Struggling to Sleep in Perimenopause: Here’s Why it’s Time to Make it a Priority and Where to Start

Most of us can push through the occasional short night, but chronic sleep loss takes a real toll. The recommendation for adults is 7-9 hours of sleep. So, while it is true that not everyone needs “8” hours of sleep, it is also true that we truly don’t actually function well on “6” hours of sleep for prolonged periods of time. Chronic under-sleeping  can disrupt our memory, mood, metabolism and even impact brain function.

Habitual lack of sleep changes how the brain functions. Research is increasingly pointing to the importance of the work the brain does while sleeping and the role of sleep in prevention of long-term cognitive decline.  During certain phases of sleep, the brain clears out metabolic waste it isn’t able to do during the day. Inadequate sleep for long periods impairs executive function, and impairs non-verbal and short term memory.

In addition to cognitive changes,  sleep is deeply connected to hormones and metabolism. Chronic sleep deprivation can disrupt metabolism in several ways. Just one night of poor sleep changes appetite hormones: ghrelin (which makes you feel hungry) goes up, and leptin (which signals fullness) goes down. The result? That bottomless-stomach feeling, that no matter how much you eat, you can’t find the bottom of your stomach. Studies are also drawing connections between lost sleep and increases in weight, in part due to the result of changes in hormones such as cortisol. 

An important hormone when it comes to sleep and metabolism is cortisol, which is referred to as the “stress hormone”. Sleep helps cortisol levels “reset” for the new day and when sleep is interrupted so is this cortisol cycle which, frustratingly, makes it harder to sleep well the next night. When cortisol levels are out of balance, it can interfere with the production of other important hormones like estrogen and progesterone. Estrogen and progesterone levels change as a normal part of perimenopause. So sleep loss starts to feel like it has a bigger impact during perimenopause… because it DOES!

All of this can make weight loss harder and increase risk of prediabetes and diabetes. Ready to make sleep a priority? Here are 4 simple steps for better sleep:

1. Build routine around bedtime

   The brain responds well to routine, particularly around sleep and bedtime. Nighttime routines can include having a cup of herbal tea, turning off electronics or creating some quiet transition time from the busyness of the day.

   
   

2. Set a realistic bed time

   If you’re trying to get to bed “earlier” then move your bedtime earlier by 15-minute increments every couple of weeks instead of trying to go to bed two hours earlier in one night.

   
   

3. Support sleep through sun exposure 

   You read that right. Getting sunlight on your eyes within 30-60 minutes of waking helps regulate the sleep hormone, melatonin. Sunlight first thing in the morning helps to maximize melatonin levels at night - when you need it. (Note: This works best outdoors. Sunlight through the window does count. Step outside for a few minutes in the morning or go for a walk, if needed).

   
   

4. Stay hydrated

   Staying hydrated throughout the day helps with sleep by: - preventing sleep disruptions like dry mouth or muscle cramping in the middle of the night - helping to regulate cortisol, and stabilize energy and mood which improves your ability to fall asleep and stay asleep - supporting body temperature regulation which is crucial for good quality sleepNOTE: Staying hydrated during the day can include drinking water and eating produce. Drinking too much water right before bed may lead to getting up in the night to use the bathroom, so start to limit fluid intake in the evening. 

There are so many reasons to focus on sleep. Maybe you’ve been meaning to work on your sleep but you haven’t found your reason for prioritizing it yet. Understanding the why is often key to making sustainable changes and diving deeper for the answers we need. While these steps are a starting place, there may be a need for more support. Work with your health care provider for more individualized support. 

Sleep isn’t a luxury, it’s a cornerstone of hormonal balance, brain health, and metabolism. If you’ve been putting off prioritizing rest, now is the time to start. Even small changes in your routine can have a powerful impact.

References

Kong, J, et al. Sleep disorders affect cognitive function in adults: an overview of systematic reviews and meta-analyses. Sleep Biol. Rhythms 21, 133–142 (2023). https://doi.org/10.1007/s41105-022-00439-9

van Egmond LT, et al. Effects of acute sleep loss on leptin, ghrelin and adiponectin in adults with health weight and obesity: A laboratory study. Obesity (Silver Spring). 2023 Mar;31(3):635-641. doi: 10.1002/oby.23616. Epub 2022 Nov 20. PMID: 36404495

Papatriantafyllou E. et al. Sleep Deprivation: The Effects on Weight Loss and Weight Loss Maintenance. Nutrients 2022, 14(8), 1549; https://doi.org/10.3390/nu14081549

https://www.mdpi.com/2072-6643/14/8/1549?