How does menopause affect sleep patterns. What is the connection between diet and insomnia in menopausal women. Can a low-glycemic index diet help alleviate sleep disturbances. What are the best dietary choices for improving sleep quality during menopause. How do high-GI foods impact sleep and overall health. What lifestyle changes can menopausal women make to enhance their sleep.

The Prevalence of Sleep Disturbances in Menopausal Women

Sleep disturbances, particularly insomnia, are remarkably common among women experiencing menopause. According to data from the National Institutes of Health, the prevalence of sleep disturbances varies significantly across different stages of menopause:

• Before menopause: 16% to 42%
• During perimenopause: 39% to 47%
• After menopause: 35% to 60%

These statistics highlight the substantial increase in sleep problems as women transition through menopause. Insomnia, characterized by frequent difficulty falling or staying asleep, can significantly impact a person’s quality of life and overall health.

Why Does Menopause Affect Sleep?

Hormonal changes during menopause can lead to sleep problems for various reasons:

• Changing sleep requirements
• Increased irritability
• Hot flashes

These factors can disrupt normal sleep patterns and contribute to the development of insomnia in menopausal women.

The Link Between Diet and Insomnia in Postmenopausal Women

Recent research has shed light on the potential connection between dietary habits and the risk of developing insomnia in postmenopausal women. A study involving over 50,000 postmenopausal women enrolled in the Women’s Health Initiative study between 1994 and 2001 examined the relationship between carbohydrate intake and insomnia risk.

The study analyzed various aspects of carbohydrate consumption, including:

• Glycemic index (GI)
• Glycemic load (GL)
• Added sugars
• Starch
• Total carbohydrate
• Dietary fiber
• Specific carbohydrate-containing foods (whole grains, processed grains, whole fruits, vegetables, and dairy products)

After a three-year follow-up, researchers observed that women with higher-GI diets and those who consumed more added sugars had a greater risk of developing insomnia. Conversely, women who consumed more whole fruits and vegetables had a lower risk of insomnia.

Factors Considered in the Study

The researchers accounted for numerous potentially confounding factors to ensure the validity of their findings. These factors included:

• Demographic factors (education, income, marital status)
• Behavioral factors (smoking, alcohol consumption, caffeine intake, physical activity)
• Psychosocial factors (stress, social connection)
• Medical factors (body mass index, various medical diagnoses, hormone therapy, snoring)

Understanding the Glycemic Index and Its Impact on Sleep

The glycemic index (GI) is a scale from 0 to 100 that ranks foods based on how much they raise blood sugar levels after consumption. Foods with a high GI are rapidly digested, absorbed, and metabolized, causing spikes in blood sugar and insulin levels.

Examples of High-GI Foods

• Processed grains (bread, pasta, baked goods, white rice)
• Foods containing added sugars (sugary beverages, sweets)

Examples of Low-GI Foods

• Most fruits and vegetables
• Legumes and beans
• Nuts and seeds
• Whole grains

It’s important to note that even some high-GI plant foods, such as bananas and watermelon, are not necessarily harmful when consumed in moderation.

The Relationship Between High-GI Foods and Insomnia

Researchers hypothesize that high-GI foods may contribute to insomnia due to the rapid spike and subsequent crash in blood sugar levels. After blood sugar and insulin levels peak, they tend to drop, potentially causing various symptoms, including awakening from sleep.

This theory is supported by multiple studies cited by the researchers of the recent study on postmenopausal women and insomnia risk.

How Do Blood Sugar Fluctuations Affect Sleep?

When blood sugar levels drop rapidly during sleep, it can trigger the release of stress hormones like cortisol and adrenaline. These hormones can cause:

• Increased heart rate
• Heightened alertness
• Difficulty falling back asleep

This physiological response to blood sugar fluctuations can disrupt the normal sleep cycle and contribute to insomnia symptoms.

The Importance of Nutrition for Overall Health and Sleep

Extensive research has consistently demonstrated the critical role of diet in various aspects of health, including:

• Heart disease risk
• Stroke prevention
• Dementia risk reduction
• Depression management
• Cancer prevention

The recent study on postmenopausal women and insomnia risk adds to this body of knowledge by highlighting the potential impact of diet on sleep quality. It emphasizes the importance of not only consuming obviously healthy foods but also avoiding those that are clearly unhealthy.

