Sleepless nights are one of the biggest health complaints of women that I see in my practise. No matter what life stage you are in, sleep can illude us, wether that is pregnancy, the early days of looking after a newborn baby, the motherhood years of looking after school children or into midlife and dealing with the peri and menopause.
Today we are going to delve into the world of female insomnia and explore its causes and triggers, as well as look at some dietary and lifestyle remedies you can start trying today to improve your sleep..
Sleepless nights can be incredibly frustrating and impact various aspects of a woman's life, from physical health to mental well-being and daily functionality. Understanding the underlying factors that contribute to insomnia is a crucial step toward finding effective solutions and achieving restful nights.. We will explore the influence of hormones, such as fluctuations during the menstrual cycle, pregnancy, and years leading to menopause, and how they can disrupt sleep patterns. Additionally, we will examine the impact of stress, anxiety, and mood disorders on sleep quality in women. Finally we will shed light on lifestyle factors like poor sleep hygiene, certain medications, and external environmental factors that can contribute to insomnia. By unraveling the causes and triggers specific to female insomnia, I aim to empower women with knowledge and strategies to overcome sleep difficulties and regain control over their rest.
1) Hormone fluctuations and sleep.
The many hormonal fluctuations that we can experience throughout our life can have a huge impact on our quality of sleep. The natural monthly fluctuations for a menstruating woman in themselves can bring different levels of sleep quality dependant upon where progesterone and oestrogen are at any given point in the cycle. Sleep disturbances are primarily observed during the luteal phase (after ovulation), partly due to elevated levels of estrogens and progesterone. eg:, women report higher daytime sleepiness and more awakenings at night during the luteal compared to the follicular phase (start of your new cycle to ovulation). Core body temperature at night is also elevated during the luteal phase, which is related to both hypersomnia (excessive sleep) and insomnia (inability to sleep).
If we have any imbalances in our reproductive hormones, which can occur at any time in our lives, but particularly more so during pregnancy, the post natal period as well as peri and menopause, we can experience difficulty falling and staying asleep. Pregnancy for example can leave us open to a whole host of physical and mental causes of insomnia such as
Needing to urinate frequently
Nausea or vomiting
Back pain
Breast tenderness
Abdominal discomfort
Leg cramps
Heartburn and reflux
Pre natal anxiety
vivid dreams
Similarly, during the peri menopause and menopause years, hormonal fluctuations can play havoc on sleep, leaving us utterly exhausted. It is the 2nd most common symptom after hot flashes. During the peri menopause the problem can be falling and staying asleep, whereas in menopause, waking too early can be the issue. The fluctuations of high and low estrogen during the perimenopause and eventual low levels of progesterone and estrogen in menopause can cause a combination of factors to arise affecting sleep including, high histamine, altered circadian rhythm, disruption of sleep centres in the brain, reduction in melatonin, impair our ability to cope with stress and cause sleep disturbing symptoms like restless legs, frequent urination, hot flashes, sleep apnea and insulin resistance which can make us drowsy and more likely to nap in the daytime affecting night time sleep.
Other hormonal related conditions such as PCOS (polycystic ovary syndrome), PMS AND PMDD, as well as Endometriosis and can also cause sleep disturbances for similar reasons.
2) Stress, anxiety, and mood disorders
Anyone who has experienced high levels of stress, anxiety or depression, will know the one of worst impacts on our wellbeing is sleepless nights and waking in the early hours to ruminate and worry. Some medications for anxiety or depression can exacerbate this further as they tend to affect levels of neurotransmittors in the brain such as serotonin and dopamine.
So how does stress, anxiety and low mood affect our quality of sleep?
The mental activation of stress, anxiety and depression can make it challenging to relax and initiate sleep. Additionally, stress can cause an increase in the production of stress hormones, such as cortisol, which can interfere with the natural sleep-wake cycle. When cortisol levels are normal, the hormone helps you wake up in the morning (when levels are higher) and drift off at night (when levels are lower) However, if these cortisol levels remain elevated all the time, particularly towards the end of the day, falling asleep may seem impossible, this can be a sign of adrenal dysfunction. At its most advanced stage this can work the other way whereby cortisol levels are so low and our adrenals are worn out, they no longer produce enough cortisol to wake us up, leaving us exhausted upon waking, as well as all day long.
