Hot flashes at night cant sleep

Menopause is a time of major hormonal, physical and psychological change for women although menopausal symptoms vary from woman to woman. During the perimenopause or transition phase, a woman’s ovaries gradually (over several years) decrease production of estrogen and progesterone. If a woman has her ovaries surgically removed (oophorectomy), periods end abruptly and menopausal symptoms become more severe. One year after menstrual periods have stopped, a woman reaches menopause, on average around the age of 50. From peri-menopause to post-menopause, women report the most sleeping problems. Most notably, these include hot flashes, mood disorders, insomnia and sleep-disordered breathing. Sleep problems are often accompanied by depression and anxiety.

Generally, post-menopausal women are less satisfied with their sleep and as many as 61% report insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring, along with pauses or gasps in breathing are signs of a more serious sleep disorder, obstructive sleep apnea (OSA).

Changing and decreasing levels of estrogen cause many menopausal symptoms including hot flashes, which are unexpected feelings of heat all over the body accompanied by sweating. They usually begin around the face and spread to the chest affecting 75-85% of women around menopause. Prior to the hot flash, body temperature rises accompanied by an awakening. Hot flashes last on average three minutes leading to less sleep efficiency. Most women experience these for one year, but about 25% have hot flashes for five years. While total sleep time may not suffer, sleep quality does. Hot flashes may interrupt sleep and frequent awakenings cause next-day fatigue.



Treatment with estrogen (Estrogen Replacement Therapy, ERT) or with estrogen and progesterone (Hormone Replacement Therapy, HRT) has been found to help relieve menopausal symptoms. The effects of HRT and ERT vary among women depending on the form taken (pill, patch, gel, cream or injection) and the number of years used. However, recent large-scale U.S. government funded studies, the Women’s Health Initiative, were stopped due to safety concerns since it was found that taking HRT may put women at risk for cardiovascular disease and dementia. For those taking HRT to reduce menopausal symptoms, it is recommended that HRT be prescribed at the lowest effective dose and used only for brief periods, not long-term. It is recommended you talk to your physician about your symptoms, the risks and benefits of HRT and alternative approaches for managing menopausal symptoms, including sleep.

There are alternative approaches for managing menopausal symptoms which may work for you. These include nutritional products and medications such as calcium supplements, vitamin D, and bisphosphonates for the prevention or treatment of osteoporosis (thinning and weakening of the bones); estrogen creams and rings for vaginal dryness; and sleep-promoting drugs for insomnia. All forms of estrogen that enter the blood stream reduce hot flashes.

An alternative treatment for menopausal symptoms may come from soy products (tofu, soybeans, and soymilk). They contain phytoestrogen, a plant hormone similar to estrogen. Soy products may lessen hot flashes, but there are no consistent results for its ability to relieve them. Furthermore, they can have gastrointestinal side effects. Just because it is a natural product does not necessarily mean it is safer to use than other treatments.

Phytoestrogens are also available in over-the-counter nutritional supplements (ginseng, extract of red clover, black cohosh). These supplements are not regulated by the Food and Drug Administration (FDA); their proper doses, safety, long-terms effects and risks are not yet known.

Deciding what, if any, product to use and, if so, for how long, are questions a woman should discuss with her doctor. The answer will depend on personal and family medical history.


  • Eat healthy. Avoid large meals, especially before bedtime. Maintain a regular, normal weight. Some foods that are spicy or acidic may trigger hot flashes. Try foods rich in soy as they might minimize hot flashes.
  • Avoid nicotine, caffeine and alcohol, especially before bedtime.
  • Dress in lightweight clothes to improve sleep efficiency. Avoid heavy, insulating blankets and consider using a fan or air conditioning to cool the air and increase circulation.
  • Reduce stress and worry as much as possible. Try relaxation techniques, massage and exercise. Talk to a behavioral health professional if you are depressed, anxious or having problems.

How Does Menopause Affect My Sleep?

Poor sleep quality and sleep disturbance are lesser-known changes during this phase of life, says Grace Pien, M.D., M.S.C.E. , an assistant professor of medicine at the Johns Hopkins Sleep Disorders Center , but they’re very common.

You might think that a good night’s sleep is nothing but a dream once you reach a certain age. Many women experience sleep problems during perimenopause , the period of time before menopause when hormone levels and menstrual periods become irregular. Often, poor sleep sticks around throughout the menopausal transition and after menopause. Fortunately, says Pien, there’s help.

What’s “good” sleep? Women should aim for between seven and eight hours of quality, uninterrupted sleep per night, Pien says. The rule isn’t hard and fast, though; some people need less sleep and others need more. “In general, if you’re waking up regularly during the night and feel that your sleep isn’t restful, those are signs that maybe you’re not getting good sleep,” she says.

Hot Flashes and Sleep

Sleeplessness due to menopause is often associated with hot flashes. These unpleasant sensations of extreme heat can come on during the day or at night. Nighttime hot flashes are often paired with unexpected awakenings.

Pien says that though it’s common to feel like a hot flash has awakened you, research shows that many menopausal women actually wake just before a hot flash occurs.

“There are changes in the brain that lead to the hot flash itself, and those changes — not just the feeling of heat — may also be what triggers the awakening,” she says. “Even women who don’t report sleep disturbances from hot flashes often say that they just have more trouble sleeping than they did before menopause.”

Other Menopausal Sleep Disruptors

At this stage of life, women can also develop sleep disorders such as sleep apnea , which may come from a loss of reproductive hormones like estrogen and progesterone. These can go undiagnosed because women often attribute symptoms and effects of sleep disorders (like daytime fatigue) to menopause itself.

“Postmenopausal women are two to three times more likely to have sleep apnea compared with premenopausal women,” Pien says. “Before we become menopausal, we’re fairly protected, but the protective effect of hormones seems to be lost with menopause. Furthermore, women often have more subtle symptoms of sleep apnea than men. Thus, they may be less likely to seek evaluation for sleep apnea. Their health care providers may also be less likely to recognize sleep apnea as a possibility, further delaying evaluation and diagnosis of sleep apnea.”

