Want to understand your menopause sleep problems from a nutritional perspective? Rosie Letts, qualified and registered nutritional therapist, explains what’s happening, and how can you can make positive changes to improve your nights/take control of menopause sleep nightmares!
We spend about one third of our lives asleep, and it’s as important to our bodies as eating, drinking and breathing. Sleep plays an active role in the regulation of emotions and energy levels, as well as longevity and our detoxification processes(1).
Finding it impossible to nod off? Waking up at 3am?
Unfortunately, it is common for menopausal women to complain of difficulty falling and then staying asleep, often with night time or early morning waking(2,3). Having your sleep disturbed can make you feel lethargic, emotional and can create a heightened perception of your menopausal symptoms(4) – put simply, poor sleep makes everything feel so much worse.
All menopausal women – in fact, all people! – benefit from improving the quality of their sleep, and the good news is that for many, this can be as simple as making a few nutrition and lifestyle adjustments. But first, let’s start with what’s happening in your body to cause the issue.
What causes menopause sleep problems?
Changing hormones affecting your body’s calming chemicals
You’ll be aware of the fluctuating hormones associated with your menopause. Specifically, progesterone levels generally start to decline altering your levels of GABA, a calming brain chemical. GABA, which is partly built using magnesium and vitamin B6 from foods, plays an important role in promoting calmness and good sleep(5,6). The good news is that you can support your body in producing this calming, sleep-supporting chemical by eating the right foods or using supplements – more on that to come!
Modern life and the stress hormone cortisol
Stress can also affect sleep patterns. Your ‘stress hormone’ cortisol provides a boost of blood sugar energy enabling you to run for that bus, meet that deadline and other ‘micro-stressors’ consistent with everyday life. Yet in reality life is a succession of micro-stressors, with each one instigating the release of cortisol. This affects our natural sleep rhythm and can manifest itself as the inability to switch off at night.
Tips to reduce cortisol:
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- If you rely on coffee or a glass of wine to counterbalance your sleep deprivation they might be part of the problem. As stimulants they increase cortisol production which, in turn, means you’re less likely to have a good night’s sleep(7). Additionally, they deplete our bodies of magnesium, often referred to as ‘Nature’s Tranquilizer’, which supports muscle and mind relaxation(8), and is essential for GABA formation – that’s the calming, sleep-supporting chemical I mentioned earlier.
- Skipping meals or eating quickly digested carbohydrates (biscuits, cakes, white bread, pasta and rice) triggers the release of cortisol which makes falling to sleep and sleeping through the night more difficult. Switch to slow energy releasing foods such as beans, lentils, chickpeas, brown pasta and rice to minimize sleep disrupting cortisol.
Gut health and good sleep
You may be surprised to learn that your gut health plays an important role in sleep regulation. Your ‘sleep hormone’ melatonin is made from the ‘feel good’ brain chemical serotonin. 90% of the serotonin in your body is produced in your gut by the bacteria that live there(9).
With this in mind, it makes sense to ensure that your gut, and its beneficial bacteria colonies, are in good shape by eating a range of vegetables including leafy green vegetables, onions, leeks and Jerusalem artichokes, fruits such as berries, apples and pears, plus oat, buckwheat and quinoa wholegrains. I also recommend getting a daily dose of fermented foods such as kefir, kombucha, sauerkraut, miso or kimchi.
How much sleep do I really need?
Most of us need at least six hours of quality sleep each night. Fewer than six hours has been associated with weight gain (due to low energy levels you’re less likely to exercise and more likely to reach for high calorie pick-me-ups) and low mood, two common menopausal symptoms(3,10).
Lifestyle Tips
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- Try to manage your stress levels – mindfulness and exercise like yoga can help. Here are yoga recommendations for disturbed sleep.
- A warm bath with a cup of magnesium-rich Epsom Salts twice a week is a good way to top up magnesium levels(11). I like to add a calming lavender bath oil to relax me instantly.
- Ensure your bedroom is cool and consider your bedding and pjs – your body needs to drop 1-2°C before sleeping(12).
Nutrition Tips
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- Avoid caffeine and alcohol, replacing with soothing teas that contain lemon balm or chamomile.
- Replace refined carbohydrates such as sugar and white bread, pasta or rice with energy sustaining foods including naturally sweet fruit like bananas, wholegrain bread, wholemeal rice and noodles or brown rice.
- Eat plenty of vitamin C rich foods such as vegetables and fruit to support your cortisol producing adrenal glands.
- Promote relaxation and support GABA levels with magnesium rich foods like leafy green vegetables, nuts and wholegrains.
- Ensure a daily intake of foods containing B vitamins such as meat, fish, eggs and wholegrains like oats and brown rice, or try a vitamin B supplement.
