how to keep your cool all night
Nothing stops women sleeping more than hot flushes ...
Many women complain of sleep disturbance when they reach their menopausal years. Certainly the chaotic hormone imbalances at this stage of life are at least partly to blame.
Insomnia, anxiety, and depression are closely related and are more prevalent in women at this age than in men.
Hot flushes and night sweats can make a full night’s sleep seem impossible, while the hormonal shifts can signal the start of sleep apnoea ( where breathing is disturbed) or PLMD (periodic limb movement disorder — see previous page for more information) which could explain why you wake unrefreshed.
Whatever your symptoms, all the studies indicate that good sleep hygiene — that is, your habits in the run up to going to bed as well as your bedroom environment — adds an important layer of protection.
When you are going through the menopause, your bedroom really does have to be cool, dark and quiet, and you should be particularly mindful of the poor effects of alcohol on sleep (as well as on hormonal control). Keep drinking to a minimum if you can, because alcohol can make flushes worse, as well as disturbing your sleep.
you can prevent sleep problems from escalating out of control if you keep a strict and regular sleep/wake time every day of the week (including weekends). This encourages your body clock to stay stable and secure.
THE BEST WAYS TO BEAT THE HEAT
If you are prone to overheating in bed at night, perfect the art of the ‘ankle release’. Pull the duvet up high enough to release your ankles to the cold night air. assuming your head and hands are already uncovered, this should increase your exposure just enough to drop your body temperature without getting too cold.
and if hot sweats are leaving you with cold, damp sheets (and waking you up in the process) it may be worth thinking about what your bedding is made of. Some fabrics such as bamboo, wool and silk can help to reduce spikes in temperature by wicking away heat, and efficiently mopping up night sweats so you can get back to sleep.
NATURAL REMEDIES YOU CAN TRY
HORMONE replacement therapy (HRT) can help ease sleep problems associated with menopause, but if you prefer not to use it, or if you have been advised to avoid it, there are non-medical alternatives which might help in some cases.
although many studies looking at herbal remedies are not as robust as drug trial studies, the products can be very effective, according to Dr Jane Johnston, a Gp and associate Specialist in Women’s Health at aberdeen Royal Infirmary and an acknowledged medical expert in the use of alternative remedies for menopause.
‘There are many products on the market which combine small quantities of various herbs and supplements as a combined treatment for menopausal symptoms,’ says Dr Johnston. ‘But these small amounts are unlikely to be at effective doses.’
Instead, she recommends patients pick one supplement at a time, find a product with a THR accredita- tion (this stands for traditional herbal registration, and can be identified by the THR symbol on the packaging), which means the product is well-tested and unlikely to contain toxic contaminants.
If you’re going down this route, Dr Johnston suggests trying a single herb on its own for two months. ‘Everyone responds differently,’ she says. ‘one alternative supplement may work for one woman, and another for someone else.’
Here are some of the natural alternatives she recommends:
Isoflavones
STUDIES indicate that supplements containing plant oestrogens, called isoflavones might help calm the hormonal imbalances that cause anxiety-based insomnia in some women.
Isoflavones can be extracted in supplement-form from soy and a type of plant called ‘red clover’ and proper scientific studies have shown this can help ease the irritability, anxiety and mood swings associated with menopause. Dr Johnston recommends choosing products which deliver at least 40mg of isoflavones per day (many of the studies are based on a double dose of 80mg per day) and sticking with it for at least two months to give it a chance to work.
Try Meno-Serene, which combines a multivitamin and a plant oestrogen complex (£8.48 for 120 tablets, healthspan. co. uk), or Promensil Double Strength (£19.12 for 30 tablets, boots.com).
although plant oestrogens (also known as phytoestrogens) are harmless when consumed in normal amounts in food, there is some concern that, in supplement form, they could possibly increase the risk of breast and endometrial cancer in susceptible women (because they so closely mimic the action of human oestrogen in the body).
‘ If you’ve had breast cancer, always check with your breast surgeon or oncologist before taking a supplement,’ advises Dr Johnston. ‘Plant oestrogens have a very weak oestrogenic effect compared to HRT or human oestrogens, but if your menopausal symptoms are very bad, you may feel a supplement is worth the small risk.’
Black Cohosh
ALTHOUGH there’s some limited data to support this plant’s effects, Dr Johnston says it may be effective against psychological symptoms such as anxiety, depression and irritability in some women.
Try Kira Menopause Relief Black Cohosh (£ 10.49 for 30 tablets, kiraforwomen.co.uk) or Boots Menolieve Black Cohosh tablets (£9.89 for 30 tablets, boots.com).
But Dr Johnston warns you should avoid black cohosh if you have liver problems, as it has been linked to cases of liver toxicity.
St John’s Wort
THIS flowering plant is one of very few herbs that has been intensively studied. ‘There’s grade-a evidence to show this helps mild to moderate depression,’ says Dr Johnston.
‘It has been shown to be just as effective as some antidepressants, with significantly fewer side-effects.’
This means it may be useful for women suffering mild to moderate anxiety and depressive symptoms during menopause, although it is known it can interact with many common drugs including antidepressants, the blood-thinning medication warfarin, anti-asthma drugs, oral contraceptives and migraine drugs — so do check with your pharmacist before taking it.
Try St John’s Wort Mood Relief (£7.23 for 60 tablets, healthspan.
co.uk) or Boots Mood Lift (£14.39 for 30 tablets, boots.com).
Starflower Oil
THESE capsules contain the essential fatty acid gamma linolenic acid (gLa) which, in high doses, can help ease flushes in some women.
Dr Johnston recommends aiming for 240mg gLa per day for two months. ‘If this doesn’t make any difference, then forget it,’ she says.
Try floresse Pure Starflower oil from £8.49 for 30, at supermarkets and pharmacies) or Boots Starflower oil (£15.99 for 90 capsules, boots.
com). However, if you are on any other medication, approach with caution — studies show gLa can interact with anti-inflammatories, beta-blockers, anti-coagulants and anti-psychotics, so check with your doctor. Side- effects include headaches, skin rashes, and nausea.
Sage
THE common herb taken as a tincture (a concentrated liquid which you add to water) ‘can ease the intensity of a hot flush in some women’, says Dr Johnston.
Try Menosan Sage Tincture (£9.75 for 50ml, avogel.co.uk).