How does menopause affect sleep patterns. What is the connection between diet and insomnia in postmenopausal women. Can a low-glycemic index diet help alleviate menopausal insomnia. What are the best dietary choices for improving sleep quality during menopause. How do hormonal changes impact sleep during menopause. What are the long-term health implications of poor sleep in postmenopausal women.

The Prevalence of Insomnia in Menopausal Women

Sleep disturbances, particularly insomnia, are a common complaint among women going through menopause. Research from the National Institutes of Health reveals a significant increase in sleep issues as women transition through different menopausal stages:

• Before menopause: 16% to 42% of women experience sleep disturbances
• During perimenopause: 39% to 47% of women report sleep problems
• After menopause: 35% to 60% of women suffer from sleep issues

These statistics highlight the substantial impact menopause has on sleep quality. Do hormonal changes solely account for this increase in sleep disturbances? While hormonal fluctuations play a significant role, recent research suggests that dietary factors may also contribute to sleep problems in menopausal women.

The Link Between Diet and Insomnia in Postmenopausal Women

A groundbreaking study involving over 50,000 postmenopausal women, with an average age of 63, has shed light on the potential connection between diet and insomnia risk. The research, conducted as part of the Women’s Health Initiative study between 1994 and 2001, examined various aspects of carbohydrate intake, including:

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

After a three-year follow-up period, the researchers analyzed the participants’ risk of developing insomnia. What were the key findings of this study?

Higher Risk of Insomnia

The study revealed that women who consumed diets with a higher glycemic index and more added sugars faced an increased risk of developing insomnia. Added sugars in this context included white and brown sugar, syrups, honey, and molasses.

Lower Risk of Insomnia

Conversely, women who incorporated more whole fruits and vegetables into their diets demonstrated a lower risk of developing insomnia.

Is this correlation between diet and insomnia risk conclusive? The researchers took great care to account for numerous potentially confounding factors, including:

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

By adjusting for these variables, the researchers strengthened the validity of their findings, suggesting a genuine link between dietary choices and insomnia risk in postmenopausal women.

Understanding the Glycemic Index and Its Impact on Sleep

The glycemic index (GI) plays a crucial role in this dietary approach to managing insomnia. How is the glycemic index defined? The GI is a ranking system that assigns a value from 0 to 100 to foods based on how quickly they raise blood sugar levels after consumption.

High-GI Foods

Foods with a high glycemic index are rapidly digested, absorbed, and metabolized, causing sharp spikes in blood sugar and insulin levels. Examples of high-GI foods include:

• Processed grain products (bread, pasta, baked goods, white rice)
• Foods with added sugars (sugary beverages, sweets)

Low-GI Foods

Low-GI foods, on the other hand, do not cause significant spikes in blood sugar and insulin levels. These typically include:

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

Why might high-GI foods contribute to insomnia? Researchers hypothesize that the rapid spike and subsequent crash in blood sugar levels caused by high-GI foods may disrupt sleep patterns. After blood sugar and insulin levels peak, they tend to drop quickly, potentially causing various symptoms, including waking from sleep.

The Broader Impact of Nutrition on Health and Sleep

The connection between diet and insomnia risk in postmenopausal women is just one aspect of the broader relationship between nutrition and overall health. How does diet influence other aspects of our well-being?

Extensive research has established links between dietary quality and the risk of numerous health conditions, including:

• Heart disease
• Stroke
• Dementia
• Depression
• Cancer

This new research on insomnia adds sleep disorders to the list of health issues that can be influenced by dietary choices. The implications of these findings extend beyond simply eating healthy foods; they also emphasize the importance of avoiding unhealthy options.

Practical Dietary Strategies for Improving Sleep in Postmenopausal Women

How can postmenopausal women apply these research findings to improve their sleep quality? In addition to practicing good sleep hygiene, consider the following dietary strategies:

1. Prioritize Low-GI Foods

Aim to incorporate 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 options with healthier alternatives. For example:

• Breakfast: Choose plain yogurt with berries and nuts instead of cereal or bagels
• Dinner: Opt for a plate of roasted vegetables and grilled salmon instead of pasta and meatballs

2. Time Your Meals Wisely

Avoid consuming large meals close to bedtime. As a general rule, aim to eat your last substantial meal at least three to four hours before going to bed. This practice allows your digestive system sufficient time to process the food, potentially reducing sleep disturbances.

3. Choose Sleep-Friendly Snacks

If you need a light snack closer to bedtime, opt for balanced, plant-based options that avoid sugars and processed grains. Some suggestions include:

• Sliced apple with a small amount of almond butter
• Blueberries with unsweetened nut milk
• Hummus with carrot sticks

These snacks provide a good balance of nutrients without causing significant spikes in blood sugar levels.