How Does Diet Affect Overall Health?

A balanced, nutrient-rich diet can:

• Reduce inflammation in the body
• Support immune function
• Promote healthy gut bacteria
• Provide essential vitamins and minerals for optimal bodily functions
• Help maintain a healthy weight

These factors collectively contribute to better overall health and may indirectly improve sleep quality by reducing the risk of various health conditions that can interfere with sleep.

Practical Tips for Improving Sleep Through Diet

Based on the findings of the study and general principles of healthy eating, postmenopausal women can incorporate the following strategies to potentially improve their sleep quality and overall health:

1. Prioritize Low-GI Foods

Focus on incorporating more low-GI foods into your diet, such as:

• Fruits and vegetables
• Beans and legumes
• Nuts and seeds
• Whole grains
• Lean proteins

Replace high-GI foods like processed grains and added sugars with these healthier alternatives. For example, opt for plain yogurt with berries and nuts instead of cereal or bagels for breakfast, and choose a plate of roasted vegetables and grilled salmon over pasta and meatballs for dinner.

2. Time Your Meals Appropriately

Avoid consuming large meals close to bedtime. As a general rule, try to eat your last substantial meal at least three to four hours before lying down. This practice allows your body sufficient time to digest the food and stabilize blood sugar levels before sleep.

3. Choose Sleep-Friendly Snacks

If you need a small snack closer to bedtime, opt for balanced, low-GI options that combine protein, healthy fats, and complex carbohydrates. Some examples include:

• Sliced apple with almond butter
• Blueberries with unsweetened nut milk
• Hummus with carrot sticks

These snacks provide a steady release of energy without causing dramatic spikes in blood sugar levels.

4. Stay Hydrated

Proper hydration is essential for overall health and can impact sleep quality. However, be mindful of your fluid intake in the evening to avoid nighttime awakenings for bathroom trips. Aim to consume most of your daily water intake earlier in the day.

5. Limit Caffeine and Alcohol

Both caffeine and alcohol can interfere with sleep quality. Limit caffeine consumption, especially in the afternoon and evening, and moderate alcohol intake. While alcohol may initially make you feel drowsy, it can disrupt sleep patterns later in the night.

Additional Lifestyle Factors for Improving Sleep During Menopause

While diet plays a crucial role in sleep quality, other lifestyle factors can also contribute to better sleep for menopausal women:

1. Establish a Consistent Sleep Schedule

Try to go to bed and wake up at the same time every day, even on weekends. This helps regulate your body’s internal clock and improve sleep quality.

2. Create a Relaxing Bedtime Routine

Develop a calming pre-sleep routine to help your body and mind wind down. This might include activities such as:

• Reading a book
• Practicing gentle yoga or stretching
• Taking a warm bath
• Listening to soothing music

3. Optimize Your Sleep Environment

Create a sleep-friendly bedroom by:

• Keeping the room cool and well-ventilated
• Using blackout curtains or an eye mask to block out light
• Investing in a comfortable mattress and pillows
• Reducing noise with earplugs or a white noise machine

4. Regular Exercise

Engage in regular physical activity, but avoid vigorous exercise close to bedtime. Aim for at least 30 minutes of moderate exercise most days of the week, preferably earlier in the day or in the early evening.

5. Manage Stress

Practice stress-reduction techniques such as meditation, deep breathing exercises, or mindfulness to help calm your mind before bed.

6. Consider Hormone Therapy

For some women, hormone therapy may help alleviate menopausal symptoms, including sleep disturbances. Consult with your healthcare provider to discuss whether this option is appropriate for you.

The Role of Nutritional Supplements in Improving Sleep

While a balanced diet should be the primary focus for improving sleep quality, certain supplements may offer additional support for menopausal women experiencing insomnia:

1. Magnesium

Magnesium plays a crucial role in regulating neurotransmitters involved in sleep. Some studies suggest that magnesium supplementation may improve sleep quality in older adults.

