I know, menopause has a habit of interrupting your sleep, so you may be thinking BIG WHOOP (that’s an aussie term- i.e. big deal:).

Some symptoms like anxiety and night sweats are main contributors to poor sleep in menopause.

In Functional Medicine, we view symptoms as the end result of dysfunction upstream. That means for sleep and hot flushes/night sweats it is more than likely that the dysfunction is in one or more of the following – the gut, liver, thyroid, hypothalamus, pituitary gland and/or adrenal glands.
By the time women hit perimenopause, dysfunction is likely, mainly because of low nutrients (poor soil, GMO crops, carcinogenic pesticides and herbicides), a lack of exercise, overwork, over-stressed and often, whilst we care for others, we often don’t create enough self-care and love for ourselves.
So, it’s not surprising that after 40 odd years of defence, the immune system, and other critical functions in the body that affect hormones and sleep are a little worn out.
However, don’t despair! The good news is, unless you have serious degeneration or chronic illness, you can reverse dysfunction and regain balance.
Did you know for instance that 70% of your melatonin (sleep hormone) and about 80% of serotonin (makes melatonin) and dopamine is made in the gut? These neurotransmitters are also essential for a good mood and energy. Even more concerning is our little energy powerhouses, called mitochondria are often low or damaged and many of them live in the gut lining and every cell.
That’s why in a Functional approach, we start with gut first!
The liver is also critical for metabolising hormones and most of our livers need a lot of love by the time we get to peri, let alone post-menopause!
It is well documented that a lack of sleep has significant and direct effects on both our mental and physical health. We also now know that you cannot make up sleep unless you do so in the same 24 hour period! This leads to sleep deprivation, putting more internal stress on the body which is also significantly associated with more severe and more frequent menopause symptoms! What’s worse is that this situation creates a negative vicious spiral where each makes the other worse and continues to worsen.
That’s why it is absolutely critical for perimenopausal and postmenopausal women (and for that matter any age woman with insomnia) to rectify it as fast as possible.
Research shows a sleep deficit can take a serious toll on your daytime energy, symptoms productivity, emotional balance, and your weight.
So here are 4 top tips to assist you to help regulate your sleep. In the next post I’ll give you another 4 tips!
I recommend that all women in their 40’s (ideally prior to perimenopause), but if not, as soon as is practicable, get a sophisticated hormone functional lab test (most doctors will not do this) and a full microbiome/gut health functional lab test (again most doctors will not do this).
In the meantime, follow these tips.

Tip 1: Get your body into the normal circadian rhythm

This is the most critical thing for women to do as it affects our hormones, cycles and emotions. Prior to about 130 years ago, we’d be asleep at 9pm and up at 5-6am (dark to sunrise). These days, for most of us, this sounds extreme. And it is if you have all the blue/green light at you all day.
The best way I have found to do this is to go glamping (I’m not a camper) or on a spiritual silent retreat to kick start your circadian rythym. You will soon find without laptop and mobile light and all the other light, you body will naturally start to adapt to the circadian rhythm.
If that sounds to harsh for you, then get in the habit of turning off all technology, tv and lights at 9pm. Use a candle and trying reading an old fashioned book – not a thriller or you’ll stay awake to read the next exciting chapter! Find something fairly mundane to read. Then get up at 6.30 to start off with. As you do so your body will start to adjust.
Get into the routine of going to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime! However, 9pm to bed and 10pm to sleep will rock your world!!!
Unfortunately, if you were like me you may have used the weekends to sleep in. However, research shows the more your weekend/weekday sleep schedules differs, the worse the sleep hangover you’ll experience. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm!
Napping. While napping is a good way to make up for lost sleep in the same 24 hour period, if you are struggling with falling asleep or staying asleep then napping is likely to make you feel worse! All naps should be no longer than 15 to 20 minutes in the early afternoon.

Tip 2: Be clever about temperature

We know that a hotter climate can create more discomfort for hot flushes and night sweats. It is recommended to keep your room temperature at 21-22 degrees Celsius throughout the year.
In summer, you should have a cool shower before bed to bring your body temperature down. Where cotton nightie/pj’s and cotton bedding (the higher the count the better). You can also buy cooling mats to help you go to sleep. If you are sleeping with a partner, use a separate sheet so you can adapt if you need to.

Tip 3: Adapt your eating habits

Timing of your meals well is really important. Keep to a twelve hour feeding window and make sure you do not eat a meal after 8pm. Avoid acidic or spicy dinners and alcohol of a night until your body returns to the circadian rhythm.
Everyone knows caffeine and nicotine will disrupt sleep. Avoid both after 12pm if you want to start getting better sleep! Swap to decaf (but remember there is still a little caffeine in decaf – make sure it is organic)! Get serious about stopping smoking – it is highly correlated with poor sleep and much more severe menopause symptoms.
Ideally avoid a lot of liquid after 8pm to avoid waking for toilet need.
Ensure you avoid sugary foods and refined carbs especially of a night. Blood sugar will then drop in the early morning hours cause cortisol to increase, melatonin to decrease and hence you are wide awake
If you are waking in the night, controlling blood sugar is critical. Buy a blood sugar tester and test your blood sugar on waking, before meals, before bed and in the night if you awake. Do this for a week to see if there are patterns. If it is a blood sugar drop, then eat a small handful of nuts, some yoghurt or a little protein one your before bed.
The other common reasons we awake of a night is if we have dysbiosis (more bad bacteria than good) or parasites (which are more common than you think) and are highly active in the wee hours of the morning. So if you do blood sugar and that doesn’t seem to be the issue, I strongly recommend a functional gut test.

Tip 4: Exercise during the day

It is well known that people who regularly exercise every day sleep better at night and are less prone to cravings and tiredness in the day. Now if you are in pain or have an illness exercising may seem like an oxymoron. I get it. For many years I suffered with really bad back pain. And one day I decided to do the thing that seemed like the most opposite thing to do in my gut – that was walking – it was bloody painful.
So, I started with 10 minutes in the morning and 10 minutes in the evening. Three years later I found myself trekking Everest!! Walking has a myriad of health benefits and for peri and postmenopausal women it is shown to help with vasomotor symptoms (i.e. hot flushes and night sweats), it is of course also know to boost energy, boost mood and boost sleep (and loads, loads more)!
We evolved to be erect so we could use those two legs, so lets’ get them moving! If you are unfit, just do 10 mins, twice a day, morning (after waking) and ideally after dinner (but only if it is around 6-7pm (any later and it is probably detrimental to sleep). Within a couple of weeks, you will be able to take that to 15 and then 20 minutes. Then you can swap if you chose to 30 minutes a session. Put on your favourite tunes on a playlist and get out there!
Exercise speeds up our metabolism, elevates our body temperature, and stimulates cortisol (stress hormone). Therefore, it is recommended if you have vasomotor symptoms to stay within a moderate heart rate. That’s because more vigorous exercise puts more stress on the body, releases more cortisol and then impacts all your other hormones. The ideal is to keep within 60-70% of your maximum heart rate. You work that out by taking your age away from 220 and multiplying by 60 and 70%.

For instance, if you are 50: 220-50= 170 60%=102 to 70%=119. So wear a heart rate monitor and try to stay in the zone.  If you get a little higher, stop for a quick stretch!

If you can find a restorative yoga class, stretching class, tai chi or qi gong, then doing these at least once a week will help with both your symptoms and your sleep.

World Sleep Day