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Hot Flushes, Sleep and the Menopause

Updated: Jul 27, 2020

I am writing this piece as I think there is a woeful amount of information out there about the impact of the symptoms of the menopause.

Many of the amazing women that I coach minimise their symptoms or feel embarrassed about the impact the symptoms of having on them. No they are not going mad their experience is real and valid.

The menopause has a multitude of symptoms but in this blog I am going to talk about hot flashes, that searing sweat that creeps up out of nowhere, keeping you up at night.

Sarah Meharg Menopause coach in Solihull

So first lets talk about sleep. We might think of sleep as being restful and time in which nothing happens. What we do know about sleep is that a lot of important functions happen at night including:

  • Hormone production

  • Processing of information

  • Memory formation

  • Muscles repair

  • Reduction of inflammation

We have different stages of sleep, these have recently been re categorised.

None Rapid Eye Movement 1: We are aware of our surroundings but our eyes are closed. This lasts 5-10 minutes.

None Rapid Eye Movement 2: Light Sleep, we are no longer aware of our surroundings, our heart rate and our body temperature lowers.

None Rapid Eye Movement 3: Deep Sleep, Blood supply to the muscles increases, we start to produce growth hormones to repair and build muscles.

Rapid Eye Movement: Our body is paralysed but our brain waves are similar to when we are in awake conscious states. This is the period of time in which we dream. The first period of REM happens just under 90 min after falling asleep

A sleep cycle lasts approximately 90 minutes and we have 4-6 cycles a night. Through each sleep cycle we experience greater periods of rapid eye movement in the later cycles.

Our body has a natural alertness sleep cycle called the circadian rhythm. There are many reasons you may feel fatigued, particularly if you are experiencing peri-menopausal symptoms. If you are experiencing sleep disturbance this may contribute towards day time fatigue.

During the menopause sleep is most likely to be disturbed for the following reasons:

  • Stress

  • Hot flushes

  • Needing to toilet

  • Health conditions impacting on pain.

Hot Flushes appear to impact on the earlier stages of sleep and will subside through rapid eye movement. The exact mechanism of what causes hot flashes is not a certainly however what we do know is that it is linked to a lowering of oestrogen (Specifically a drop in oestrogen rather than low levels of the hormone)

There is an area of the brain called the hypothalamus. This area of the brain has a number of functions including the release of hormones that regulate temperature, stress response, appetite and sex drive and the production of Estrogen, this Estrogen in turn helps the hypothalamus regulate. During menopause there is dysregulation of the hypothalmic pituitary axis.,

Medication such as HRT may help however there are a number of changes that you can make that can influence your circadian rhythm and help you feel more energised in the day and sleep through the night.

At night the most helpful things you can do is keep the room cooler (about 18 degrees Celsius)

Have natural fibre bedding that extracts the heat away (Wool duvets can be great for this) and potentially have sheets that you can layer to make it easy to adjust your temperature.

Diet can influence sleep and hormonal regulation and I will write about that in more detail in my post on menopause and diet.

Morning and early afternoon exercise has been shown to help promote a good nights sleep for a number of reasons:

  • Helps your body control it's temperature and makes recovery for heat easier to achieve.

  • Reduces hot flushes at night. (although you may experience them during exercise)

  • Reduce stress

  • Reduce hypothalmic inflammation

  • It can help you feel more energised during the day

  • It can strengthen pelvic floor muscles reducing the need to toilet.

I have create a sleep hygiene checklist that also covers how to manage the stress cycle that can impact on sleep. Sign in to our resources page if you would like a free copy.

Finally if you are not sleeping well it is incredibly common to become anxious about a lack of sleep. Worrying about the impact a lack of sleep can cause a fight in which we are trying hard to fall asleep. Anxiety and battles supress the "rest and digest" response that creates sleep. Notice any worries or battles and explore ways to diffuse whilst accepting the situation will help you function. Do what you can to not worry about the lack of sleep. Change the things that are within your control and for the things that aren't within your control remember that your body is incredibly resilient. If it is becoming too difficult to manage speak to your G.P.

If you would like to find out more explore these other menopause posts

Sarah is an Occupational Therapist and personal trainer who is passionate about helping people flourish @MoodLifterPT She is always happy to be contacted if you want to find out more.

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