- Eat regularly so that your body doesn’t look for energy during the night by releasing cortisol which will wake you up. If you find that you wake up hungry in the night or very early in the morning, try having a small carbohydrate rich snack before bed. Something like hummus on oatcakes or a bircher muesli is perfect.
Supplements
- Magnesium
Low magnesium levels are common in menopausal women. I recommend sipping water during the day containing magnesium citrate plus a 375-400mg magnesium citrate tablet in the evening until your sleep patterns are established.
- L-theanine
Found in tea leaves, L-theanine may reduce ‘mental chatter’ at bedtime, support the relaxation response and improve sleep quality.
- Lemon Balm
Lemon balm prevents the body from converting GABA into a more excitory brain chemical so you’ll feel calmer for longer. In 3 small studies, between 300-1000mg of lemon balm extract reduced anxiety, insomnia and stress(13,14). A good way to try and include it in your bedtime routine is with a herbal tea.
- Valerian
Valerian regulates GABA’s calming activity(15). Studies show that taking 300-1000mg of valerian at night reliably improved sleep quality in people with insomnia and restlessness(16). It may also reduce pain associated with periods(17).
Key points
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- Disturbed sleep is a common complaint during the menopause
- Reduce your stress levels
- Eat foods which support your body’s relaxation mechanisms
- Eliminate stimulants
About Rosie Letts
Rosie is a qualified and registered nutritional therapist. She has worked with hundreds of women experiencing menopausal symptoms, helping to combine nutrition and lifestyle changes that have helped to prevent or reduce the severity of symptoms including sleeping problems, mood changes, weight gain, and headaches.
Her qualifications, memberships and awards include: BSc in Nutritional Therapy – University of Westminster; ICHAN outstanding practice 2018 award; Member of the Complementary & Natural Healthcare Council (CHNC); Member of the British Association of Nutritional Therapists (BANT).
Read Rosie’s full biography here
References
1 Vyazovskiy, V. (2017). Sleep, recovery, and metaregulation: explaining the benefits of sleep. Nature and Science of Sleep 2015; 7, pp.171–184.
2 Ameratunga, D. et al. Sleep disturbance in menopause. Internal Medicine Journal 2012;42(7), pp.742-7.
3 Santoro, N. (2016). Perimenopause: From Research to Practice. Journal of Women’s Health, 25(4), pp.332-339.
4 Larson, R. & Carter, J. (2016). Total sleep deprivation and pain perception during cold noxious stimuli in humans. Scandinavian Journal of Pain, 13(1), pp.12-16.
5 Follesa, P. et al. (2000). Allopregnanolone synthesis in cerebellar granule cells: roles in regulation of GABAA receptor expression and function during progesterone treatment and withdrawal. Molecular Pharmacology, 57(6), pp.1262-1270.
6 Ehlen, J. et al. (2010). GABA involvement in the circadian regulation of sleep. GABA and Sleep, pp. 303-321. Springer:Basel.
7 Winkelmayer, W. (2005). Habitual Caffeine Intake and the Risk of Hypertension in Women. Journal of the American Medial Association, 294(18), p.2330.
8 Johnson, S. (2018). The multifaceted and widespread pathology of magnesium deficiency Journal of Women’s Health 2016 Apr 1; 25(4), pp.332–339.
9 Jenkins, T. et al. (2016). Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients, 8(1), p.56.
10 Baker, F. et al. (2018). Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and Science of Sleep, Vol 10, pp.73-95.
11 Gröber, U. et al. (2017). Myth or Reality—Transdermal Magnesium?. Nutrients, 9(12), p.813
12 F Murphy, P. & Campbell, S. (1997). Night-time Drop in Body Temperature: A Physiological Trigger for Sleep Onset?. Sleep, 20(7), pp.505-511.
13 Kennedy, D. et al. (2004). Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm).. [online] Pdfs.semanticscholar.org. Available at: https://pdfs.semanticscholar.org/de8d/56fcb9b841ec… [Accessed 25 Jan. 2019].
14 Kennedy, D et al, D. (2002). Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). – PubMed – NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12062586 [Accessed 25 Jan. 2019].
15 Benke, D. et al. (2009). GABAA receptors as in vivo substrate for the anxiolytic action of valerenic acid, a major constituent of valerian root extracts. Neuropharmacology, 56(1), pp.174-181.
15 Bent, S. et al. (2006). Valerian for Sleep: A Systematic Review and Meta-Analysis. The American Journal of Medicine, 119(12), pp.1005-1012.
16 Cuellar, N. & Ratcliffe, S. (2009). Does valerian improve sleepiness and symptom severity in people with restless legs syndrome? [online] Available at: https://www.ncbi.nlm.nih.gov/pubmed/19284179 [Accessed 25 Jan. 2019].
17 Mirabi, P. et al. (2011). Effects of valerian on the severity and systemic manifestations of dysmenorrhea. International Journal of Gynecology & Obstetrics, 115(3), pp.285-288.
