Let’s face it, nobody is sleeping too well these days. Between Covid-19 and the social unrest that has swept the country with the tragic loss of George Floyd, it’s about as tense a time as I can remember in my lifetime.
But to paraphrase Shakespeare, “Sleep knits the raveled sleeve of care.” And making some simple changes in your life can help to improve your sleep during perimenopause and menopause, and even if you aren’t in perimenopause or menopause.
During perimenopause and menopause, estrogen levels fluctuate in a downward direction, until they reach levels women haven’t experience since before they entered puberty. Here are some tips to help you from my best selling book, The Estrogen Fix.
Estrogen not only improves sleep by reducing night sweats, it also increases REM (Rapid Eye Movement) sleep. For women who prefer not to take a full regimen of estrogen, one trick I share with patients is a low dose of oral estradiol at bedtime. It lasts in the blood for about 8 hours and acts as a surrogate sleeping pill. Whether you choose to take estrogen or not, the good sleep hygiene suggestions below will help.
- Don’t watch the late news. Think of all the negative things typically reported on the evening news: rapes, murders, bombings, financial problems, and other heartaches. This negative input just before bedtime plants a seed of thought, and our brains like to process the last things we think about. It’s called dream incubation and is used intentionally by some people to solve problems. For a more restful sleep, wind down at least 2 hours before bedtime–no TV, computers, e-mails, or smartphones. Instead listen to relaxing music, take a relaxing bath, read a relaxing book, or have a relaxing talk with friends. Note the frequent use of the word relaxing.
- Use associate activation to connect going to bed with a positive experience. In this process, ideas that have been evoked trigger many other ideas. It’s very complex neuroscience, but as an example, you link together two words, like bed and happy. Your brain starts to involuntarily make a story of this. And in an amazing, virtually immediate sequence of events, your brain takes this nugget of a thought and creates a ripple effect that becomes the story your brain is telling you. Think of positive words or phrases at bedtime to associate your slumber with good things.
- Prime your brain to lower anxiety and sleep better. Nobel Prize laureate Daniel Kahneman describes this process in his book Thinking Fast and Slow. He tells of an experiment in which the participants were told they were testing the quality of audio equipment and were instructed to move their heads to check for distortions of sound. Half were instructed to nod their heads up and down, while the other half were directed to shake their heads from side to side. The ones who nodded up and down tended to feel favorable about the editorials they heard; the ones who shook their heads from side to side tended to reject the editorials’ hypotheses. Once again, positive actions led to positive behaviors. Engage in things you enjoy doing before bedtime.
- Go to bed at the same time each night, avoid large meals before bedtime, and don’t use caffeine, alcohol, or nicotine near bedtime.
- Use a white noise machine or app to block undesirable sounds. These come with all kinds of soothing sounds, from heavy rainfall to a babbling brook that will block out loud neighbors, a snoring partner, or traffic.
- Sleep in a darkened, cool room. Use an eye mask or purchase room-darkening shades. It’s easier to fall asleep in a cool, rather than a warm or hot, environment. Creating a true sleep environment will help you fall and stay asleep.
- Exercise is a great and effective antidote for chronic insomnia. Even a single exercise session of moderate-intensity aerobic exercise like walking reduces the time it takes to fall asleep and increases the length of sleep compared to a night not preceded by exercise. However, in the same study, more vigorous aerobic exercise such as running or weight lifting did not improve sleep. As people began to exercise more frequently for 4 to 24 weeks or longer, adults with insomnia fell asleep more quickly, slept slightly longer, and had better sleep quality than before they began exercising.
- Write it down. If you have unresolved issues at work or a problem on your mind, write it down on a pad with a pen kept next to the bedside. It’s called “docking your problem.” That way you won’t have to worry about forgetting the issue in the morning. It will help clear your brain as you drift off to sleep.
- Listen to Relaxing Music. Sleep can be induced in a non-pharmacologic way by listening to relaxing music at bedtime. It’s why lullabies are so helpful for babies when they attempt to go to sleep. Click Here to listen to some award-winning music that I have written to help you relax.
- Keep a sleep diary. A sleep diary lets you learn about your sleep patterns and habits and helps your doctor help you. Download a Free Sleep Diary Here.
As you have read, estrogen plays a major role in your brain. Estrogen improves sleep, bloodflow, and cognition and has a favorable effect on mental health challenges, particularly in perimenopause and menopause. Estrogen fights Alzheimer’s disease, inflammation, and brain aging and improves your work ability. And estrogen is most effective if taken during your estrogen window. For more information visit http://bit.ly/TheEstrogenFix
