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.

The Impact of Menopause on Sleep Patterns

Menopause is a significant life transition that affects women in numerous ways, including their sleep quality. Sleep disturbances, particularly insomnia, are extremely common among menopausal women. According to data from the National Institutes of Health, the prevalence of sleep disturbances increases dramatically during and after menopause:

• 16% to 42% before menopause
• 39% to 47% during perimenopause
• 35% to 60% after menopause

Insomnia is characterized by frequent difficulty falling asleep or staying asleep, which negatively impacts a person’s daily life. The hormonal changes associated with menopause can contribute to sleep problems in various ways:

• Altered sleep requirements
• Increased irritability
• Hot flashes

These factors can significantly disrupt sleep patterns and lead to chronic insomnia in menopausal women.

The Relationship Between Diet and Insomnia in Menopausal Women

Recent research has shed light on the potential connection between diet and insomnia risk in postmenopausal women. A study involving over 50,000 postmenopausal women (average age 63) enrolled in the Women’s Health Initiative study between 1994 and 2001 examined the relationship between carbohydrate intake and insomnia risk.

The researchers analyzed various aspects of carbohydrate consumption, including:

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

After a three-year follow-up period, the study revealed significant findings regarding the relationship between diet and insomnia risk in postmenopausal women.

The Role of Glycemic Index in Sleep Quality

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

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

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

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

The study found that women with higher-GI diets had a greater risk of developing insomnia. Additionally, women who consumed more added sugars (such as white and brown sugar, syrups, honey, and molasses) were also at an increased risk of insomnia.

The Benefits of a Low-GI Diet for Sleep

The research suggests that adopting a low-GI diet may help improve sleep quality in menopausal women. This dietary approach offers several potential benefits:

1. Stabilized blood sugar levels: Low-GI foods help maintain steady blood sugar levels, reducing the likelihood of nighttime awakenings caused by blood sugar fluctuations.
2. Reduced inflammation: Many low-GI foods are rich in antioxidants and anti-inflammatory compounds, which may contribute to better sleep quality.
3. Improved hormone balance: A low-GI diet may help regulate hormone levels, potentially alleviating some menopausal symptoms that disrupt sleep.
4. Enhanced overall health: Low-GI diets are associated with numerous health benefits, including reduced risk of heart disease, diabetes, and certain cancers.

Incorporating more low-GI foods into your diet may not only improve sleep quality but also promote overall health and well-being during menopause.

Dietary Recommendations for Better Sleep During Menopause

Based on the study findings, here are some dietary recommendations to help improve sleep quality during menopause:

1. Prioritize low-GI foods: Focus on incorporating fruits, vegetables, legumes, nuts, seeds, and whole grains into your meals.
2. Limit high-GI foods: Reduce consumption of processed grains and foods with added sugars.
3. Choose balanced snacks: Opt for nutrient-dense, low-GI snacks, especially if eating close to bedtime.
4. Avoid large meals before bed: Aim to eat your last substantial meal at least 3-4 hours before bedtime.
5. Stay hydrated: Drink plenty of water throughout the day, but limit fluid intake close to bedtime to prevent nighttime awakenings.

By following these dietary guidelines, menopausal women may be able to improve their sleep quality and reduce the risk of developing insomnia.

The Importance of Timing and Portion Control

While the types of foods consumed play a crucial role in sleep quality, the timing and portion sizes of meals are equally important. Here are some additional recommendations to optimize your diet for better sleep:

• Establish regular meal times: Eating at consistent times each day can help regulate your body’s internal clock and improve sleep patterns.
• Practice portion control: Overeating, especially close to bedtime, can lead to discomfort and disrupt sleep.
• Consider intermittent fasting: Some studies suggest that intermittent fasting may improve sleep quality. Consult with a healthcare professional before starting any new dietary regimen.
• Limit caffeine and alcohol: Both can interfere with sleep, especially when consumed later in the day.

By paying attention to not only what you eat but also when and how much you eat, you can further optimize your diet to support better sleep during menopause.

Addressing Other Factors That Affect Sleep During Menopause

While diet plays a significant role in sleep quality, it’s important to address other factors that can affect sleep during menopause. These may include:

• Stress management: Practice relaxation techniques such as meditation, deep breathing, or yoga to reduce stress and promote better sleep.
• Exercise: Regular physical activity can improve sleep quality, but avoid vigorous exercise close to bedtime.
• Sleep environment: Ensure your bedroom is cool, quiet, and dark to create optimal sleeping conditions.
• Hormonal therapy: Discuss the potential benefits and risks of hormone replacement therapy with your healthcare provider if menopausal symptoms are severely impacting your sleep.
• Natural supplements: Some women find relief from sleep disturbances with supplements like melatonin or valerian root. Always consult with a healthcare professional before starting any new supplement regimen.