Depressive symptoms and anxiety may also be risk factors for poor sleep during menopause.

Sleep Problems and Menopause: What Can I Do?

The years of the menopausal transition are often a time when there are other changes in a woman’s life. You may be caring for aging parents, supporting children as they move into adulthood, and reflecting on your own life journey. Add hot flashes on top of all this, and you may find yourself having trouble sleeping at night.

Not getting enough sleep can affect all areas of life. Lack of sleep can make you feel irritable or depressed, might cause you to be more forgetful than normal, and could lead to more falls or accidents.

Some women who have trouble sleeping may use over-the-counter sleep aids like melatonin. Others use prescription medicines to help them sleep, which may help when used for a short time. But, medicines are not a cure for insomnia. Developing healthy habits at bedtime can help you get a good night’s sleep.

Getting a Good Night’s Sleep During the Menopausal Transition

To improve your sleep through the menopausal transition and beyond:

  • Follow a regular sleep schedule. Go to sleep and get up at the same time each day.
  • Avoid napping in the late afternoon or evening if you can. It may keep you awake at night.
  • Develop a bedtime routine. Some people read a book, listen to soothing music, or soak in a warm bath.
  • Try not to watch television or use your computer or mobile device in the bedroom. The light from these devices may make it difficult for you to fall asleep.
  • Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
  • Exercise at regular times each day but not close to bedtime.
  • Avoid eating large meals close to bedtime.
  • Stay away from caffeine (found in some coffees, teas, or chocolate) late in the day.
  • Remember, alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Read and share this infographic to get tips on how to get a good night’s sleep.

If these changes to your bedtime routine don’t help as much as you’d like, you may want to consider cognitive behavioral therapy. This problem-solving approach to therapy has recently been shown to help sleep disturbances in women with menopausal symptoms. Cognitive behavioral therapy can be found through a class or in one-on-one sessions. Be sure that your therapy is guided by a trained professional with experience working with women during their menopausal transition. Your doctor may be able to recommend a therapist in your area.

Learn more about getting a good night’s sleep as you age.

For More Information on Menopause and Sleep

National Sleep Foundation

North American Menopause Society

This content is provided by the National Institute on Aging (NIA), part of the National Institutes of Health. NIA scientists and other experts review this content to ensure that it is accurate, authoritative, and up to date.

Content reviewed: May 13, 2017

How Can I Treat Sleep Problems Related to Menopause?

The traditional treatment for the symptoms related to menopause — like hot flashes and insomnia — has been hormone replacement therapy (HRT). HRT consists of estrogen given as a pill, patch, or vaginal cream, either alone or combined with progesterone (for women who still have their uterus).

If you are not a candidate for HRT, if your symptoms are not severe, or if you simply decide not to use HRT, medications originally used as antidepressants may help relieve hot flashes. These include low doses of fluoxetine (Prozac), paroxetine (Brisdelle, Paxil), venlafaxine (Effexor)), and many other SSRI’s. In addition, the Bazedoxifene (Duavee) has been shown to incease sleep quality. And two other drugs — the anti-seizure drug gabapentin and the blood pressure medication clonidine — also may be effective for menopausal symptoms.

In addition to medication,the following tips might keep you cooler at night and help you sleep better without the use of hormones:

  • Wear loose clothing to bed. Clothing made of natural fibers, like cotton, is usually best.
  • Keep your bedroom cool and well-ventilated.
  • Avoid certain foods that may cause sweating (such as spicy foods), especially right before bed.

Other practices that may ease sleep problems during menopause include:

  • Maintain a regular bedtime schedule, including going to bed at the same time every night.
  • Exercise regularly but not right before sleep.
  • Avoid excessive caffeine.
  • Avoid naps during the day, which can prevent you from sleeping well at night.
  • Talk to your doctor about prescription medications that can help you sleep.
  • Make sure you empty your bladder before bed.

Insomnia and Menopause

Many women have trouble sleeping during the menopause. Here we list 8 ways for you to improve your sleep during menopause. It may be time to get a new mattress.

Maybe indulge in some nice new bed linen.

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Difficulty sleeping can be one of the more challenging symptoms of menopause

Insomnia is a very common symptom of menopause, but may not always be recognised or identified as such. Sleep changes include difficulty going to sleep or falling asleep quickly only to spring wide-awake several times a night or every hour on the hour.

What causes insomnia during menopause? Do hormones cause insomnia?

Some of this waking can be linked to menopausal symptoms. Anxiety and worry can prevent us getting to sleep, and when we finally get to nod off hot flushes can wake us again. Our sleep may also be disturbed by having to get up during the night to go to the toilet. It is also common to wake in the early hours of the morning, particularly if we go to sleep in an anxious state of mind with niggling worries and concerns. Women often say that they can put up with night sweats, but they can’t cope with the lack of sleep. This continuous lack of sleep can cause us to become depressed.

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    A relaxing bath can be a great way to unwind.

A time of transition in sleeping habits

Other sleep problems may be related to the fact that perimenopause, like adolescence, is a time of transition in sleep patterns. Typically, this changes again after menopause, when we tend to need less sleep than during our 20s and 30s. Some women find daytime naps help during the transition.

