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Ask the expert
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Get a solid night's sleep during menopause
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By Dr. Adam Moscovitch
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Q: I am considered peri-menopausal. I have no trouble falling asleep, but I wake up at 1, 2 or 3 o'clock every morning and have a difficult time falling back to sleep. Most nights I am awake until it is time go get up. Any suggestions?
Typical body changes during menopause result in sleep becoming lighter and more sensitive to both internal and external stimuli.
Normally, people experience the deepest part of sleep during the first three to four hours of slumber. In your case, instead of coming up to the lighter stage of sleep, you come up to full awakening, which is not unusual.
Your situation could also be due to some physiological triggers as you go through hormonal changes of menopause such as: periodic leg movements, leg kicks and twitches, and snoring, including sleep apnea (pauses in breathing).
If you are experiencing significant daytime effects, you should seek medical attention. You will most likely need to see a sleep specialist, who can easily evaluate your issues in a sleep laboratory.
Environmental factors such as room temperature and light level could also be contributing to your problem; in particular if you're starting to experience night sweats.
Here are some simple things you can try to sleep better:
1. Keep a relatively regular schedule and reserve your bedroom primarily for sleep and sex.
2. Make sure that you have a comfortable bed, and room temperature should be kept around 20C or 72F.
3. Sleep on sheets that absorb heat in case of night sweats.
4. Address your caffeine intake, and don't consume caffeinated beverages after early afternoon.
5. If you smoke, particularly in the evening or at night, cut it out. Smoking is notorious for sleep fragmentation.
6. Don't drink excessive amounts of alcohol which also results in sleep fragmentation, in particular during in the second part of the night.
Above all, if you continue with those awakenings, stop clock watching, and instead of staying in bed and getting aggravated by being awake, get out of bed, go and do something relaxing, and return to bed when you feel sleepy again.
The good news is, it's not a given that sleep has to be lousy during menopause. In knowledgeable hands, help is available. Good luck.
Dr. Adam Moscovitch is the medical director of the Canadian Sleep Institute in Toronto and Calgary. For more information about sleep medicine, contact the Canadian Sleep Institute at 1-866-98NIGHT (6-4447) or visit csisleep.com.
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