2. Melatonin

Melatonin is a hormone naturally produced by the body that regulates the sleep-wake cycle. Short-term use of melatonin supplements may help some people with insomnia, but it’s essential to consult a healthcare provider before use.

3. Valerian Root

This herb has been used traditionally to promote relaxation and improve sleep quality. Some studies suggest it may be helpful for insomnia, but more research is needed.

4. L-theanine

An amino acid found in tea leaves, L-theanine may help promote relaxation and improve sleep quality. It’s often available as a supplement.

It’s important to note that while these supplements may be beneficial for some individuals, they are not a substitute for a healthy diet and lifestyle. Always consult with a healthcare provider before starting any new supplement regimen, especially if you have existing health conditions or are taking medications.

The Importance of Individualized Approaches to Sleep and Diet

While the research on low-GI diets and sleep quality in postmenopausal women is promising, it’s crucial to remember that everyone’s body responds differently to dietary changes. What works for one person may not be as effective for another.

Factors Influencing Individual Responses to Diet

• Genetic variations
• Existing health conditions
• Medication use
• Lifestyle factors
• Personal food preferences and tolerances

Given these individual differences, it’s essential to approach dietary changes with a personalized mindset. Consider working with a registered dietitian or nutritionist who can help you develop a tailored eating plan that supports your sleep goals and overall health.

Monitoring Your Progress

As you implement dietary changes to improve your sleep, keep track of your progress by:

• Maintaining a sleep diary
• Noting any changes in sleep quality or duration
• Recording any improvements in menopausal symptoms
• Tracking your energy levels and mood throughout the day

This information can help you and your healthcare provider identify which strategies are most effective for your individual needs.

The Broader Implications of Diet and Sleep Quality

The connection between diet and sleep quality extends beyond menopausal women and has implications for overall public health. Poor sleep is associated with numerous health risks, including:

• Increased risk of obesity
• Higher rates of cardiovascular disease
• Impaired cognitive function
• Weakened immune system
• Greater risk of mental health disorders

By focusing on the relationship between diet and sleep, researchers and healthcare providers can develop more comprehensive strategies for improving public health outcomes.

Future Research Directions

The study on postmenopausal women and low-GI diets opens up several avenues for future research, including:

• Investigating the effects of low-GI diets on sleep quality in other populations
• Exploring the potential mechanisms behind the diet-sleep connection
• Developing targeted dietary interventions for specific sleep disorders
• Examining the long-term effects of dietary changes on sleep quality and overall health

As our understanding of the complex relationship between nutrition and sleep continues to grow, we may discover new ways to promote better sleep and improve quality of life for people of all ages and backgrounds.

Menopause and insomnia: Could a low-GI diet help?

Sleep disturbances such as insomnia are extremely common, especially in women after menopause. According to data from the National Institutes of Health, sleep disturbance varies from 16% to 42% before menopause, from 39% to 47% during perimenopause, and from 35% to 60% after menopause.

Insomnia is a serious medical problem defined by frequent difficulty falling or staying asleep that impacts a person’s life in a negative way. Hormone changes around menopause can lead to sleep problems for many reasons, including changing sleep requirements, increased irritability, and hot flashes.

What menopausal women eat could have an impact on their risk of developing insomnia

Researchers recently looked at detailed dietary data from over 50,000 postmenopausal women (average age 63) enrolled in the Women’s Health Initiative study between 1994 and 2001. Carbohydrate intake was measured in several ways: glycemic index (GI) and glycemic load (GL), measures of added sugars, starch, total carbohydrate, and dietary fiber, and specific carbohydrate-containing foods such as whole grains, processed or refined grains, whole fruits, vegetables, and dairy products. They then looked at each participant’s risk of developing insomnia after three years of follow-up.

They found that the risk of developing insomnia was greater in women with a higher-GI diet, as well as in women who included more added sugars in their diet. Added sugars included white and brown sugar, syrups, honey, and molasses. The risk of developing insomnia was lower in women who ate more whole fruits and vegetables.