Try these simple ways to enhance your chances of getting a good night’s sleep:

  1. If night sweats are the main cause of your night time waking then the first thing to do is to try to reduce or eliminate night sweats – click here for some practical solutions.
  2. Avoid all caffeine, not just at night but during the day as well. Use calming herbal teas such as chamomile and lemon balm to relax your mind.
  3. Your mattress: You may need to improve your sleeping environment. Many people realise that their mattress has lost support and needs to be replaced. Don’t forget that you spend one-third of your life asleep!! Most mattresses need to be replaced every at least every 10 years. Maybe indulge in some nice new bed linen. Make sure that your bed is a glorious haven! Visit Anna’s post to find out more about mattress choice and care.
  4. Look to make changes in diet and nutrition. Eat plenty of lean protein, green vegetables, and complex carbohydrates. Eat early in the evening and ideally don’t eat after 6 pm. If your digestion is working properly, you will probably sleep better.
  5. Develop good pre-sleeping habits: a regular sleeping ritual each evening helps set the tone for good sleep. Don’t surf the web or read, watch, or listen to anything that might be disturbing or thought-provoking before bedtime. Avoid stressful discussions or difficult phone calls near bedtime. Spend time relaxing before going to bed – this helps to stop the mind from buzzing and we are less likely to be kept awake by stressful thought patterns and their effect on our adrenal glands.
  6. If you are waking during the night and feeling anxious try to anticipate this problem by writing down worries that are on your mind. Make a list of things you need to do the next day before you go to bed, and then try and forget them. This will help you calm down and means that you do not have everything rushing around in your mind as you try to go to sleep. Keep a journal or notebook beside your bed to jot things down if you wake during the night.
  7. Consider using herbal tinctures such as Avena Sativa, best taken in warm water before bedtime. Alternatives include Valerian and Passiflora, and they all help to re-establish a good sleeping pattern.
  8. Listen to some guided meditations. If you search online you’ll find different voices and lengths of guided meditation search around for one that appeals to you. I like some of the 10 minute guided meditations, you might prefer something longer.
  9. Sleep on Silk! Some are saying that ‘Silk is the new Sleep’ and we agree. Through our sister company The Silk Pillowcase we have developed a beautifully luxurious ivory silk pillowcase to enhance deep and relaxing sleep. Silk pillowcases have the added bonus that they are recommended by dermatologists for their skin benefits and many women swear by them for their anti-aging, anti-wrinkle properties. We also love them for the fact that you can always find a nice cool spot in the midst of a night sweat frenzy. And our curly headed Second Springers love that they reduce frizziness as silk is a non-static fabric. Use the code Silk10 at to get your Second Springer 10% discount.

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    You can find yourself waking up several times a night

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  • From the benefits of a daytime nap to the right things to do just before bed, here is your must-have guide to helping you relax, unwind and get a good night’s sleep

    Changing hormone levels associated with the menopause can wreak havoc on our sleep which, as well leaving us exhausted, can impact our mood, confidence and even our skin. The good news is there’s plenty we can do to get more shuteye.

    Boost your sleep hormones

    Dr Sohère Roked, GP and hormone expert at the Omniya MediClinic, says boosting our melatonin levels can improve the depth, quality and pattern of sleep. “We produce most melatonin between 10pm and 2am so aim to be in bed before midnight. Even alarm clock light can disrupt production so make sure your bedroom is completely dark.”

    Get the right bedtime routine

    “Smartphones, laptops and tablets emit blue rays that can disrupt sleep so switch devices off 30 minutes before bed,” says Dr Roked. “Instead, take a warm bath, read a book or meditate. For evening exercise try yoga, pilates or walking. Intensive cardio will boost energy during the day and help you sleep, but it spikes levels of the stress hormone cortisol so best avoided four hours before bed. Also, cut out caffeine after midday – it can stay in your system for 8 hours.”

    Stay in bed

    ‘While the menopause may trigger insomnia, it tends to be the anxiety and fear associated with sleeplessness that amplifies the problem,” explains Dr Guy Meadows, clinical director of the Sleep School and sleep expert for Bensons for Beds. “The traditional advice is to get out of bed and do something boring, like read a book, but when you get up it’s logged by your internal body clock and can become a habit. Your body says: ‘Hey it’s 2am, time to get up!’. There’s a lot of benefit from simply resting at night so I recommend staying in bed and using mindfulness to ease anxiety instead.”

    Let it go

    “The more you worry about not sleeping the less you’ll sleep,” says Dr Meadows. “Mindfulness can help loosen the grip of unhelpful thinking patterns, enabling us to observe thoughts without buying into them. Take a few minutes to focus on something that anchors you to the present – the movement of your breath or the touch of the bed on your body. Be open to the fact that your mind will wander then choose to let go of that thought and come back to your breath or the bed. It’s not designed to get you back to sleep, but to let go of unhelpful thoughts. Practise during the day for about 10 minutes. You don’t have to lie in a darkened room – you can do it on the bus, train or when you’re walking.”

    Rethink your nightcap

    “Alcohol tends to increase the speed with which we fall asleep” explains Dr Meadows. “It takes an hour to metabolise one unit. So if you have a glass of wine at 7pm it will probably be out of your system by 9.30pm and won’t impact your sleep. If you drink the bottle then you’ll probably feel the consequences.” Dr Roked adds: “Alcohol is also a vasodilator – it opens up the blood vessels, making sleep-disrupting hot flushes worse.”

    To nap or not to nap

    “People believe daytime napping will weaken their drive to sleep at night but, like an overtired child, forcing yourself to stay awake can actually lead to more fractious sleep,” says Dr Meadows. “Try a power nap of up to 30 minutes between midday and 3pm, when we have a natural slump. It doesn’t matter if you sleep, just use the time to rest. It can still improve anxiety and energy.”

    Coping with hot flushes

    “Mindfulness can be a powerful tool for night sweats,” says Dr Meadows. “Once you’ve controlled everything you can – wearing light clothes and so on – you’re left with the stuff you can only accept. I teach people to be willing to experience the discomfort in a more neutral, objective way. By describing it without judgement – eg, ‘I feel a hot flush. I feel it most in my back. I’m sweating right now’ – you’re not amplifying it with anxiety.”

    Watch Yvette Fielding discuss her experience of the menopause in the video below “

    The ‘me’ in menopause

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    This article reflects the opinions of Dr Sohère Roked and Dr Guy Meadows and is intended as general information only. You should seek advice from a professional before starting any new regime or course of conduct.

