One of the most vital aspects of health, sleep (and the absence of it) can have a profound affect on our lives.
Sleep is needed for everything from rest and recovery to restoration and rebalance; however, as a woman ages, this key component to wellbeing can become shifty and anxiety-ridden.
Falling asleep and staying asleep are both common issues for perimenopausal women (typically starting when women are in their late 30s to mid 40s when estrogen and progesterone begin to decline), creating a love-hate relationship with this important part of life.
Following, we asked Dr. Graves about sleep in perimenopause:
What sleep issues do you treat in perimenopausal women?
Dr. Graves: I treat trouble falling asleep and/or staying asleep with the most common being the latter.
You say staying asleep tends to be one of the biggest issues. Why do many women find themselves up in the middle of the night?
Dr. Graves: Many women wake up between 1-3am when blood sugar declines and cortisol is released to increase it.
This is a normal cycle that is usually buffered by progesterone and estrogen and slept through.
However, when estrogen and progesterone (and to some extent, testosterone) decline, the body becomes more sensitive to the released cortisol, resulting in wake ups.
What is the role stress plays in sleep and perimenopause?
Dr. Graves: Some women say things are more stressful than they used to be (think raising kids, aging parents, work expectations, etc.), some say they can’t deal with stress like they once did (the same stress-relief tools aren’t cutting it anymore), and others have a combination of both.
None of it is uncommon for those in perimenopause.
As hormones shift, the body has difficulty responding to stress like it once did in which the effects of stress are amplified, hence struggles with falling and staying asleep.
What therapeutic options at the CNMA office can help restore sleep during perimenopause?
Dr. Graves: There are a variety of things I recommend, but all are based on the actual sleep issue at hand.
For most patients, I start by prescribing acupuncture and herbal supplements.
Getting qi (energy) moving, supporting the body’s regulation to cortisol, and calming of the nervous system can all be restorative effects of acupuncture.
On average, weekly sessions for 4-6 weeks followed by maintenance sessions can help restore sleep (if after this time no notable change has occurred, I reassess with possible testing and other recommendations).
It can also be important to incorporate herbal supplements for sleep such as:
Cortisol Manager® by Integrative Therapeutics
Sleep Easy™ by Mountain Peak Nutritionals
Melatonin PR (Prolonged Release)
Lavela WS 1265™ by Integrative Therapeutics
CBD
and/or bio identical hormones like ProgonB-L 4X and PhytoB-L 4x™ by Bezwecken.
In addition, both massage and holistic counseling are complementing therapies that can help relax the nervous system and process stress.
What can a woman do at home to support good sleep?
Dr. Graves: It’s important for women to have a variety of tools to help manage stress regulate cortisol.
For good sleep hygiene, I recommend cortisol-reducing activities such as:
- yoga
- walking
- eating protein at each meal
- not drinking excessive wine and alcohol
- reducing high-sugar and processed foods
- taking adaptogen herbs (teas, supplements, tinctures, etc.)
- epsom salt baths
- daily relaxation/self-care time
and other activities that support a healthy stress response.
What is a next step for woman with sleep issues in perimenopause (or in any other life stage)?
Dr. Graves: I welcome anyone dealing with sleep difficulties to schedule a free 15 minute phone consultation with me, or call our office for scheduling at (303) -688-6698, to discuss the issues, ask questions, and determine naturopathic options.
The CNMA office provides naturopathic care, testing, massage, and holistic counseling to those in Castle Rock, Castle Pines, Highlands Ranch, Lone Tree, Centennial, Parker, Larkspur, Monument, Colorado Springs, and the greater Denver metro area. For those outside of these areas, virtual appointments are available.
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