The Long-Term Benefits of Addressing Menopausal Insomnia

Why is it crucial to address sleep issues in postmenopausal women? The implications of chronic insomnia extend far beyond feeling tired during the day. Poor sleep quality and quantity can have serious long-term health consequences, including:

• Increased risk of cardiovascular disease
• Higher likelihood of developing type 2 diabetes
• Compromised immune function
• Cognitive decline and increased risk of dementia
• Mental health issues, such as depression and anxiety
• Accelerated aging processes

By adopting a low-GI diet and implementing other sleep-promoting strategies, postmenopausal women can potentially improve their sleep quality and mitigate these long-term health risks.

The Role of Hormonal Changes in Menopausal Insomnia

While dietary factors play a significant role in sleep quality for postmenopausal women, it’s essential to understand the hormonal aspects of menopausal insomnia. How do hormonal changes during menopause affect sleep patterns?

The transition through menopause is marked by significant fluctuations in hormone levels, particularly estrogen and progesterone. These hormonal changes can impact sleep in several ways:

1. Altered Sleep Architecture

Hormonal shifts can lead to changes in sleep architecture, affecting the amount of time spent in different sleep stages. This may result in less restorative sleep overall.

2. Hot Flashes and Night Sweats

Many women experience hot flashes and night sweats during menopause, which can significantly disrupt sleep. These vasomotor symptoms can cause sudden awakenings and difficulty falling back asleep.

3. Mood Changes

Hormonal fluctuations can contribute to mood swings, anxiety, and depression, all of which can negatively impact sleep quality.

4. Changes in Sleep-Wake Cycle

Hormonal shifts may affect the body’s circadian rhythm, potentially leading to changes in sleep-wake patterns and increased difficulty falling asleep or staying asleep throughout the night.

Understanding these hormonal influences highlights the complexity of menopausal insomnia and underscores the importance of a multifaceted approach to managing sleep issues during this life stage.

Combining Dietary Strategies with Other Sleep-Promoting Practices

While adopting a low-GI diet can be beneficial for improving sleep quality in postmenopausal women, it’s most effective when combined with other sleep-promoting practices. What additional strategies can help enhance sleep during menopause?

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 ritual to help your body and mind wind down. This might include activities such as reading, gentle stretching, or meditation.

3. Optimize Your Sleep Environment

Ensure your bedroom is conducive to sleep by keeping it cool, dark, and quiet. Invest in comfortable bedding and consider using blackout curtains or a white noise machine if needed.

4. Limit Screen Time Before Bed

The blue light emitted by electronic devices can interfere with your body’s production of melatonin, a hormone that regulates sleep. Try to avoid screens for at least an hour before bedtime.

5. Stay Active During the Day

Regular physical activity can help improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week, but avoid vigorous exercise close to bedtime.

6. Manage Stress

Practice stress-reduction techniques such as deep breathing, progressive muscle relaxation, or yoga to help calm your mind and prepare for sleep.

7. Consider Hormone Therapy

For some women, hormone therapy may help alleviate menopausal symptoms, including sleep disturbances. Discuss this option with your healthcare provider to determine if it’s appropriate for you.

By combining these strategies with a low-GI diet, postmenopausal women may be able to significantly improve their sleep quality and overall well-being.

The Importance of Individualized Approaches to Menopausal Insomnia

While research provides valuable insights into potential strategies for managing menopausal insomnia, it’s crucial to recognize that every woman’s experience of menopause is unique. How can postmenopausal women develop an effective, personalized approach to improving sleep?

1. Consult with Healthcare Providers

Work closely with your healthcare team, including your primary care physician, gynecologist, and potentially a sleep specialist, to develop a comprehensive treatment plan tailored to your specific needs and health status.

2. Keep a Sleep Diary

Maintain a detailed sleep diary to track your sleep patterns, diet, physical activity, and any symptoms you experience. This information can help identify triggers and patterns affecting your sleep quality.

3. Experiment with Different Strategies

Be open to trying various approaches, including dietary changes, sleep hygiene practices, and stress-reduction techniques. What works for one woman may not work for another, so it’s essential to find the combination that best suits your needs.

4. Consider Underlying Health Conditions

Be aware that certain health conditions, such as sleep apnea or restless leg syndrome, can contribute to sleep disturbances. If you suspect an underlying condition may be affecting your sleep, discuss this with your healthcare provider.

5. Be Patient and Persistent

Improving sleep quality often requires time and consistent effort. Be patient with yourself and persistent in implementing positive changes. It may take several weeks or even months to see significant improvements in your sleep patterns.

By taking an individualized, holistic approach to managing menopausal insomnia, women can work towards achieving better sleep quality and overall well-being during this significant life transition.

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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The full composition of the non-hormonal biocomplex Lady’s formula® Menopause Day-Night ™ with anti-age effect is presented on the website. You can buy it at a pharmacy or order online.

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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.