    This article is intended as general information only. Seek advice from your GP before starting a new exercise regime. Ask a qualified trainer to demonstrate exercise moves.

    14 ways to stay cool at night without AC

    Is there anything worse than being too hot to sleep? Probably, but no one likes to feel like they’re fighting sweaty sheets.

    Not only is heat uncomfortable, it’s bad for your sleep, too. The ideal temperature for sleep is somewhere in the low to mid-60 degrees Fahrenheit. In fact, anything above 75 degrees interferes with the quality of your sleep.

    If you live without air conditioning, you no longer have to suffer during sweltering hot summer nights. Just follow our top fifteen tips to stay cool at night without A/C.

    1. Switch out your pillow.

    Your brain generates a lot of heat while it works, and that holds true even when you’re sleeping. To cool down at night, you’ve got to cool down your head. That means cooling down your pillow. Here are a few options for doing so:

    • Use a foam or buckwheat pillow instead. Both of these types of pillows do a better job at comfortably cradling your head and neck while also sleeping cooler. Memory foam pillows provide superior contour in particular. Look for models made with cooling gel-infused foam or ventilated foam for optimal airflow.
    • Take it to the next level with a pillow specifically designed for a cooler sleep experience. Cooling pillows are typically made from gel-infused memory foam or latex, with breathable fabric covers.

    2. Invest in cooling sheets.

    Just as there are cooling pillows, there are cooling sheets. These sheets are made from breathable materials like organic cotton or bamboo. They’re also designed to wick away moisture, so in the off chance you do sweat, you’ll still be comfortable and dry.

    If you want the cozy feel of a blanket, but without the heat, you can get a cool comforter, too. Consider trading in your winter flannels for a set of cooling sheets in the summer.

    3. Make your own A/C.

    It’s time to unleash your inner Macgyver. Build your own A/C by putting cold ice cubes in a large bowl and placing that in front of an electric fan. As the ice melts, the fan will blow a cool breeze throughout the room.

    Depending on the size of your fan, you may want to play around with the optimal placement. Even a small personal fan in front of a small bowl on your nightstand will help cool your head at night. Bonus points if you set up multiple fans around the room.

    4. Sleep like an Egyptian.

    If anyone knows how to stay comfortable while it’s hot, it’s the Egyptians. Follow this sleep hack, known as the “Egyptian method,” to cool down your bedroom at night.

    Soak a bedsheet or a large towel in water. Then wring it out or put it in the washing machine on the spin cycle. Once it stops dripping, get into bed and lay the towel or sheet on top of you. As long as you have a breeze going—from a ceiling fan, floor fan, or open window—you’ll feel your body cool down.

    Alternatives include hanging the sheet in front of an open window or wearing damp clothes to bed. To prevent any damage to your mattress with this method, you’ll want to put a dry towel underneath you to catch any moisture.

    5. Sleep naked.

    Here’s an economical tip: save on pajamas and sleep naked. Sleeping naked is actually ideal for your sleep quality, as without pesky clothing on, it’s easier for your body to thermoregulate and maintain a cool body temperature.

    If you feel too exposed, you can always throw on a pair of socks.

    6. Shut the blinds.

    The sun emits a lot of light, and a lot of heat. During the summer, the sun’s rays are even more powerful. Keep your curtains drawn and your blinds shut during especially hot days, to prevent the sun from heating up your home.

    For ultimate protection against the sun’s rays, get yourself some blackout curtains. These will keep the light out all day and night, keeping your home cool and helping you sleep more deeply at night.

    7. Get a cooler mattress.

    Your mattress is yet another source of heat in your sleep environment—especially if you’re sleeping on a mattress known to trap heat. Memory foam mattresses are notorious for trapping body heat, while organic latex, innerspring, and some hybrid mattresses are the best mattresses for staying cool.

    If you don’t have the budget for a new mattress, you can split the difference with a cooling mattress pad or topper. These are designed to give you extra cushioning, while also neutralizing your mattress’s surface temperature. For an extra cool sleeping experience, look for ones that contain fans or water tanks built-in.

    8. Put your sheets in the freezer.

    While you’re following your bedtime routine, pop your sheets in the freezer for a few minutes. You want to leave them in there long enough to feel cool to the touch, but not too long that they actually freeze. You’ll love how these feel once you’re ready to go to sleep.

    9. Fill a water bottle with ice water.

    Hot water bottles may be for warming you up in the winter, but that doesn’t mean you can’t get creative with them. During hot nights, fill yours up with ice cold water. Tuck it into bed with you, down by your feet. Your feet are particularly sensitive to temperature, so keeping them cool will cool your whole body down.

    10. Cool off your pulse points.

    You’ll need more room in your freezer for this one. Put some wet washcloths or ice packs in your freezer. Before you go to bed, lay down and place these on pulse points like your neck, wrists, elbows, groin, ankles, and behind your knees. Cooling down these areas will set off a chain reaction that quickly cools down the rest of your body.

    Alternately, you can dip your feet in a bowl of cool water.

    11. Take a shower.

    Even when it’s hot, not everyone can bear to take a cold shower. Good news: you don’t have to for this tip to work. You can even go so far as to take a warm bath.

    When you get out of the tub or shower, the water will evaporate from your skin. As this happens, your body cools down, reinforcing your natural circadian rhythms and signaling to your brain that it’s time to sleep.

    12. Move your bed closer to the floor.

    We all know hot air rises. Get yourself further away from hot bedroom air by lowering your bed closer to the floor. This may mean removing it from your bed frame during the summer.

    Most beds are covered to be placed on a solid surface like your floor, but always check your mattress warranty first to ensure you’re covered.

    13. Change your sleep position.

    It can be tough to train yourself to sleep in a new position, but it is possible. If you’re desperate to cool down at all costs, try changing your sleep position to your back in a spread eagle, with your arms and legs stretched out. Keeping your body parts away from each other prevents them from trapping heat and creating sweaty situations.

