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For me it started in my early forties, all of a sudden I would wake up in the middle of the night and wouldn’t be able to go back to sleep, instead, I would start pondering. Even though beforehand I was the one with the deepest sleep at home and used to be able to fall asleep anywhere. Suddenly I was no longer able to do that, something I simply took for granted beforehand, which turned out to be a real burden on me.  Mattresses and room climate became things I had to consider. Also, I didn’t know that I needed daylight to sleep better at night. All in all, I didn’t know anything about good sleep. So naturally, I also didn’t know that dwindling hormones during Perimenopause can torpedo our need for sleep. But let’s take it from the top for a moment:

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How much sleep do we need?

Most adults need between seven and nine hours of sleep per night. Full stop. Anyone who says they need less is lying to themselves. Very few people actually get by on very, very little sleep. We can safely assume that we are not one of them. For a few years, I only got six or seven hours of sleep, because with two teenagers and a full-time job, there just weren’t enough hours in the day. And: I was always tired. I thought I had some kind of undiscovered virus inside me that made me tired … According to the National Sleep Foundation, it’s probably not a big problem to miss an hour of sleep every now and then. But getting too little sleep on a consistent basis is a concern. Sleep deprivation is associated with health consequences such as obesity and high blood pressure. You also have slower reaction times when driving or operating machinery. And on top of that, lack of sleep causes bad moods, concentration problems and mood swings. All of which is not what a woman needs!

A lot happens while we sleep

For example, our body releases more somatotropin – also called growth hormone. This can be used to rebuild muscles and joints. The more sleep we get, the better our body can repair itself.

In the brain, cerebrospinal fluid is pumped through our brain faster. You can think of it as a hose that quickly flushes through and removes everything that needs to come out of the brain. And in the morning you wake up with a clear head.

While the brain is being scrubbed and cleaned, our heart is enjoying some relaxing time. During the non-REM phases, both the heart rate and the blood pressure drop. The same goes for breathing: we breathe more slowly and regularly when we sleep. During the day, our breathing varies greatly depending on our effort.

Our digestion is also related to our sleep: certain foods such as soybeans, cashews or cocoa powder contain the essential amino acid tryptophan. Among other things, tryptophan causes sleepiness. With carbohydrate-rich meals, the following happens: the carbohydrates make the tryptophan more available to the brain, which is why we can become tired. For those who would like to delve deeper into this, I would recommend sleep.org.

What do hormones have to do with our sleep?

  1. Melatonin, the “sleep hormone”, decisively determines our day-night rhythm. It regulates our sleep. As soon as our retina stops receiving light impulses in the evening, the pineal gland releases melatonin. In the morning, when the light comes on, the melatonin level drops again to the daytime level. In addition, altered oestrogen and progesterone levels can influence our melatonin levels.
    • Are you still exposed to artificial light (e.g. screen, mobile phone) in the evening before going to bed? This can affect the release of melatonin and thus your sleep.
    • How much time do you spend outside in normal daylight on a normal day? If we spend most of our time indoors, e.g. getting into the car from the house, then driving to the underground car park and going to the office from there and making the same trip back in the evening, this can also affect our melatonin production because we have not been exposed to ‘normal’ daylight.
  2. Progesterone is the hormone that calms and relaxes us. During perimenopause, the first thing that decreases is progesterone secretion. Such an age-related progesterone deficiency during the perimenopause can manifest itself as restlessness, irritability, anxiety and sleep disturbances. This includes a tendency to wake up frequently. Progesterone is the hormone that is most effective in the second half of the cycle and during pregnancy. It stimulates the growth of the lining of the uterus and it then prepares it for the implantation of the fertilised egg. If fertilisation of the egg occurs, progesterone prevents further follicle maturation. Progesterone has a relaxing effect because it increases the production of GABA. This is a messenger substance in our brain that supports sleep. If less progesterone is secreted, less GABA is secreted, which can lead to sleep disorders.
    • Do you have problems falling asleep or sleeping through the night and are between 35 and 50 years old? Then this can also be related to a decreasing progesterone level.
  3. At the same time, stress can lead to less progesterone reaching the cells. The “stress hormone” cortisol is responsible for this. When we suffer from chronic stress, our body uses up cortisol faster than it can produce it. To meet the demand anyway, it goes to pregnenolone. Pregnenolone is the prehormone of progesterone and progesterone is the prehormone of cortisol. So cortisol is produced at the expense of our progesterone supply. And if that’s not enough on its own, cortisol can also additionally block our progesterone receptors. This means that although progesterone is present in the blood, it does not reach the cell nucleus and thus cannot act accordingly. As a result, our stress tolerance decreases and we don’t calm down and feel run down.
    Do you often feel rushed and stressed and have trouble falling asleep and staying asleep? Then this may also be related to cortisol. With chronic stress, we have low cortisol levels in the morning and high cortisol levels in the evening in our daily profile. We wake up tired and sleepless and still can’t fall asleep well in the evening. If you want to know exactly whether this is the case, a cortisol test is recommended.
  4. If the thyroid gland is underactive, fewer thyroid hormones are produced. These are important, however, because a corresponding amount of thyroid hormones are needed to produce progesterone. Progesterone is formed from pregnenolone this is in turn formed from cholesterol and our thyroid hormones are responsible for that. If our thyroid is already at its limit, this also affects our progesterone levels.
    And last but not least: low testosterone levels can also have a negative effect on sleep duration and quality in women.
    So there is a lot of hormonal effect on sleep. It is rarely monocausal. Usually, several things come together. What about your sleep? What do you do to fall asleep or sleep through the night better? What have you already tried and what would you recommend? Leave a comment and we’ll get back to you.
  5. Last but not least: a low testosterone level can also have a negative impact on sleep duration and quality in women.

So there’s quite a bit of a hormonal effect on sleep. It is rarely monocausal. Most of the time, several things come together. What about your sleep? What do you do to fall asleep or sleep through the night better? What have you already tried and what would you recommend? Write a comment and we will get back to you.

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