Insomnia and other sleep disturbances are often blamed on menopause. But while it may appear that hormones are to blame, there are usually underlying health conditions keeping you up at night. In this second part of a series on menopause and insomnia the latest news from the North American Menopause Society (NAMS) puts some persistent rumors to rest.

Sleep disturbances in menopausal women
At the NAMS 21st Annual Meeting, new information presented on the topics sleep disorders and insomnia during menopause demonstrated how myths of menopause and sleeplessness persist. Dr. James J. Herdegen of the University of Illinois at Chicago, is a leading healthcare expert devoted to discovering why North American women experience insomnia during menopause. He explains that while women tend to blame insomnia on vasomotor symptoms (brought on by increased blood flow) such as hot flashes and night sweats, patients and their doctors need to look beyond vasomotor symptoms for answers.

As the Medical Director at the University of Illinois at Chicago’s Sleep Science Center, Herdegen devotes his research to understanding the causes of insomnia. “Sleep is not often studied,” Herdegen notes as women arrive at his clinic blaming their sleeplessness on menopause. Most of the women insist that they wake up during the night because of night sweats. What women do not realize is that they are often awake prior to the night sweats.

Herdegen’s approach is to find the real underlying causes for sleep disturbances including changes in body temperature throughout the night or the circadian rhythms, fluctuating thyroid levels which are higher in the early evening, and a drop in cortisone levels which usually takes place around 4 or 5 a.m.

Herdegen further states that sleep apnea or sleep disordered breathing affects many of his patients. Combined difficulty breathing at night with other risk factors such as stress, obesity and smoking are more likely to be causing sleeplessness than the fluctuating hormone levels of menopause. Sleep apnea is often dismissed as mere snoring or considered to be a men’s health issue. But women suffer just as much from sleep disordered breathing, putting them at risk for increased irritability and low energy levels during menopause.

The issue is far more serious, as Herdegen’s abstract for his paper Sleep Apnea and Disordered Breathing: “(Sleep Disordered Breathing) SDB has been associated with a lower quality of life and a higher association with insulin resistance, hypertension, and cardiovascular disease.” He also indicates that those suffering with sleep apnea are at a higher risk of dying in their sleep brought on by cardiac arrest.

Herdegen’s advice for women is to come prepared to discuss their insomnia with their doctor. Understanding sleep disorders is not a quick discussion; your doctor needs to know the exact nature of your sleeplessness in terms of symptoms and quality of sleep. As part of his ongoing studies, Herdegen concentrates on the importance of finding the underlying causes for insomnia in order to make a proper diagnosis and decide on a subsequent course of treatment including:

*Positional training to prevent sleep apnea due to blocked air passages
*Weight loss
*Devices to keep the jaws and tongue in place to avoid breathing disruptions
*Specially designed masks and pillows to encourage proper sleep posture
*Surgical options

During menopause your sleeplessness may be keeping you awake but it does not have to. Before reaching for the sleeping pills or blaming hormones, talk to your doctor to better understand what is keeping you awake at night. By dealing with the real causes of your insomnia you will be able to finally get the rest you need.

Special thank you to James J. Herdegen, MD, ABSM, Section of Pulmonary, Critical Care, Sleep & Allergy, University of Illinois at Chicago, Chicago, IL for our interview at the NAMS 21st Annual Meeting.

You can access the NAMS site at www.menopause.org to learn more about this and other menopause related health issues

Menopause, Your Doctor, and You