Perimenopause is the period of time a few years or more before true menopause. It causes a decline in female hormones that will ultimately lead to the cessation of menstrual periods. Many symptoms are associated with this time and there is significant connection between perimenopause and insomnia, due to the number of changes a woman's body undergoes. Quite a few women report poor sleep or regular sleep deprivation that is due to a variety of factors including decline in magnesium levels, increased anxiety or depression, higher risk for sleep apnea and hot flashes. Often, a combination of several side effects of perimenopause makes sleep difficult.
One of the more “unseen” impacts of declining hormones is reduction in magnesium and calcium levels. Magnesium, in particular, is associated with sounder sleep. When it is absent or lower than normal, sleep quality may decline. In part, perimenopause and insomnia are connected through lowered magnesium levels, and women may experience difficulty getting to sleep or remaining asleep through the night.
Low magnesium is seldom the only connection between perimenopause and insomnia. This time of life is associated with challenging mood changes that can make it hard to sleep. Some women experience real, clinical depression or anxiety that creates sleep deprivation, and ironically, poor sleep creates depression and anxiety. It’s a double-edged sword where one symptom may lead to the other and both can become serious. Regular lack of sleep and extreme changes in moods need treatment.
An additional tie between perimenopause and insomnia is that lowered hormone levels may make it easy to gain weight, and with easy weight gain comes increased risk of sleep apnea. Apnea occurs when a person stops breathing during sleep, and can occur in the night and prevent normal sleep cycling. Women who don’t recall nighttime waking but who always feel tired when they wake might want to have a sleep study performed to investigate this as a cause. In the interim, getting exercise (preferably long before bedtime) and pursuing healthy eating habits is a useful plan.
From time to time, perimenopause and insomnia are directly connected by an obvious perimenopausal symptom. Hot flashes, which can occur at night while women sleep, create wakefulness and sleep disturbance. Some women have many of these and will be woken several times nightly, and others only find this occasionally disturbing.
It’s clear that the connections between perimenopause and insomnia are diverse. These relationships suggest multiple barriers to healthy sleep, and they can lead to significant problems like depression. Many women simply live through the insomnia created by all of these causal factors, but there are a number of ways to address poor sleep. Some treatments that might be suggested include hormone therapy, therapy for depression, magnesium supplementation, and sleep medicines. Once true menopause occurs, continued treatment is not always necessary.