The researchers accounted for and adjusted for many potentially confounding factors, including demographic (education, income, marital status), behavioral (smoking, alcohol, caffeine intake, physical activity), psychosocial (stress, social connection), and medical factors (body mass index, various medical diagnoses, hormone therapy, snoring).

What is the glycemic index of food, and how could this affect sleep?

The glycemic index (GI) is a ranking of foods on a scale from 0 to 100 according to how much they raise blood sugar levels after eating them. I’ve written previously about planning meals with knowledge of the GI and the glycemic load of foods. High-GI foods are those that are rapidly digested, absorbed, and metabolized, and cause spikes in blood sugar and insulin levels. Some examples of high-GI foods include anything made with processed grains (bread, pasta, baked goods, white rice) and anything containing added sugars (sugary beverages, sweets).

Low-GI foods don’t cause your blood sugar and insulin levels to spike, and include plant foods such as most fruits and vegetables, legumes and beans, nuts, seeds, and whole grains. Even plant foods that have a high GI — such as bananas and watermelon — are not likely “bad” for you when eaten in moderation.

Researchers hypothesize that high-GI foods cause insomnia because of the rapid spike and then crash of blood sugar levels. Essentially, what goes up must come down, and after blood sugar and insulin levels peak, they tend to drop, which can cause a lot of symptoms, including awakening from sleep. The researchers of this new study cite multiple studies supporting this theory.

Nutrition is critical for so many aspects of our health, including sleep

Endless research connects the quality of our diet with our risk for heart disease, strokes, dementia, depression, and cancer. This new research notes that diet can also impact our risk for certain sleep problems. It’s not just about eating the obviously healthy foods, but also about avoiding the obviously unhealthy foods.

So how can you apply these findings?

In addition to practicing good sleep habits, here are some additional ways postmenopausal women can incorporate what we have learned from this study to sleep better (and be all-around healthier):

• Go for low-GI foods as much as possible. This means aiming to eat fruits and vegetables, beans and legumes, nuts and seeds, whole grains, and lean protein instead of anything made of processed grains or with added sugars. Think plain yogurt with berries and nuts instead of cereal or bagels for breakfast; a big plate of roasted vegetables and grilled salmon instead of pasta and meatballs for dinner.
• Never eat large meals close to bedtime. As a general rule, a large meal should be eaten at least three to four hours before lying down, maybe more. You do not want to go to bed with lots of food in your intestines!
• If you have to have a little something closer to bedtime, avoid sugars and processed grains. A sliced apple with a little almond butter; some blueberries and nut milk; or maybe hummus and carrots. Those are all well-balanced, plant-based snacks.

References

Insomnia: Definition, Prevalence, Etiology, and Consequences. Journal of Clinical Sleep Medicine, August 2007.

National Institutes of Health State-of-the-Science Conference Statement: management of menopausal symptoms. Annals of Internal Medicine, June 21, 2005.

High glycemic load and glycemic index diets as risk factors for insomnia: analyses from the Women’s Health Initiative. The American Journal of Clinical Nutrition, December 11, 2019.

Sleep Disorders in Postmenopausal Women. The Journal of Sleep Disorders and Therapy, August 2015.

About Glycemic index. The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders and Charles Perkins Centre at the University of Sydney.

Sleep Problems and Menopause: What Can I Do?

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The years of the menopausal transition are often a time when there are other changes in a woman’s life. You may be caring for aging parents, supporting children as they move into adulthood, taking on more responsibilities at work, and reflecting on your own life journey. Add symptoms of menopause on top of all this, and you may find yourself having trouble sleeping at night.

Hot flashes, especially night sweats, and changes in mood — depression in particular — can contribute to poor sleep. Managing these issues may help to manage sleep symptoms as well.

Some women who have trouble sleeping may use over-the-counter sleep aids such as melatonin. Others use prescription medications to help them sleep, which may help when used for a short time. But these are not a cure for sleep disturbances, such as insomnia, and should not be used long term.

Not getting enough sleep can affect all areas of life. Lack of sleep can make you feel irritable or depressed, might cause you to be more forgetful than normal, and could lead to more falls or accidents. And research now suggests that waking from sleep itself may trigger hot flashes, rather than the other way around.

