Professor Nick Panay
President of the International Menopause Society, Consultant Gynaecologist at Imperial College Healthcare NHS Trust, and Professor of Practice at Imperial College London
If you’re experiencing menopause-related sleep disturbances, it’s important to recognise the symptoms. Don’t suffer in silence: make sure you see your healthcare provider.
Professor Nick Panay calls sleep “the universal vanquisher.” That’s because, after a good night’s sleep, you feel energised, refreshed, alert and ready to take on the world. Unfortunately, good quality sleep can elude many women going through menopause.
Impact of menopause-related sleep disturbances
Alongside hot flushes and mood symptoms, a bad or restless night’s sleep is common during this time of life. In fact, it’s estimated that between 40% and 69% of menopausal women experience some kind of sleep disturbance.
That shouldn’t be trivialised because lack of sleep can impact mood, anxiety, cognitive function, memory and general health. “It can affect many aspects of women’s lives,” says Prof Panay, President of the International Menopause Society, Consultant Gynaecologist at Imperial College Healthcare NHS Trust, and Professor of Practice at Imperial College London. “It can impact them personally, socially and professionally. We know that work time and sometimes jobs can be lost through loss of sleep.” Relationships can suffer, too.
What sleep disturbance typically looks like
Sleep disturbance increases as women go through menopause and may persist for years and decades. Despite this, women and healthcare providers don’t always recognise sleep disturbance as a symptom associated with menopause, which therefore remains undiagnosed and untreated.
That must end, says Prof Panay, who believes it’s important to identify menopause-related sleep disturbance so that women understand what is happening to them and feel empowered to do something about it. He also recommends keeping a diary of symptoms so that these can be reported accurately to a healthcare professional.
Sleep disturbance associated with menopause is mainly characterised by difficulty staying asleep. For instance, in contrast to non-menopause-related insomnia where falling asleep is a key issue, menopause-related sleep disturbance doesn’t necessarily make it harder for women to fall asleep but may cause women to wake up frequently in the middle of the night. “It may disrupt their sleep so that their sleep quality is poor,” notes Prof Panay. “As a result, they wake up feeling tired and not satiated by their sleep.” They may also wake up too early.
It’s estimated that between 40% and
69% of menopausal women experience
some kind of sleep disturbance.
Factors causing menopause-related sleep disturbances
There are many reasons why menopause-related sleep disturbances happen. Changes in female hormone levels associated with menopause may cause sleep disturbance — by impacting an area of the brain that regulates body temperature and sleep, causing hot flushes at night and disrupting the pathway that modulates sleep.
It’s recognised that sleep disturbance is particularly common for women who undergo surgical menopause, where their ovaries are removed, rather than natural menopause. “This may be because of the more profound and rapid withdrawal of hormones that occurs if the ovaries are removed,” says Prof Panay. It is however estimated that many instances of wakefulness are not accompanied by hot flushes, suggesting that other factors can contribute to sleep disturbance associated with menopause.
Report symptoms to your healthcare professional
Wider recognition of the association between sleep disturbances and menopause is needed as sleep disturbances remain undiagnosed. Prof Panay’s advice to anyone experiencing menopause-related sleep disturbance is simple. “Don’t suffer in silence,” he says.
“You should see your healthcare professional, such as your GP or clinical nurse specialist; discuss your individual problem; and find the best management plan that works for you.” He also recommends seeking menopause information from NHS England and Women’s Health Concern, the patient arm of the British Menopause Society.
Crucially, it’s important to ensure that any menopause-related information — including information on sleep disturbances — is balanced and evidence-based, insists Prof Panay. “The way we empower women to look after their menopause is for them to receive the right information about it,” he says. “They’ll then feel confident that they can utilise it to discuss their symptoms.”
This article has been supported and funded by Bayer Global.
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Date of preparation: October 2024