    If you don’t already sleep on your back, getting a pillow for back sleepers can make this transition easier.

    14. Get hydrated.

    Staying hydrated helps your body thermoregulate more efficiently, and it also makes your sleep better. Drink a cool glass of water before bed (but not more than that, unless you want to wake up in the middle of the night for a bathroom break).

    If water bores you, switch things up with crushed ice or a popsicle. Just make sure your popsicle isn’t too fruity, or the sugar rush may keep you up.

    For more advice on sleeping well, check out our pro tips for better sleep hygiene and how to fall asleep faster.

    Too Hot to Sleep? How To Keep Cool On Hot Summer Nights

    While high-end temperatures make a welcome debut for us sun-starved Britons, steamy nights and baking bedrooms do little to lull us to sleep. Here are our tips for keeping cool and comfortable in bed when it’s too hot to sleep.

    • Take the air. Open windows – and doors – to create a draught
    • Lose the duvet and blankets. Just use a cotton sheet, if anything, or a duvet with a low tog rating
    • Slip into something a little more comfortable. Wear light cotton nightwear – or go completely naked
    • Soak up some shower power. There’s nothing more refreshing on a hot summer night than a deliciously cool shower (or bath) before bedtime
    • Tap into drink. Have plenty of cold water and always keep a glass handy by the bed
    • Try the diet for good dreams. Avoid too much alcohol or a big meal – both can make you hot and steamy in the middle of the night through dehydration and over-active digestion
    • Sleep like a baby. Fill a hot water bottle with ice cold water
    • Don’t be a hothead. Put your pillow case in the fridge before bedtime
    • Breeze through the night. Use an electric fan and put a tray with ice cubes in front of it.
    • Sock it to them. Chill socks in the fridge before bedtime as it will help to lower your core body temperature.
    • Keep some space between you and your partner. Stop snuggling and put some space between you to help stay cool. It helps if you have a big enough bed too! In fact, next time you buy a new bed, make sure it’s big enough for two of you to sleep without disturbing each other: 5ft should be your minimum.

    Have you any further tips for when it’s too hot to sleep? We would love to hear them.

    This post was first published June 2018 and has since been amended

    40 tips for sleeping during a heat wave (when you don’t have AC)

    It appears that the summer’s first heat wave has already come (and gone, for some), but that is no indication that super-hot nights aren’t still on the calendar over the coming weeks.

    If you do not have household air conditioning or window or wall units, it can be extremely difficult to sleep during hot summer nights. However, your body needs to maintain a core temperature that’s normal to slightly less than normal for the circadian system to work most efficiently. That means keeping yourself as cool as you can at bedtime. (See also our forum discussion: How cold or warm is your bedroom?)

    While no single tip we offer here is a foolproof solution for reducing room and body temperatures during a heat wave, you might find that when you put together several of these sleep hygiene solutions, you’ll achieve some comfort at bedtime during the next string of hot days that’s sure to come this summer.

    40 Tips for Sleeping During a Heat Wave (without air conditioning)

    Use cotton sheets; they are a better choice than polyester, satin or silk because they are breathable and promote ventilation.

    Freeze a gel-filled eye mask and put it on at bedtime.

    Stow you sheets in a plastic bag, then freeze them. Put them on right before you go to bed.

    Keep your windows closed at night if the exterior of your house is warmer than the interior. Or, keep your windows open at night if the exterior of your house is cooler than the interior. This is where one of those digital indoor-outdoor thermometers comes in handy.

    Use your hot water bottle or heatable buckwheat pack or pillow for cooling down: freeze water in the hot water bottle or tuck the buckwheat pack or pillow in the freezer.

    Avoid alcoholic beverages, as they can have a warming effect on the body’s core temperature, and they can also disrupt sleep patterns.

    If you have a shady side of the house, opening the windows on that side can help bring in cool morning air.

    Remember that heat rises. Some people actually drag their mattress to the first floor or sleep on the couch to avoid stuffy upper floor bedrooms.

    Invest in room darkening shades in your bedroom to deflect heat.

    Depending upon your bedroom window’s exposure, you may wish to open your bedroom window during a cool shady morning, then close it before the sun strikes that side of the building.

    Remove your blanket and replace with a sheet that you spritz with water. Keep the spritz bottle nearby to refresh the sheet (and your face) during the night.

    Try this makeshift air conditioner: Set a shallow roasting pan full of ice in front of a fan, then turn on the fan. The fan’s breeze will be cool and mist-like.

    Choose moisture wicking pajamas, if you can. Or try sleeping in the nude. Whatever is most comfortable for you matters most.

    Avoid getting too much sun during the day; you’ll feel the radiance of burned skin while trying to sleep at night. Use cooling aloe on the skin at night before bed, even if you don’t have a sunburn; it can refresh the skin and cool it down.

    Purchase herbal cooling towelettes or cold compresses and apply them to hot spots on your body (base of the neck, wrists, insides of elbows, around the groin, and behind the knees). Apply at pulse points on wrists and ankles, as well.

    Use multiple fans to keep the air circulating, if you have them.

    If you just can’t get enough quality sleep at night, plan for a nap in a cool space during the day until the heat wave passes so you don’t become sleep deprived.

    Use a high-tech pillow known as a “chillow,” which is engineered to stay cool all night long.

    Avoid swaddling infants and keep an eye on them; if they begin to breathe rapidly, sweat more than usual, have severe diaper or skin rash or extra-red faces, have them drink some water and get them to a cooler space.

    Sleep alone; shared body heat is great in the winter, but not so great during a heat wave.

    Keep all window treatments facing the south, east, or west closed to block out the sun, no matter what time of day. (This is for the northern hemisphere; for those “down under,” block sun coming from the north, east, or west.)

