Summary Menopause: ULTIMATE Guide to Sleep, Hot Flashes, and Disorders (Youtube) www.youtube.com
1,289 words - YouTube video - View YouTube video
Dr. Audrey Wells Hi, everyone. I'm doctor Audrey Wells. I'm a board certified sleep medicine physician. As a sleep expert who is going through the early stages of menopause menopause myself, I know that sleep is 1 of a host of issues you might be facing. So I wanna give you some tips and tricks that I've learned and try to give you better sleep too.
Dr. Audrey Wells Let's start by talking about perimenopause. This is a period of transition in the first few years leading up to menopause. Your menstrual periods become irregular as you are experiencing hormonal fluctuations and an overall decline in estrogen and progesterone. These changes in your hormones are associated with symptoms that affect people differently and to varying degrees and time frames. Everyone is unique.
Dr. Audrey Wells You may be surprised to know that a decline in your sleep quality is common. 1 third and even up to a half of women experience sleep problems. They may even experience hormonally induced changes to their circadian rhythm. Then there's the brain fog related to sleep deprivation on top of hormonal shifts. You can also get mood changes and not in the way that you want.
Dr. Audrey Wells Women frequently experience mood swings, irritability, and symptoms of depression or anxiety. Finally, weight gain and redistribution of fat to the abdominal area is often a noticeable symptom leading up to menopause. But the bane of existence for a perimenopausal or even a postmenopausal person is hot flashes. 3 out of 4 women will experience hot flashes, which are also known as vasomotor symptoms or VMS for short. Hot flashes are also associated with sleep disruption, and poor sleep creates its own set of problems or even amplifies existing problems.
Dr. Audrey Wells 1 thing women often say is that they're woken up at night by hot flashes. What's interesting though is that if you were undergoing an in lab sleep study with sensors on your scalp to detect brainwaves, what I'd actually see is that there would be an EEG or brainwave disturbance happen first, in other words, an awakening, and then the hot flash ensues with sweating and discomfort. This is because you're having a sleep disturbance when the hormone surge changes the thermostat for body temperature in your brain. While I know these hot flashes are so annoying, there are some home remedies that you can try to help with the symptoms. You may already know about wearing pajamas and sleeping in sheets that are made from natural fibers like cotton or bamboo.
Dr. Audrey Wells These kinds of fabrics are breathable. And if you layer them, you can peel off layers during the night if you need to. You can also use a fan in your bedroom or just have 1 handy at your bedside to turn on if you're having a hot flash. Be sure to cut back or even cut out caffeine and alcohol to reduce the frequency of hot flashes. And my best advice for quick relief is to put a cold pack on your upper face, on the palms of your hands, or the soles of your feet.
Dr. Audrey Wells These are areas of high blood flow. Cooling them rapidly can help you return to comfort and get back to sleep. But if things are still not going well for you, hormones or other prescription medications could be helpful and even necessary. Now we can't talk about menopause without addressing hormone supplementation or hormone replacement therapy. In the past, there was a lot of scary information about the side effects of hormone therapy, and you may have heard it linked to an increased risk for breast cancer, heart attack, or stroke.
Dr. Audrey Wells But new research has revised that opinion. Hormone replacement is a valid consideration and a decision you can make with your physician. In fact, the North American Menopause Society recognizes hormonal treatment as first line in appropriate candidates with moderate to severe hot flashes, especially when sleep quality is affected. Replacing estrogen or estrogen plus progesterone can quickly restore sleep quality and daytime functioning. These are meaningful outcomes.
Dr. Audrey Wells You should not feel like your symptoms are not bad enough for a doctor visit. In most cases, hormones should start low and be increased slowly for symptom control and then periodically reevaluate it to see if they're still needed. You can use hormone patches or oral medication. And other non hormonal options include SSRI medication, gabapentin, some supplements which can work for, some people, exercise, and there's a newer medication out called Vioza. Now, let's talk about menopause.
Dr. Audrey Wells A woman has entered menopause when her menstrual cycles have been absent for 1 year, and this typically occurs around age 50, give or take 10 years or so. Menopausal women will also deal with hot flashes and the same treatments that I've already discussed apply. A factor going forward is the reality that your age may be associated with sleep disruption. And it follows that poor sleep quality is associated with mood fluctuation, memory problems, metabolic syndrome, obesity, and increasing risk for cardiovascular disease. There's a myth out there that you need less sleep as you get older, but this is not true.
Dr. Audrey Wells Don't make the mistake of attributing everything to aging. Sleep disorders such as insomnia, restless leg syndrome, and sleep apnea are increasingly common with age and especially for women who are postmenopausal. With sleep apnea, be aware that women can present with nonspecific symptoms, Symptoms that look different than what a man typically experiences. Risk for sleep apnea is on par with that of men in the postmenopausal season. Amid my trialing of home sleep apnea test, I find that I am now capturing the beginning of my own sleep apnea.
Dr. Audrey Wells And this is due to several factors including my age, my oral anatomy, my family history, and my menopausal status. And over time, it's normal for the severity of sleep apnea to worsen. Having sleep apnea means you have a breathing problem that not only significantly disrupts your sleep, but also interrupts the oxygen supply to your brain. Now you wouldn't tolerate low oxygen levels during the day, so don't put up with it at night either. Your brain is your most important asset, and it needs a continuous supply of oxygen and a reliable supply of sleep.
Dr. Audrey Wells Now the other thing that's important to address is the overall psychology to menopause because what you're experiencing can cause significant problems getting to sleep and staying asleep. For many women, there is frustration with weight gain. You might have brain fog or mood swings. There could be a decline in your sex life. And let's be honest, you've come to the end of your fertile time.
Dr. Audrey Wells And for many women, that is something to grieve. Menopause can be a really disorienting time for some women if your body and brain start to feel and act in unfamiliar ways. Whatever you're experiencing during this season of life, I see you, I believe you, and just know it can get better. Let's focus on what is under your control. You can regulate your sleep schedule, especially your wake up time and just keep it consistent day after day.
Dr. Audrey Wells You can clean up your diet, reduce or eliminate caffeine and alcohol. You can use exercise as an important factor for cardiovascular health, and it's important to bump up your strength training regimen to preserve or to build muscle. If these lifestyle changes are not entirely effective, it is not necessary to continue suffering. Consult with your doctor who is in the know about hormonal replacement therapy and also have a relatively low threshold for sleep testing just to make sure there aren't any blind spots that needs to be addressed. Thanks for watching, everyone.