When sleep goes south

 Sleep is a hot topic these days. A search of the App store on my phone reveals hundreds of apps designed to help us nod off, from pre-bedtime meditations to sleep trackers to rain and white noise sounds to soothe us into a snooze. Getting a solid 7-9 hours, it seems, is eluding many of us.

 This is a problem. Because evidence is growing to show that sleep – getting enough, and getting good quality – has an impact on many, many aspects of our lives and health. If we regularly get fewer than six hours’ sleep, we’re at greater risk of many diseases, including diabetes, heart disease and stroke. Poor sleep is associated with weight gain. And sleep issues, it seems, can affect our likelihood of cognitive decline.

 What’s more, not sleeping makes us feel like crap! For me, when I haven’t had enough sleep, everything is just a wee bit darker and more negative. It’s no surprise poor sleep is also linked with anxiety and depression.

 For women in midlife, the sleep deck is stacked against us. As we approach menopause and enter the turbulent perimenopause years, we can suddenly find ourselves staring at the ceiling in the wee hours more often. Up to half of women experience insomnia during perimenopause; far more than younger women. That’s because of our rollercoaster hormones; oestrogen fluctuating and causing hot flushes and night sweats is a main culprit.

 So what can be done? If you’re having trouble sleeping, don’t suffer in silence. It’s really worth seeking help to sort it. Endocrinologist Dr Anna Fenton told me:

 “Sleep is a pivotal symptom to get sorted, because if you’re sleeping better, you’re going to feel like your brain’s working. You’ll feel more energetic; you’ll feel better mood-wise. That has more flow-on effects in terms of quality of life than any other.”

 Here are five sleep strategies recommend by sleep experts and doctors.

 1.     First, get your ‘sleep hygiene’ sorted. These are the basic things we know but tend to ignore. Turn off the screens well before bedtime; the blue light from screens messes with our melatonin, another of the sleep hormones. Make sure your bedroom is cool and dark; both encourage sleep. Go to bed at the same time every night and schedule your wake-up at the same time each morning. Don’t use the bed for anything except sex and sleep.

2.     Exercise. There’s evidence to suggest regular exercise is linked with better sleep and falling asleep faster. We know exercise is great for us for lots of other reasons, too, so there’s no downside here. Just don’t exercise right before bedtime.

3.     Ban the booze and caffeine. We know this one, right? Caffeine has a long ‘half life’; that means five hours after having that last coffee, half of its caffeine is still in our systems. You can do the maths and work out when the last coffee of the day should be for you; but if sleep’s an issue, make it in the morning. Alcohol is similar: we might feel it helps us get to sleep, but it has a negative effect on the quality of our sleep, stopping us getting the restorative rest we need. If you’re waking feeling tired, it might be time to knock the wine with dinner on the head.

4.     Get yourself checked. Midlife is when more women start to experience sleep apnoea; this is when the airways are obstructed during sleep, waking you up many times a night. It’s thought this may happen because of a drop in the hormone progesterone; it could also be related to weight gain. If you have a partner, ask if they’ve noticed any strange patterns to your breathing (or snoring) at night. It might be worth checking in with your doctor and investigating apnoea.

5.     Treatments to try. There’s no shortage of prescription and over-the-counter remedies for sleep issues. You might like to start at the low-impact end of the spectrum with something herbal; there’s some evidence valerian or magnesium supplements might be helpful as sleep aids, so they’re worth a try.  Meditation and mindfulness practices, including yoga, might also encourage better sleep.

If you need more serious help, talk to your doctor. If you’re also experiencing other symptoms that are troubling you (especially hot flushes and night sweats) it might be that you’d benefit from some hormonal help. There’s good evidence hormone therapy been can improve sleep quality, as it tackles those other issues as well.

 There’s a deep dive in This Changes Everything on sleep, in the chapter: Sleepless – Insomnia, disrupted sleep and what to do about it.