    Pick a different place to sleep. Basements, ground floors, and indoor hammocks may all be better options for temporarily weathering a heat wave.

    Open all the doors in your house to keep air circulating, unless you have rooms you wish to avoid and seal off.

    Take a cold shower or bath right before bed. Getting your hair and head wet (without shampooing) can help reduce core body temperature.

    Use your ceiling fan like a pro. Set the fan blades to spin counter-clockwise at a higher speed to push hot air down and create a wind-chill effect.

    Worry less about room temperatures; worry more about body core temperatures. If you can keep your body temperature at normal, you have a much better chance of falling and staying asleep. The body needs to be at normal or slightly lower than normal temperature in order for the circadian rhythms to modulate sleep.

    Keep the lights off. Radiant heat from light bulbs can increase the room’s temperature.

    If you have built-in fans in your kitchen and/or bathroom, turn them on. They’ll help pull hot air up and away.

    Hang a wet sheet over an open window, especially if there is a cross breeze. You may want to keep a spritz bottle filled with water nearby to keep it damp in the middle of the night.

    If it’s breezy outside, use fans to accelerate and direct that breeze throughout your house.

    Drink a tall glass of water right before bed. This can be a simple way to lower your body’s core temperature. Keep a pitcher of ice water nearby, just in case.

    Keep down the household temperature by cooking everything either in the microwave or on the outdoor grill. Or, don’t eat food that needs to be cooked.

    Wear a lightly soaked or frozen bandanna around your neck at bedtime.

    Eat very light dinners that are easy to digest; the body generates less heat when it digests light foods such as fruits and vegetables.

    Use a misting hand fan if you have one. Keep it at your bedside for quick cooling spritzes at night.

    Soak your feet in a bucket of cold water right before bed. Keep the same bucket at bedside in case you need a fresh dunk after midnight.

    If your house is hot and stuffy and you have a shady yard, you might want to simply sleep outside where the air is cooler and more likely to circulate.

    As appealing as it may sound, do not sleep in a car while its motor is running! This can be dangerous, illegal, even fatal. Accidents can occur as well as carbon monoxide poisoning and damage to the vehicle itself.

    Don’t have AC but know a loved one who does? Ask if you can crash at their place. They’ll understand.

    If you cannot cool down, and you have a cooling center in your neighborhood, don’t be afraid to take advantage. People die from heat stroke every year during heat waves unnecessarily when they could have used the services of a cooling center.

    Menopause and insomnia

    Are you sleeping easy or counting sheep?

    We all need sleep. The optimum amount for a healthy adult is deemed to be around seven hours. Insufficient sleep has been shown to have later detrimental effects on things like our mental health, heart health, cognitive functions and even risk of osteoporosis. Further, too much sleep, (more than 8 hours), can be associated with increased risk of cardiovascular disease though cause and effect are unclear; prolonged sleep may be a marker for underlying disease.

    The best kind of sleep is non-REM (rapid eye movement), which consists of three separate stages (1, 2 and 3), which follow in order, upwards and downwards as your sleep cycle progresses. Stage 3 is said to be the best kind. This is a deep sleep where we are essentially cut off from the outside world and unaware of any sounds or other stimuli. This usually occurs during the first half of the night and is where our brain activity, breathing, heart rate and blood pressure are all at their lowest levels. It’s the time when we are most likely to dream too.

    Your sleep can influence and be influenced by your health and other health conditions as you move through menopause.

    Types of disturbance

    Types of sleep disturbance include:

    • Difficulty getting to sleep
    • Difficulty staying asleep (awakening during the night)
    • Early morning wakening
    • Less total sleep time
    • Overall quality of sleep (non-restorative)
    • Problems with sense of well-being
    • Overall functioning
    • Sleepiness/fatigue during the day.

    Sleep disturbances are common during the perimenopause, menopause and postmenopause. Figures given for how many women experience sleep disturbance during the menopause range from 28 to 63%. Differences in the ways that studies have measured sleep disturbance may account for the wide range; self-reporting tends to show underestimation of total sleep time and number of arousals, with overestimation of time taken to get to sleep, compared to laboratory sleep studies. Overall, studies consistently show increased likelihood of sleep problems during the menopausal transition, with close association with the presence of flushes and sweats.



    The menopausal decline of estrogen contributes to disrupted sleep by causing menopausal symptoms from hot flushes and sweats (vasomotor symptoms) to anxiety and depressed mood; anxiety leading to difficulty getting to sleep, and depression leading to non-restorative sleep and early morning wakening. However, it has been proposed that menopausal sleep disturbance may be the underlying cause of anxiety and depression. Joint aches and pains, and bladder problems such as passing urine at night, are also common consequences of estrogen decline and can cause sleep disruption. Menopausal progesterone decline may also be involved in sleep disturbance since progesterone has a sleep inducing effect by acting on brain pathways. Melatonin, another vital hormone for sleep, decreases with age. Secretion of melatonin is partly influenced by estrogen and progesterone and levels decrease during the perimenopause, often compounding the problem.

    Sleep apnoea

    Sleep apnoea has been considered, in the past, as a sleeping disorder of men but that view is changing. Studies have shown that night sweats and hot flushes may be linked to increased risk of sleep apnoea, and it appears to be more common in women who have had a surgical menopause compared to natural menopause. It may also be associated with weight gain and there is a possible role of progesterone. Progesterone has an effect on muscle activity at the back of the throat as well as stimulus for breathing, such that decline in progesterone may contribute to partial upper airway obstruction and reduced breathing drive. Sleep apnoea is not just about loud snoring and gasping. Sleep apnoea in women can also manifest itself in other ways including headaches, insomnia, depression or anxiety and daytime fatigue. Not every woman will snore or snort loudly whilst asleep.

