Why Do I Sweat In My Sleep?:
Menopause & Insomnia

What Happens During Menopause?

Let’s first start by taking a closer look at menopause, which is the end of a woman’s fertility and her menstrual cycle.

This means:

• Your ovaries no longer produce the hormones estrogen and progesterone
• Your periods have stopped for one year

Menopause is a natural occurrence that usually happens around the age of 50 and is a part of aging. But the exact age these changes will start for you depends on a few different factors.

For some women, these changes can start earlier, even before the age of 40. This is referred to as premature menopause.

Common reasons women may experience early menopause include:

• Genetics
• Surgery
• Treatment of certain diseases
• Illness

We tend to talk about menopause as though it’s an instant, immediate change, but that’s certainly not the case. In fact, it’s a process that happens over a few years through three different phases.

Phase 1: Perimenopause

Your body may begin to have low testosterone, estrogen, and progesterone levels. With this, you may begin to experience some symptoms, including insomnia; however, some women can still get pregnant at this stage. Perimenopause generally lasts a few years for most women.

Phase 2: Menopause

Your body experiences your final menstrual cycle. You won’t know this is your last period until one year has passed without another. Symptoms are very common during this stage such as insomnia.

Phase 3: Postmenopause

Postmenopause is marked one year after the final menstrual cycle. Though most symptoms will have lessened, it’s still common for women to continue to experience some particularly insomnia.

But what exactly do we mean when we say symptoms of menopause? Most people immediately think of hot flashes. And while they certainly are a part of the experience, they aren’t the only ones.

Other common symptoms include:

• Changes in mood
• Lower than normal sex drive
• Hot flashes
• Hyperhidrosis (or excessive sweating)
• Increased heart rate
• Headaches
• Vaginal dryness
• Painful sex

Last but not least, many women going through menopause commonly experience insomnia as a result.

According to Dr. Carleara Weiss, Ph.D., MS, RN, and Sleep Science Advisor at Aeroflow Sleep notes:

“Insomnia is a common sleep disorder in women in all three stages. However, the likelihood of insomnia increases as the stages progress, meaning that women at postmenopausal are more likely to experience insomnia.”

It’s important to point out that many of the above-listed symptoms can be a sign of other medical conditions outside of menopause, particularly hyperthyroidism (or overactive thyroid) if you’re experiencing excessive hot flashes and night sweats.

With that in mind, it’s imperative you speak with your doctor to understand exactly what’s happening with your body.

Why Menopause Wrecks Your Sleep

So what does menopause have to do with sleep anyway? Why would the conclusion of your menstrual cycles wreck your sleep?

It turns out this has to do with the hormonal changes happening in your body, specifically the drops in estrogen and progesterone.

According to Dr. Weiss:

“Perimenopausal women experience hormonal changes in estrogen and progesterone levels that affect their metabolism, behavior, mood, and sleep. Hot flashes are one example of a result of these hormonal changes. The increase in body temperature caused by hot flashes and the sweating that follows it is often associated with insomnia. Furthermore, reduced estrogen levels may cause vaginal dryness, anxiety, and depression, ultimately leading to insomnia.”

Let’s take a closer look at estrogen first.

This hormone is key to women’s health and places a role in your:

• Reproductive system
• Urinary tract
• Heart and blood vessels
• Bones and muscles
• Skin and hair
• Brain

Estrogen is known for having an antidepressant effect. So when your body produces less, it can be an underlying cause of changes to your nervous system.

It’s also directly related to crucial neurotransmitters, including serotonin, that play a key role in your sleep-wake cycle. So when your levels decrease, your circadian rhythm is affected.

Additionally, estrogen helps regulate your body temperature, particularly at night. Less estrogen means your body may struggle to stay cool at night.

There are several common causes of night sweats, and menopause is one of them.

Having a cool body temperature is imperative in getting restorative sleep. Hence, why your sleep gets interrupted.

Next, let’s look at progesterone.

This hormone plays a key role in pregnancy. But it’s also known as a “relaxation hormone” that can help produce a sedative effect.

Again, if your body isn’t able to relax, chances are your sleep will be wrecked.

What Does Insomnia Look Like During Menopause?

The hallmarks of insomnia are:

1. Trouble falling asleep
2. Trouble staying asleep for a full 7-9 hours

And there are specific signs anyone can be on the lookout for if they suspect they are experiencing sleep difficulties including:

• Taking longer than 30 minutes to fall asleep
• Getting less than 6 hours of sleep more than 3 nights in a week
• Waking up too early in the morning
• Not feeling restored even after sleep
• Feeling groggy throughout the day
• Worrying about your sleep

But what does insomnia look like specifically for women going through menopause? All of the above and then some.

Perhaps the most notable difference is the addition of hot flashes and night sweats. Like we talked about above, the changes in hormone levels lead to your body having a difficult time regulating your body temperature at night.

