4 surprising sleep problems in perimenopause and menopause

Menopause Advisor
Ask Eileen

29 April 2024

Sleep problems during perimenopause and menopause

According to our online symptom checker, poor sleep is the second most common symptom of perimenopause and menopause.* The usual sleep problems would be things like not being able to fall asleep, taking ages to fall asleep, waking up early, or waking up two or three times during the night and not being able to get back to sleep. But some less common and surprising sleep issues could appear as well.

Surprising sleep problems that can develop or get worse

These are 4 surprising sleep issues you might start experiencing or notice have become worse recently:

1. Vivid dreams or no dreams at all

Vivid dreams - these are the ones that you get where you actually feel like you're in a movie, and when you do wake up, you feel absolutely exhausted. So, it's dreams that go into great detail, and you feel like you're there right in the middle of everything. On the other side, for some people, it could be that you stop dreaming completely.

This is a really interesting one because there is a part of the brain called the amygdala. This is a major processing centre in the brain that deals with our emotions. It also has a link to many other brain abilities, such as memories, and how we learn things. It can be connected to our sense of smell and also our fear responses.

Falling oestrogen levels or lower oestrogen during perimenopause and menopause can impact on the amygdala and make it much more reactive and sensitive to less stimuli. So here you are, you're asleep, so there's less processing going on in the brain. But what happens? The amygdala can then kick in and these emotions can be released into our dreams. This is why, very often, they become action-packed.

If you're not getting any dreams at all, it may well be that during the day you find that your emotions are just shutting down. You're stepping back from everything. So that, again, can affect your dreams, and you might find it quite strange when you wake up and you can't remember anything.

2. Nightmare and night terrors

Nightmares can also be associated with what's going on in the amygdala, purely because our fear responses can be released. So, when we start dreaming, it may well be affected by the fact that we can be more fearful anyway during menopausal transition. It could be that we're just more fearful about what's going on in the world in general, so that when we go into that dream state, the fear centre in the brain is activated and we get the nightmares.

With night terrors, which can be part of nightmares, again, it can just be the fact that you're overly fearful when you're having this nightmare. But also, there's another reason for night terrors, which is a really interesting one.

When we fall asleep, part of the sleep process is that during the dream stage of sleep our muscles become semi-paralysed, to prevent our bodies from acting out the physical motions we’re making in our dreams. Otherwise, we’d be thrashing around and waking ourselves up. The ‘paralysed’ effect should wear off before we wake up, but because of hormonal changes you may wake up very quickly, before this effect decreases, finding it hard to breathe and temporarily struggling to move.

I've had it happen a couple of times. It's absolutely terrifying because you can't even talk. You can't call out. And very often, it's associated with dreams as well, maybe nightmares. When you're trying to call out, you may feel as if someone or something is sitting on your chest, stopping you from breathing. You can't move, and it is this whole sort of paralysing effect.

Eventually, after maybe a minute or so, that effect wears off, and then you're okay. But in the meantime, you have been through an extremely terrifying few moments, and as I say from my own experience, your heart's going like mad, and you end up having to get up and just calm yourself down.

How do you sort this one out?

It's quite a difficult one. I've tried to do a little bit of research on it, and what I found or what they seem to say is that if you're getting very vivid dreams, action-packed dreams, nightmares, or night terrors, then it's time to calm the amygdala down. And this seems to be helped by mindfulness.

So, before you go to bed, maybe in the evening, mindfulness, some meditation, just a short meditation session before bed, no stimuli. You want to calm your brain down as much as possible, so that's no TV, especially no scary TV, no scary books. You do not want to strike up the fear response and have that already working before you go to sleep.

Another thing that can help is walking in nature. A 2022 study found that walking in nature has a very calming impact on the amygdala's ability. (1) When they did the studies of people walking for the same length of time in towns, it had no effect at all. So, this is another one of these situations where walking in nature seems to have some really great health benefits generally.

3. Sleepwalking or talking

These can also be caused by the amygdala overfiring, especially if we're not actually getting that calm down phase before bed, and don’t enter the ‘semi-paralysis’ phase properly.

The other thing it can be is something called sleep apnoea, and this seems to be quite common. In perimenopause and menopause, falling oestrogen levels can affect the stability and strength of the airways in the throat and the lungs. So, what happens when you fall asleep? The airways are weaker, and they tend to sag, stopping you from breathing for a second or two. This ongoing lung weakness can trigger something called sleep apnoea. So, if you find that you are waking up gasping for breath at night, then it's really important to get this one checked out by your doctor. But this whole process seems to trigger the sleepwalking and the sleep talking too.

Alcohol also seems to be quite a trigger for sleepwalking. These two sleep issues can also be causes by general stress.

4. Snoring

So many of you tell me that suddenly your other half has been telling you that you're snoring like a steam train. So again, this can be due to sleep apnoea. It can be due to the weakness in the throat and the airways I mentioned above. If the snoring has suddenly appeared, if you're told that it's really loud, and it's stopping and starting, get this one checked out by your doctor.

What else can help?

Remember to have a really good sleep routine and avoid tea, coffee, and alcohol in the evening. You can also try our Sleep Well sachets. These contain lemon balm, which is known to aid a restful sleep.

A.Vogel Sleep Well Dissolvable Granules | Pour Directly into Mouth | Natural Orange Flavour

£15.99 (14 sachets x 2g) In Stock

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So, I hope you found this helpful. I certainly found it a really interesting one. If any of you have had issues like this, what did you do? What happened to you? And remember, as always, I love your stories, and, you know, thank you so much for sending in your questions and your comments. I will see you later, and have a lovely week.

*correct as of 04/24

You may also find these topics helpful:

How to sleep better during perimenopause and menopause
3 sleep problems during menopause
Perimenopause sleep problems: Struggling to fall asleep
Perimenopause sleep problems: Frequently waking during the night
What to eat to sleep better during menopause

Did you know?

You won’t get the menopause the minute you turn 50! The average starting age is actually between 45 and 55 and it can often depend on a number of factors including hereditary, weight and health, however every single woman will have an individual menopause.

Learn the truth behind other menopause myths

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