For me it started in my early forties, suddenly I would wake up in the middle of the night, couldn’t fall back asleep, and started thinking. Out of everyone this was happening to me, even though I was the one at home who slept the best out of all of us. I could sleep anywhere and at any time. To suddenly not be able to do that anymore was and is a heavy burden. All of a sudden, what I always took for granted became an issue. And that was annoying. In the past, I had never thought about mattress quality or room climate. Nor did I know that I needed daylight to sleep better at night. I didn’t know anything about good sleep. And I didn’t know that the dwindling hormones during perimenopause could also torpedo our sleeping needs. But let’s just start from the beginning:
How much sleepdo we need?
Most adults need between seven and nine hours of sleep per night. Period. Anyone who says they need less is lying to themselves. Very few people actually get by on very, very little sleep. We can take it as a given, that we’re not one of them.
For a couple of years, I would only get six or seven hours of sleep because the day with two teenagers and a full-time job just didn’t have enough hours. And: I was always tired. I used to think that I had some sort of undiscovered virus that made me tired … According to the National Sleep Foundation, missing an hour’s sleep every now and then is probably not a big problem. However, it is worrying to sleep too little permanently. Sleep deprivation is associated with health consequences such as obesity and high blood pressure. You also have slower reaction times while driving or operating machinery. In addition, lack of sleep causes bad mood, concentration problems and mood swings. None of these things are what women need!
A lot happenswhile we sleep
For example, our body releases more somatotropin – also known as 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, the cerebrospinal fluid – in short: our brain water – is pumped faster through our brain. You can picture it like a high-pressure cleaner, which is used to quickly rinse and remove everything that doesn’t belong in the brain. And in the morning, you wake up with a clear head. While the brain is scrubbed and cleaned, our heart takes a breather. During the non-REM phases, both heart rate and blood pressure drop. It’s similar with our breathing: we breathe more slowly and regularly when we sleep. During the day however, our breathing varies greatly depending on our exertion. Our digestion is also related to our sleep: certain foods such as soybeans, cashew nuts or cocoa powder contain the essential amino acid tryptophan. Among other things, tryptophan causes drowsiness. The following happens with carbohydrate-rich meals: the carbohydrates make tryptophan more available to the brain, which is why we can get tired. For those of you who want to go even deeper into this, sleep.org is recommended.
What do hormones haveto do with our sleep?
- Melatonin, the “sleep hormone”, determines our day/night cycle in a very decisive way. 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 back in, the melatonin concentration drops back to daytime level. In addition, altered estrogen and progesterone levels can affect our melatonin levels.
- Are you still exposed to artificial light in the evening before going to bed (e.g. screen, mobile phone)? This can affect the release of melatonin and therefore 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, driving into the underground car park and from there to the office and back the same way in the evening, this can also affect our melatonin production because we were not exposed to ‘normal’ daylight.
- Progesterone is the hormone that calms and relaxes us. In perimenopause, the first thing that happens is that the release of progesterone decreases. The age-related progesterone deficiency during perimenopause can manifest itself in restlessness, irritability, anxiety and sleep disorders. This also includes the tendency to wake up frequently during the night. Progesterone is the hormone which is mainly effective in the second half of the cycle and during pregnancy. It stimulates growth of the uterine lining and prepares it for the embedding of the fertilized egg. If the egg is fertilized, 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 released, less GABA is also released, which can then lead to sleep disorders.
- Are you between 35 and 50 years old and have problems falling and staying asleep? This could be related to a sinking progesterone level.
- At the same time, stress can cause less progesterone to reach 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. In order to cover the need nevertheless, our body uses pregnenolone. Pregnenolone is the pre-hormone of progesterone and progesterone is the pre-hormone of cortisol. Thus, cortisol is produced at the expense of our progesterone supply. As if that were enough, cortisol can additionally block our progesterone receptors. This means that although progesterone is present in the bloodstream, it does not enter the cell nucleus and therefore cannot act accordingly. The consequence is that our stress tolerance decreases, and we cannot relax and feel rushed.
- Do you often feel rushed and stressed and do you have trouble falling asleep and sleeping through the night? This could be related to cortisol. In chronic stress, our daily profile shows low cortisol levels in the morning and high cortisol levels in the evening. We wake up exhausted and tired and still cannot fall asleep easily in the evening. If you want to know exactly whether this is the case, we recommend a Cortisol Test (affiliate link)
- If the thyroid gland is underactive, less thyroid hormones are produced. These hormones, however, are important because a corresponding amount of thyroid hormones is needed to produce progesterone. This is because progesterone is made from pregnenolone, which is made from cholesterol, for which our thyroid hormones are responsible. If our thyroid gland 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 the length and quality of sleep in women.
So, this is where a lot of hormonal effects on sleep add up. It is rarely monocausal. Usually, it is several things adding up. What about your sleep? What do you do to fall asleep more easily or sleep better through the night? What have you already tried and what would you recommend? Write a comment and we will get back to you.