    Restless legs syndrome

    Restless legs syndrome (RLS) is another symptom and women are about twice as likely as men to experience it. Sufferers get tingling, creepy crawly sensations in their legs at night. One study of RLS patients found 69 per cent of post-menopausal women perceived their symptoms as worse than before menopause. However, it is not clear whether restless leg syndrome contributes to sleep disturbance, or if women who are not sleeping well are more aware of the problem.

    Treatments for poor sleep

    There are some fundamental tenets that contribute towards healthy living in general that can help you sleep well:

    • Exercise
    • Healthy eating
    • Managing stress
    • Maintaining health relationships and being socially active
    • Intellectual stimulation.

    However there are also times when you cannot control things and you need a little help. At all ages, hypnotics have been used for sleep disturbance, but there are specific treatments to consider for menopausal sleep disturbance.


    Can HRT help?

    Research says yes. Many studies have consistently shown a benefit of HRT on sleep in women who have vasomotor symptoms, when the vasomotor symptoms are causing the sleep disturbance. The main part of HRT is estrogen, to treat symptoms caused by estrogen deficiency. However, for sleep disturbance, the addition of progesterone may have an added benefit and has been shown to be associated with increased non REM 3 sleep. Progesterone or progestogen is recommended to be taken along with estrogen to prevent estrogenic stimulation of the womb lining, though is not

    needed if you have had a hysterectomy. When sleep disturbance is a prominent menopausal symptom, consideration can be given to use progesterone as the womb lining protection, rather than progestogen, which does not have the beneficial effect on sleep.

    Other medications that are used for treating vasomotor symptoms and so may help, include low-dose anti-depressants, Gabapentin and Clonidine. HRT is recommended to be used first line for menopausal symptoms but these other prescribed medications can be considered in women who are unable to take HRT.

    Studies have shown that Cognitive Behavioural Therapy reduces menopausal symptoms including low mood, anxiety and sleep disturbance. See WHC fact sheet Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms

    Isoflavones, yoga, acupuncture and massage may provide some benefit.

    If sleep apnoea is thought to be the underlying problem, then general tips on improving sleep and consideration of Continuous Positive Airway Pressure (CPAP) can be helpful. CPAP involves wearing a face or nasal mask during sleep, which, connected to a pump, provides a positive flow of air into the nasal passages to keep the airway open.

    With recognition of the role of melatonin in sleep disturbance, interest has been shown in the use of Melatonin, with studies confirming benefit. However, there is some uncertainty around the appropriate dose and possible interactions with other medications. Further research is needed.

    It’s important to remember, menopause isn’t a disease or a disorder, it’s a natural stage of life for women. It is also a time in women’s lives when our health risks change. Understanding these can help you to make the right decision to ensure your health and wellbeing through menopause and as you age. Every woman’s particular risk factors will be different, but every woman can benefit from a focus on getting a good night’s sleep, counting our blessings rather than sheep!

    Tips for improving sleep long term

    • Go to bed and get up at a regular time. Routine is very important for establishing a good sleep pattern. Establishing and sticking to set times may take a few weeks so bear that in mind
    • Ideally avoid having a nap in the day. If you do, make it no more than 30-40 minutes in the early afternoon
    • Exercise regularly but don’t overdo it within two hours of going to bed
    • Get to know what sleep you need. The average is 6-8 hours but this does vary for individuals and reduces as you age
    • Other factors can of course interfere with sleep including physical symptoms, other than those associated with the menopause. If you are taking medication for other reasons ensure you take them at the time of day they are prescribed for.
    Before going to bed:
    • Get yourself into a routine, perhaps have a warm bath or do some light reading
    • Avoid going to bed when you’re too hungry or too full. A light snack is OK
    • Have your last caffeine drink in the late afternoon/evening, including any fizzy drinks or chocolate
    • Alcohol does not help you to sleep so best avoided if you can.
    Your environment:
    • Ensure your bedroom has a restful feel. Ideally the room should be cool but not cold and screen out as much noise and light as is practical for you
    • Get comfy! Good bedding and a good mattress are essentials
    • Use your bedroom just for sleep and sex!
    • Avoid watching TV in bed or using your laptop and/or phone.
    If you wake up in the night:
    • If you just can’t get back to sleep after 20 minutes get up and go into another room. Try doing something quiet and once you begin to feel sleepy go back to bed
    • Don’t clock watch or sit in front of the TV
    • It may be hard but if you have worries or problems try hard not to focus on them during this quiet time.

    5 Ways to Stop Night Sweats and End Sleepless Nights

    By Colleen McCleery, MD, FACOG, OB/GYN—Exuberan® by Virtua

    Women experience many symptoms during menopause, but sleeplessness may be the worst.

    Lack of sleep impairs your attention, alertness, concentration and can make you accident prone. Not only that, chronic sleep loss can put you at risk for heart issues, high blood pressure, stroke and diabetes.

    The main cause of sleeplessness during menopause is night sweats.

    When the body heats up, you wake up. So, the key to a better night’s sleep is being mindful about controlling your body temperature.

    Below are some ideas for staying cool.

    Avoid alcohol and spicy foods

    Spicy food and alcohol increase your body temperature, making it more likely that you’ll have night sweats. Instead, drink a cool glass of water to start your bedtime routine. Remaining well-hydrated helps keep the sweats at bay.

    Don’t exercise in the evening

    A sure way to elevate your body temperature is evening physical activity, which increases night sweats. Schedule your cardio for earlier in the day, and instead plan for stretching or gentle yoga at night to to relieve stress and lower your body temperature.

    Take a cool bath or shower

    Showering or bathing in cool water will lower your body temperature and minimize your chance of having night sweats.

    Optimize your bedroom conditions

    Avoid using polyester sheets, as they hold heat. Use cotton sheets instead and run a fan. The cotton sheets can breathe and the fan will keep cool air flowing around you all night.

    Try bioidentical hormone replacement therapy

    While you may be able to keep your night sweats at bay with the above ideas, you could also eliminate them all together with bioidentical hormone replacement therapy.

