October 18, 2023

Better Bedtime Tips for Menopausal Women

At a time when restorative sleep can be a challenge, these strategies can help.


By Selene Yeager


Sleep can be a great source of stress for women in and beyond the menopause transition, when a sound night of shuteye can feel as elusive as a cat when it’s time to go to the vet. The harder you try to find and grasp it, the more it slips away.


If hot flashes and night sweats are wrecking your sleep, menopausal hormone therapy (MHT) can help. A recent meta-analysis on how different MHT regimens impacted sleep quality finds that transdermal therapy was more beneficial than oral medications. Also, the combination of estrogen and progesterone had a positive effect on sleep disturbance, while estrogen therapy alone did not. Research has also found progesterone can be helpful for sleep disturbances in menopausal women. Working with a trained menopause specialist is key here.


Women also often have success with assorted stress-reducing, sleep-inducing supplements like ashwagandha, magnesium, tart cherry juice, and various forms of cannabinoids. These can take some trial and error to dial in and obviously don’t work the same for everyone.


There are some other simple lifestyle strategies that can help you get the restorative sleep you crave. Here’s what studies show.


Give Your Feet the Spa Treatment


A warm bath has long been a recipe for a good night’s sleep. Sleep expert  Dr. Sophie Bostock explained why on an episode of Hit Play Not Pause


“Your body needs to cool by a couple of degrees to get into a deep sleep,” Bostock explained. “Anybody who’s experienced temperature fluctuations or night sweats and hot flashes is going to know that it becomes much harder to fall into a deep sleep…When you step into a warm bath, the temperature of your skin starts to increase. That means your body is sending more blood flow to your extremities, which helps to cool down your core body temperature.” So, you’ll be able to drift asleep more readily when you’re snuggled up in your cool room.


That’s great, but it’s also not necessarily feasible to indulge in a bath before bed every night. What may be more realistic is a nice foot soak, which you can do while reading, catching up on last minute work items, or streaming your favorite shows. Research shows that submerging your soles in a foot bath before bed can reduce disruptive menopause symptoms and lead to a better night’s rest. 


It works the same way as your total body bath does. According to Medical News Today, warming the feet before bed helps dilate blood vessels in those lower extremities, which releases heat and helps to lower your core body temperature, which in turn sends signals to your brain that it’s time to sleep. 


If you’re not sure you can swing a nightly foot bath either, you may want to give some heatable bed socks (microwavable booties to warm your tootsies) a go. A study published in Physiology & Behavior found that manipulating your foot temperature with either foot baths or heatable bed socks before or, in the case of socks, after tucking under the covers helps people with age-related insomnia fall asleep faster.


Eat an Early Dinner


This one comes up a lot. Try to eat dinner no later than 7 or 7:30. If that’s not possible, plan your dinnertime so you have two hours between dinner and bedtime. That gives your body time to digest and wind down and get the signals that the day is done.


Another benefit of eating an early dinner is that you have a better chance of being hungry for breakfast when you wake up. Eating within an hour of waking up, even just yogurt and some fruit, signals to your circadian clock that you’re going to ramp up your energy and get your day going, explains Bostock. That, in turn, helps you fall into a rhythm that supports better sleep come nighttime. 


Take a Music Break


Mindfulness and stress management can help improve sleep. Lots of women still struggle to work those stress-management breaks into their day. But what if we had a soundtrack for our brain break? Research shows, and I quote, “Listening to music can help reduce depression levels and symptoms of menopause in postmenopausal women.” 


That’s the conclusion of a study published last year in Menopause, where researchers from Turkey sought to determine the effect of listening to music on depression levels and the symptoms of menopause. For six weeks, they had 21 postmenopausal women between the ages of 40 and 65 (none using hormone therapy) listen to music (the women got to choose among three Turkish classical music selections) for 15 minutes three times a week, while another group of 27 women received no music therapy recommendations. The researchers also collected data on the women’s menopausal symptoms and moods using the Beck depression inventory (BDI) and menopause rating scale (MRS). 


At the end of the study, there was a significant decrease in the depression scores among the women who received music therapy compared to their peers who did not have music sessions. The women in the music group also had a significant decrease in their MRS score after the intervention. And for many women, fewer symptoms means better sleep.


There’s good science behind these results. Music stimulates the secretion of key brain neurotransmitters including dopamine, serotonin, and endorphins along with the feel-good hormone oxytocin, while decreasing the level of circulating stress hormones like cortisol, which can be a challenge to keep in check during menopause. These chemicals and hormones play a role in blood pressure, as well as heart and respiratory rates.



Tuck in Between 10 and 11 p.m.


When it comes to exercise recovery, making muscle, burning fat, and your cardiovascular health, hitting the hay on the earlier side, like before 11 p.m., may be your best bet. 


A study of more than 88,000 adults (58 percent women), average age 61, found that compared to falling asleep between 10:00 and 10:59 p.m., falling asleep after midnight was associated with a 25 percent higher risk of heart disease. Falling asleep between 11:00 and 11:59 was associated with a 12 percent increase in heart disease risk. Interestingly, there was also a 24 percent higher risk for those who fell asleep before 10:00 p.m., likely because of how sleep time impacts circadian rhythms. 


“The body has a 24-hour internal clock, called circadian rhythm, that helps regulate physical and mental functioning,” said study author Dr. David Plans of the University of Exeter, UK in a press release. “While we cannot conclude causation from our study, the results suggest that early or late bedtimes may be more likely to disrupt the body clock, with adverse consequences for cardiovascular health.” These associations were also stronger among women.


Going to bed before 11 may also help you produce more human growth hormone (HGH), which helps you build muscle and burn fat, while also stimulating tissue growth and allowing you to recover faster—all benefits women need, especially right now, because muscle is harder to hang onto during menopause and HGH naturally declines with age.


You make the majority of HGH in your sleep. Getting sufficient amounts of sleep—between seven to nine hours a night—is important for prime HGH production. But it’s also produced earlier in the night, so your bedtime matters.


“The majority of secretion is between 11 p.m. and 1 a.m. and then it starts shutting down,” says Christopher Winter, MD, author of The Sleep Solution, who I have interviewed multiple times on the topic. So this is another reason for us to try to call it a night before 11 p.m., if and when possible (recognizing that there are plenty of shift jobs that can make this difficult if not impossible).


There’s no magic to any of these strategies. But sometimes the basics work better than we give them credit for, and they’re always worth a try, especially since they’re free and easy and are bound to make you feel better and help your health in the long run.

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