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Ask a Sleep Expert: "Why can't I fall asleep or stay asleep?"

Dr. Shelby Harris talks sleep issues in perimenopause and menopause.

By Womaness Editors   2-Minute Read
Dr. Shelby Harris menopause sleep expert for WomanessWelcome to ASK AN EXPERT, a series where we pose your real questions to our menopause experts for the answers you need. Have a question? Post it on The After Party, our private Facebook Group.

 

Your Question:

What's the first advice you give to a woman who’s in midlife and says to you, ‘I can't fall asleep and I can't stay asleep'?

 

The Answer:

From Dr. Shelby Harris, licensed clinical psychologist in behavioral sleep medicine: “One of the first things I ask is their age. I also ask about how they're breathing at night. Once you start to hit perimenopause and menopause, rates of snoring and sleep apnea get equal to men. So that can be one reason why you wake up in the middle of the night: you're not breathing.

Sometimes women will say, "I wake up and I'm startled," and they think it's a panic attack. A lot of times, it's actually sleep apnea waking them up. So if you're dragging during the day and you feel like there are issues going on with the quality of your sleep, definitely get an evaluation from a doctor who's going to listen to you, because for women in this age range, it gets missed all the time.

Other things I ask are, "What's going on in your life? Are you going to bed with everything on your brain?" If you don't think of sleep as a kind of dimmer switch and only think of it as an on-off switch, whatever's on your brain when you go to bed is going to be there when you wake up at 2:00AM.

 

"Once you start to hit perimenopause and menopause, rates of snoring and sleep apnea get equal to men."

 

You have to learn to prioritize turning that dimmer switch on and figuring out ways to wind down, which is a luxury in today's society. If you don't always have an hour to wind down, start with 10 or 20 minutes to do things to get it out of your brain, like writing it all down.

If you frequently wake up in the middle of the night because of hot flashes or night sweats, there are wonderful products out there. Do whatever you can to cool down your body, wear loose clothing, and limit alcohol and spicy foods. There's sweat-wicking pajamas and bedding you can buy. And the newest thing (though it could be a little cost prohibitive for some people!) are cooling mattress pads like ChiliSleep or Eight Sleep.

Another big thing I do with people sounds counterintuitive, but if they're up for a long time in the middle of the night, I have them spend less time in bed. I ask them to go to bed later but wake up at the same time, so it consolidates and condenses sleep. It goes against what we always say about "eight hours." But if you only sleep at four hours a night, then you have no business being in bed for eight; it's not going to do anything. I have them spend a little less time in bed so they fall asleep faster and stay asleep more throughout the night.”

 

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Disclaimer: This article is intended for informational purposes and is not intended to replace a one-on-one relationship with a physician. Womaness strives to share the knowledge and advice from our network of experts and our own research. We encourage you to make healthcare decisions in partnership with a qualified healthcare professional. 
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