Developing healthy habits at bedtime can help you get a good night’s sleep.

Getting a good night’s sleep during the menopausal transition

To improve your sleep through the menopausal transition and beyond:

• Follow a regular sleep schedule. Go to sleep and get up at the same time each day.
• Avoid napping in the late afternoon or evening if you can. It may keep you awake at night.
• Develop a bedtime routine. Some people read a book, listen to soothing music, or soak in a warm bath.
• Try not to watch television or use your computer or mobile device in the bedroom. The light from these devices may make it difficult for you to fall asleep.
• Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
• Exercise at regular times each day but not close to bedtime.
• Avoid eating large meals close to bedtime.
• Stay away from caffeine (found in many coffees, teas, and chocolate) late in the day.
• Remember, alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Read and share this infographic to help spread the word about ways to improve your sleep.

Talk to your doctor if you are having trouble sleeping. If these changes to your bedtime routine don’t help as much as you’d like, you may want to consider cognitive behavioral therapy for insomnia. This problem-solving approach to therapy has been shown to help improve sleep in women with menopausal symptoms. Cognitive behavioral therapy can be found through a class or in one-on-one sessions. Be sure that your therapy is guided by a trained professional with experience working with women during their menopausal transition. Your doctor may be able to recommend a therapist in your area.

Learn more about getting a good night’s sleep as you age.

For more information on menopause and sleep

National Center for Complementary and Integrative Health
888-644-6226
866-464-3615 (TTY)
[email protected]
www.nccih.nih.gov

National Sleep Foundation
703-243-1697
[email protected]
www.thensf.org
www.thensj.org/sleep-health-topics/

North American Menopause Society
440-442-7550
[email protected]
www.menopause.org

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
September 30, 2021

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• prolong REM sleep, make it easier to fall asleep;
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The decrease in hormones during menopause is reflected in sleep.

What to do with hot flashes and insomnia during menopause? Experts often suggest starting artificial hormones. They replace their own estrogens and thereby eliminate or reduce the symptoms of menopause. Such drugs should not be taken without analysis and agreement with the doctor, subsequent health monitoring. Hormone therapy is contraindicated in a number of chronic diseases, which, unfortunately, are not rare in women over 45-50 years old.

An alternative to drugs for insomnia with menopause are complexes with phytoestrogens. These are active ingredients of plant origin, sensitive to estrogen, reduce the severity of menopause symptoms. Phytoestrogens do not have side effects and contraindications characteristic of synthetic hormones, they have a cumulative effect, they act gently, they can be taken for a long time, and dependence is not formed.

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How to deal with insomnia during menopause

The period of menopause is accompanied by significant changes in the female body. With menopause, women may be disturbed by various unpleasant symptoms: hot flashes, excessive sweating, dry skin, brittle nails and hair, and health disorders.

One of the most common menopausal companions is insomnia. According to statistics, every third woman suffers from it. There are several reasons for this:

• changes in hormonal levels – a decrease in estrogen production,
• deterioration in the synthesis of melatonin – the hormone of sleep and rest,
• overweight,
• lack of physical activity.

Smoking, drinking alcohol, energy and caffeinated drinks, and malnutrition can worsen the situation and lead to sleep disturbances.

Why is it important to take action early?

Insomnia during menopause not only worsens overall well-being, but can also cause serious health problems. Among them:

• decrease in natural immune defense,
• development of gastritis, inflammation of the pancreas,
• malfunctions of the endocrine system,
• increased risk of stroke and heart attack,
• depression and neuroses.

You can’t let the situation take its course – you need to take timely measures to cope with insomnia during menopause. Find out how.

Helping ourselves

How to deal with insomnia during menopause? You should start by following simple rules.

• Increase your physical activity as directed by your doctor. Preference should be given to cardio training, yoga, fitness. It is better to study before noon to avoid nervous overexcitation.
• Review your diet. Include sour-milk products, more vegetables and fruits, seafood, whole grains, low-fat varieties of fish and meat in the menu.