the factors affecting your sleep; now, we can begin to work through each one, one at a time.
I have a cartload of tips from science and my own lived experience of dealing with sleep issues. Subscribe below and you’ll receive some of my best sleep tips without using medications, melatonin, supplements, or CBD. My tips will be included in your welcome email as a 2-page printable PDF link.
Although lifestyle modifications can reduce many sleep issues, if you don’t see any improvement after cleaning up your sleep habits, addressing body factors, working on your mindset, and setting up your environment for success or you’re concerned about something, please see your primary care physician or schedule an appointment with a doctor who specializes in sleep (check your health insurance coverage first).
💖This article assumes that you’re healthy but dealing with some perimenopausal and women’s sleep issues. There may be times when you need medical intervention to assist with sleep. If that’s the case, please consider including lifestyle modifications in your sleep plan. They will still be helpful.
We also need to consider that some people are natural night owls or work during the evening. This doesn’t mean that they are doomed to fail. We have to work WITH our biology and not AGAINST it when we can. Dr. Michael Breus, author of The Power of When, discusses the theory of sleep chronotypes - lion, bear, wolf, and dolphin - and how to apply this information to your life for better sleep. I’m a dolphin, BTW.
I caution you to be careful about purchasing commercial sleep products and devices. There are special pillows, devices, and supplements sold in stores or online that promise good sleep. Please do your research and make sure that any option has been researched to back up any claims. The sleep product industry is expected to grow to $585 billion sales in 2024.10 That’s a lot of our hard-earned money spent on the promise of sleep.
Now I have to get back to sleep!
Be well, stay cool!
~Shelby
P.S. This article was worth getting up at 3am for!
Disclaimer, Content Use Policy, Privacy Policy
Dr. Lindsey Berkson, Hormone specialist
Dr. Lindsey Berkson, Hormone specialist
For more information, visit www.sleepfoundation.org
Shahram Nikbakhtian, Angus B Reed, Bernard Dillon Obika, Davide Morelli, Adam C Cunningham, Mert Aral, David Plans, Accelerometer-derived sleep onset timing and cardiovascular disease incidence: a UK Biobank cohort study, European Heart Journal - Digital Health, Volume 2, Issue 4, December 2021, Pages 658–666, https://doi.org/10.1093/ehjdh/ztab088
An extreme allergic sensitivity reaction syndrome
Britt Frank, MSW, LSCSW, SEP, author of The Science of Stuck and The Science of Stuck Workbook
For more information, visit www.sleepfoundation.org
Shelby, are you still offering the sleep tips PDF? I must have missed it. 🙈