By addressing these factors in addition to optimizing your diet, you can create a comprehensive approach to improving sleep quality during menopause.

The Role of Specific Nutrients in Sleep Regulation

Certain nutrients play crucial roles in regulating sleep patterns and promoting restful sleep. Incorporating foods rich in these nutrients into your low-GI diet may further enhance sleep quality:

• Magnesium: Found in leafy greens, nuts, seeds, and whole grains, magnesium helps regulate neurotransmitters involved in sleep.
• Tryptophan: This amino acid, found in turkey, chicken, eggs, and dairy products, is a precursor to serotonin and melatonin, both important for sleep regulation.
• Vitamin B6: Present in fish, poultry, and bananas, vitamin B6 helps produce melatonin.
• Omega-3 fatty acids: Found in fatty fish, flaxseeds, and chia seeds, omega-3s may help improve sleep quality by reducing inflammation.

Incorporating these nutrient-rich foods into your low-GI diet can provide additional support for healthy sleep patterns during menopause.

The Long-Term Benefits of a Low-GI Diet Beyond Sleep Improvement

While improving sleep quality is a significant benefit of adopting a low-GI diet during menopause, this dietary approach offers numerous other health advantages that can contribute to overall well-being during this life stage:

1. Weight management: Low-GI diets can help control appetite and reduce cravings, making it easier to maintain a healthy weight during menopause when metabolism typically slows down.
2. Reduced risk of chronic diseases: A low-GI diet has been associated with a lower risk of developing type 2 diabetes, heart disease, and certain types of cancer.
3. Improved cognitive function: Some studies suggest that low-GI diets may help protect against age-related cognitive decline and reduce the risk of neurodegenerative diseases.
4. Better mood regulation: Stable blood sugar levels can contribute to more balanced moods, potentially alleviating some of the emotional symptoms associated with menopause.
5. Increased energy levels: By avoiding the energy crashes associated with high-GI foods, a low-GI diet can help maintain steady energy levels throughout the day.

These long-term benefits highlight the importance of adopting a low-GI diet not only for improving sleep quality but also for promoting overall health and well-being during menopause and beyond.

Practical Tips for Transitioning to a Low-GI Diet

Making the switch to a low-GI diet may seem challenging at first, but with some practical strategies, it can become a sustainable and enjoyable way of eating. Here are some tips to help you transition to a low-GI diet:

• Start gradually: Begin by replacing one high-GI food with a low-GI alternative at each meal.
• Plan your meals: Prepare a weekly meal plan focusing on low-GI ingredients to ensure you always have healthy options available.
• Experiment with new recipes: Try new low-GI recipes to keep your meals interesting and varied.
• Read food labels: Learn to identify hidden sources of added sugars and refined grains in packaged foods.
• Cook more at home: Preparing meals at home gives you greater control over the ingredients and cooking methods used.
• Stay mindful of portion sizes: Even low-GI foods can contribute to weight gain if consumed in excess.

By implementing these strategies, you can successfully transition to a low-GI diet and potentially improve your sleep quality and overall health during menopause.

The Importance of Individualized Approach

While the research on low-GI diets and sleep quality in menopausal women is promising, it’s essential to remember that every woman’s experience with menopause is unique. What works for one person may not work for another. Therefore, it’s crucial to adopt an individualized approach when making dietary changes:

• Consult with a healthcare professional: Before making significant changes to your diet, discuss your plans with your doctor or a registered dietitian who can provide personalized advice based on your health history and current medications.
• Keep a food and sleep diary: Track your food intake and sleep patterns to identify any correlations between specific foods and your sleep quality.
• Be patient: It may take some time for your body to adjust to a new dietary pattern. Give yourself at least a few weeks to notice any changes in your sleep quality.
• Consider other lifestyle factors: Remember that diet is just one aspect of sleep health. Continue to address other factors such as stress management, exercise, and sleep hygiene.
• Listen to your body: Pay attention to how different foods make you feel and adjust your diet accordingly.

By taking an individualized approach and being attentive to your body’s responses, you can optimize your diet to support better sleep and overall well-being during menopause.

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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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.

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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.