Some features of anxiety can increase arousal or alertness, that could lead to sleep-wake alterations, Imbalances of neurotransmittors seen in depression can similarly make sleep challenging.
Not only can stress deplete many nutrients in our body, but also cause our digestive system to function poorly, meaning we may not breakdown and absorb the nutrients in our food. Conversely, this can also cause and exacerbate conditions such as anxiety and depression. Common nutrient deficiencies related to mental health disorders can include, Iron, Magnesium, B vitamins, Vitamin D, omega fatty acids and Zinc
3) Gut/Brain connections
Did you know that your gut bacteria talks to your brain? Your brain can then alter the state of your gut bacteria.....crazy right?? This means that our gut can have an effect on stress, mood, appetite and sleep through a number of different mechanisms including interacting with your immune system, regulating the production of neurotransmittors and through your vagus nerve and sending messages to your brain which can affect sleep. If you have any regular symptoms of digestive dysfunction such as bloating, acid reflux, frequent fungal infections, constipation or diarrhea, along with sleep disturbances, strengthening your digestion definately needs to become a priority.
4) Lifestyle factors
A big consideration when it comes to insomnia has to be our lifestyle. We all live in such a busy, modern world, where many of us spend hours upon hours online, looking at a screen. A third of the British workforce admitting to waking in the night and tackling work issues between 11pm and 6am. If you find yourself regularly doing this, it can have major detrimental impact on your ability to get quality sleep which has a knock on effect to overall health.
Putting into place good sleep hygiene practises, which includes cutting down on screen time and if possible switching screens off an hour before bed. Switching on the blue lights filter on screens can also help. along with making sure that your room is dark as well a quiet. if you are currently looking after a newborn or child who struggles with their sleep and are frequently waking, consider taking it in turns with your partner to share the load with taking a night, or period of the night to cover each, so the other can get some rest. Reaching out for help with your little ones sleep can also be a game changer, so don't be afraid to get a fresh perspective from a trained sleep professional.
Exercise can be a big help in gaining quality of sleep, particularly outdoor exercise which can restore normal circadian rhythms helping us nod off at bedtime. Exercise also has a healthy impact upon many health conditions which as we discussed, can affect our sleep wether that hormone imbalance, anxiety, depression and stress, and even gut health. Restorative types of yoga such as Hatha can be a wonderful way to wind down in the evening before bed, rather than stimulating high body temperature and brain arousal through a Hiit session.
My 7 top tips to start improving your sleep today
Increase consumption of magnesium rich foods which help to support the nervous system, as well as helping to balance hormones. Include nuts and seeds, dark leafy green veg (spinach, kale, bok choy, chard) flax and chia seed seed, 70% +Dark chocolate (no later than 7pm as can be stimulatory due to the caffeine)
Switch one of your teas or coffee to a herbal tea to reduce your caffeine intake and try to not have tea or coffee past 2pm. Try a cup of chamomile, lemon balm or passion flower in the evening to help wind down
Slowly increase your intake of fibre rich vegetables, beans, legumes as well as nuts and seeds like chia and flaxseed. Just focusing on adding one small handful of extra fibre rich foods a day, over time, can help to boost your gut bacteria
Aim to switch your ipad, mobile or other screens onto blue light mode, helping to protect your circadian rhythm
Try heading out for a quick 10 minute walk after dinner and get natural light as soon as you wake up, even if its just sitting outside with your breakfast or drink
keep to a regular wake up and bedtime schedule daily, even at the weekends, its not always possible with social comittments, but keeping to this schedule for the majority of the week can help reinforce a regular sleep routine
Experiment with gut friendly probiotic foods such as kimchi, sauerkraut, organic natural yoghurt and kefir, even just a tsp added to your meals, a few times per week can help to populate your gut with beneficial bacteria
Conclusion
Sleep issues, insomnia and the factors which are driving this, can be a highly personalised experienced and won't affect everyone in the same way. Seeking help through a qualified nutritional therapist who is able to help you get to the root cause of your insomnia through a detailed analysis of your current diet, an in depth assessment of your health history, as well as symptoms. Consideration of functional testing and personalised and targeted supplementation may add more detail to the factors affecting your sleep and help provide you with the nutrients you need to help bring your body back to balance.
If you would like some help to get to the bottom of your difficulty nodding off or staying asleep, click the button below to book your free 20 minute health review to discuss your health goals and find out how I can help you get back to having a restorative nights sleep again
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