    Bioidentical hormone replacement therapy is proven to relieve symptoms of menopause in women (and andropause in men) by restoring lost vitality due to age-related hormone changes. It’s designed to replenish the testosterone and estrogen that both men and women progressively lose after they hit their mid-40s.

    Each pellet is custom made to fit an individual’s unique body chemistry and is based on overall well-being, physical exam, lab results, gender, age and weight.

    If you’re a menopausal or peri-menopausal female, are experiencing hot flashes, night sweats, insomnia, irritability, worsening memory and lack of mental clarity, and have a decreased or absent sex drive then bioidentical hormone replacement therapy may be for you.

    To schedule a consultation, call 1-888-982-3726.

    Updated May 29, 2019

    Source: Sleep to Be Sexy, Smart and Slim; Reader’s Digest

    1. Think about short-term HRT.

    Surprised? Hormone replacement therapy (HRT) has largely fallen out of favor among women and their doctors, and for good reason. Long-term research studies have found it can increase your risk of blood clots, breast cancer, and gallbladder disease.
    Still, the fact is that perimenopausal women who use HRT sleep better. Whether it’s because it reduces hot flashes or has some other effect isn’t known.

    How do you weigh the risks and benefits? ‘The risks and benefits of any treatment need to be individualized to your particular body‘not just what the research says or professional scientific associations prescribe,’ says Dr. Becky Wang-Cheng, a medical director at Kettering Medical Center and author of Menopause.

    If breast cancer runs in your family but hot flashes are preventing you from getting enough sleep to do your job, a super-low dose of hormones might be helpful despite the research. And we’re not talking about long-term or daily use. ‘Sometimes just one pill a week is enough to keep symptoms in check,’ says Wang-Cheng.

    Dr. JoAnn Manson, the Harvard researcher who pioneered much of the research that uncovered the dangers of HRT and author of Hot Flashes, Hormones and Your Health, agrees that HRT should still be an option for some women.

    Most women do not need hormone therapy to get through the hormonal transition into menopause, says Manson. Menopause is natural, and we need to guard against the over-medicalization of our lives. ‘However, for about one in every five women, menopausal symptoms are severe enough to disrupt sleep and quality of life,’ she adds. ‘Hormone therapy still has an important role to play for such women.’

    2. Reinforce your sleep schedule

    Like other kinds of insomnia, the sleeplessness of perimenopause can be overcome by sticking to the cycles of sleeping and waking that you have previously established with your biological clock. This helps your body override some of the conflicting messages it may be getting from wayward hormones activated by perimenopause.

    It’s important that you keep your sleeping and waking schedules pretty steady‘no Sunday sleep-ins, for example’if you want to be able to count on good, restorative sleep during this uneasy stage of life. And good, restorative sleep is the best gift you can give yourself at this time.

    If you don’t already have a firm sleeping schedule, now is certainly the time to develop one. It isn’t hard to do, and the benefits will serve you for the rest of your life.

    3. Consider an alternative treatment.

    Women who are reluctant to use estrogen may want to talk with their doctors about the antidepressant Effexor, says Wang-Cheng. It decreases the hot flashes that can disrupt sleep and is even prescribed by doctors for breast cancer patients who are undergoing active therapy.

    ‘It’s not as good as estrogen,’ adds the physician, ‘but it reduces hot flashes by 40 to 60 percent and will make you drowsy.’

    4. Work with a therapist.

    Eight or 10 weeks with a certified cognitive behavioral therapist will frequently give you a handful of sleep strategies custom-tailored to your particular issues during this life stage. If you’re regularly waking up in the middle of the night and can’t get back to sleep, however, you might find it more helpful to contact a psychiatrist to talk over old struggles that may be troubling you.

    5. Take a sleep break.

    After those nights when your reproductive hormones and the hormones that control your sleep/wake cycle really can’t work together, try to get back some of the sleep you’ve lost by 4:00 p.m. Not all of it’that’s not practical for most of us. Just take the edge off your drowsiness and you’ll be surprised at how effectively your brain cells will start firing again. If you drive to work, go out to the car at lunch, put down the backseat, and snooze for 10 minutes. Or just put your head down on your desk for 5.

    6. Wick away the problem.

    If hot flushes are your particular sleep disrupter, buy long johns, or gym shorts and T-shirts made from fabrics that athletes use to wick away moisture. Then wear them as pj’s. They won’t stop a hot flash, but they’ll keep it from turning into a majorly disruptive night sweat in which you have to get up and change clothes.

    7. Chill in bed.

    Chillow is a pillow with a cooling water insert that lowers your body temperature. It won’t stop hot flashes, but it can reduce their intensity and their ability to disrupt your sleep.

    8. Drop your temp.

    Lower the temperature of your bedroom before you climb into bed, says Wang-Cheng. Lower temperatures signal your body that it’s time to sleep, and they make hot flashes less disruptive. If your bed partner objects, just tell him to bundle up.

    A hot bath also helps you lower your body’s temperature. Yeah, your temperature goes up while you’re in the bath, but your body’s response to the heat will be to drop your temperature.
    As long as perimenopausal dryness hasn’t resulted in painful intercourse, enjoy a quickie, suggests Wang-Cheng. Some 44 percent of perimenopausal women say they don’t have time for sex. But the Big O is still one of the most sleep-inducing agents around. Just don’t forget to protect yourself against an unanticipated side effect that could appear nine months later. Now that would really trash your sleep!

    9. Tone it down.

    Toning down a jumpy sympathetic nervous system will encourage a balanced sleep/wake cycle in perimenopausal women. Think about tai chi, meditation, prayer, biofeedback, yoga’any activity that allows you to cultivate a peaceful center and a sense of balance.

    10. Talk to a sleep doc.

    If you suspect you have a sleep disorder involving breathing difficulties, restless legs or narcolepsy, ask your primary-care physician for a referral to a sleep center for testing, diagnosis, and treatment.

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