And yes, there is a rise in body temperature and you experience sweat. Blood rushes to your face. Your cheeks flush.

But what exactly is happening here?

It turns out this is a rise in adrenaline that’s a response to the decrease of those other hormones. This sudden burst of energy in your body not only wakes you up but can make it very hard for you to fall back asleep.

Of women who experience hot flashes, 44% present the most common symptoms of chronic insomnia.

Another thing that should be taken into account is medication side effects.

Many women begin taking new medications and supplements to combat the symptoms of menopause. But these same medications may have the unfortunate side effect of worsening your sleep.

And let’s be clear here:

Just because a woman is going through menopause, it doesn’t mean that it’s the only culprit of poor sleep or even the culprit at all.

Menopausal women are still susceptible to other insomnia causes including life stress, dietary choices, lifestyle habits, or changes in time zone.

How Else Can Menopause Affect Sleep?

In addition to insomnia, women are susceptible to other sleep disorders including restless leg syndrome and obstructive sleep apnea.

Sleep apnea, in particular, is common during this life stage. It’s believed the loss in progesterone levels can prevent the body from being able to relax the upper airways leading to snoring and lapses in breathing.

It’s also important to note that changes in mood during menopause, as well as poor sleep, can lead to mental health conditions like depression and anxiety.

It’s imperative to reach out to your doctor if you begin to experience any of these to keep up with your wellness.

Recommendations For Better Sleep During Menopause

Thankfully there are numerous options for anyone experiencing insomnia including:

• Supplements like melatonin or magnesium
• Certain sleep medicines
• Practicing sleep hygiene
• Implementing regular exercise into your routine
• Maintaining a balanced diet
• Undergoing Cognitive Behavioral Therapy
• Acupuncture

You can also try making a few small changes to your lifestyle.

For instance, make sure you’re getting regular moderate exercise. This can help you manage many of the unwanted side effects, including challenges with weight loss.

Additionally, you might change your diet up as certain food items like spicy foods, fatty foods, and alcohol can make night sweats worse.

It’s also worth noting that you should practice healthy sleep hygiene practices, including keeping your thermostat at a sleep-friendly temperature and making sure your room is dark as possible.

There are also specific treatments available for women undergoing menopause.

Hormone Replacement Therapy

The first is Hormone Replacement Therapy (HRT) where you receive either estrogen, progesterone, or sometimes both in the form of a pill, patch, or vaginal cream.

This has been shown to be a very effective treatment in reducing hot flashes and night sweating which can, in turn, improve sleep.

However, it’s not the right option for all women. In particular, women who have experienced health conditions like blood clots, have a history of heart attack or stroke, or have a history of cancer or other health problems may not be candidates for HRT.

Regardless, hormone therapy is usually only prescribed at a very low dose and is only used as a short-term solution. Make sure to speak with your health care provider to determine if the benefits outweigh the risks for you.

Low Dose Birth Control

This option is most often used for women who are going through the perimenopause phase.

At this stage, it’s common for women to experience irregular periods, poor sleep, hot flashes, and night sweats.

Similar to HRT, low doses of birth control may relieve symptoms like hot flashes and true night sweats which may improve sleep.

This treatment usually stops once you move from perimenopause into menopause. Again, it’s important to work with your doctor to understand if this option will be helpful to you.

Low Dose Antidepressants

In the instance that a woman isn’t a candidate for HRT or chooses to not undergo it, selective serotonin reuptake inhibitors (SSRIs) may be used.

These can include, among others:

• Prozac
• Paxil
• Effexor

The anticonvulsant Gabapentin and blood pressure medication Clonidine may also be prescribed.

Again, these medications have been shown to relieve uncomfortable symptoms like night sweats and hot flashes. More research is needed to fully understand why, but early studies indicate that these medications ease these symptoms by balancing norepinephrine (adrenaline) and serotonin.

This allows your body to balance its temperature more effectively which can help you sleep.

How Long Do Menopausal Symptoms Last?

Last but not least, how long should you expect the symptoms of menopause to stick around?

According to Dr. Weiss;

“The bad news is that perimenopausal insomnia, if untreated, may last for as long as the other symptoms, such as hot flashes last. The good news is that treatment for hormonal imbalance, such as estrogen replacement therapy also relieves insomnia. Therefore, it is recommended that insomnia treatment with medications, lifestyle, and dietary changes should be conducted in combination with hormonal treatment.”

Before you begin any of the above treatment options, it’s imperative you speak with a doctor. In some cases, an over-the-counter medication like ibuprofen or acetaminophen can be helpful in managing symptoms of menopause. In the case of excessive sweating at night, you can also try applying clinical strength deodorant to your underarms.

Regardless of what method you choose, the important thing is to find whatever works to get you better rest as improving your sleep can improve your quality of life. To find what can help ease night sweats and get better sleep at night, make sure to speak with your doctor.