English
I’m sitting at my desk trying to concentrate on my next project, but I can’t keep my eyes open. It’s only 1:00 p.m. and I just want to sleep. Instead, I make myself another cup of coffee, grab a bag of chips, and head back to my desk to get through the rest of the day.
I haven’t slept well in a few months. I wake up in the middle of the night drenched in sweat. Then I toss and turn in bed until the early morning hot flashes stop. If I’m lucky, I get about four hours of good sleep. Most days I consume caffeine and comfort foods to do what I need to do, and I know that’s not healthy. It’s a vicious cycle that leaves me confused and in a bad mood by the time the middle of the afternoon rolls around.
According to Menopause: The Journal of the Menopause Society, hot flashes and night sweats, also known as vasomotor symptoms (VMS) of menopause, can cause distress in up to 3 in 5 peri- and postmenopausal women.
Hot flashes are sudden warm sensations in the face, neck, and chest that occur when estrogen levels drop. They can cause heavy sweating, flushed skin, a feeling of cooling down when the hot flashes stop, and a feeling of anxiety. All of this can make it difficult to sleep. “This may include shorter sleep times or difficulty falling or staying asleep,” said Dr. JoAnn Pinkerton, Medical Director of Midlife Health Center and member of HealthyWomen’s Women’s Health Advisory Council. But waking up in the middle of the night from SVM doesn’t just ruin the next day. This could also have long-term consequences.
Lee: Are there any lasting health effects once the hot flashes stop? >>
Why it is necessary to sleep well at night
If you don’t get enough sleep, your mental and physical health could deteriorate. “Poor sleep can lead to fatigue, confusion, difficulty concentrating, daytime sleepiness, irritability and lower work productivity. It can also impact relationships,” Pinkerton said.
Poor sleep can also affect your heart health. A study by the American Heart Association (AHA) showed that menopausal women who don’t get enough or enough sleep are three times more likely to have poor cardiovascular health outcomes, including heart disease and stroke.
Lack of sleep can also lead to belly fat in midlife. “When women don’t sleep, levels of cortisol, the stress hormone, increase, which increases the likelihood of developing belly fat,” Pinkerton said. This is a vicious circle. Poor sleep leads to higher cortisol levels, which leads to the formation of excess fat. And because you’re tired, you’re less likely to exercise or make healthy eating choices.
How hot flashes and night sweats affect your sleep
On average, women in the United States enter menopause at age 51, but SVMs can begin shortly after age 30 and end after age 70. Falling estrogen levels during menopause lead to an imbalance between estrogen and a brain chemical called neurokinin B (NCB). Too much NCB causes the KNDy neurons in your brain to become overactive and disrupt the brain’s temperature control center. Your body thinks it’s getting hot and eventually overheats, causing your blood vessels to dilate to cool your body, triggering hot flashes that can lead to hot flashes and sweats. The intensity of a hot flash in the middle of the night can vary. “People can feel anything, including waking up, the feeling of being with or without a blanket, or sweating profusely, even soaking their beds or pajamas,” Pinkerton said.
In white women, SVMs typically last an average of seven years, while black and Hispanic women experience hot flashes for an average of 10 years. In people of color, hot flashes are often more intense and last longer, but more research is needed to understand why, Pinkerton said. One theory is that anxiety and stress can worsen SVM and that people of color may have more anxiety and stress.
“Black women may have more stress in their lives, and that can increase the duration and frequency of hot flashes,” Pinkerton said. People with darker skin may also be less likely to try to get help and talk about menopause or seek treatment.
How to reduce the impact of hot flashes and night sweats on your sleep
Pinkerton said the first thing you can do to ensure you get a good night’s sleep is to pay attention to your sleep hygiene. This includes trying to get 7 to 9 hours of sleep every night. “That means sticking to a sleep schedule, keeping your bedroom dark and cool, limiting screen time and avoiding stimulation before bed,” she said.
Prepare for hot flashes and night sweats
- Reduce the temperature in your bedroom to 68 degrees or lower or open a window
- Use a fan
- Add a cooling gel mattress protector or cooling sheet to your mattress
- Wear moisture-wicking pajamas
- Sleep with cold compresses on your neck
Avoid dietary and environmental triggers for hot flashes and night sweats
- Reduce caffeine consumption, especially at night
- Avoid spicy food
- Limit alcohol
- Stop smoking cigarettes
You may also want to talk to your doctor about prescription hormonal and non-hormonal therapy options for menopause-related VMS.
How hormonal and non-hormonal therapy can be useful
Hormone therapy can be helpful for better sleep by restoring estrogen levels in your body, which decrease during menopause. This allows the brain’s temperature control center to stabilize and reduce the frequency and intensity of SVMs. Good candidates for hormone therapy are women under 60 who are in the first 10 years of menopause and are healthy. “We have newer and safer options than we had 10 years ago,” Pinkerton said.
For women who cannot or do not want to undergo hormone therapy, some non-hormonal options are available, such as neurokinin receptor antagonist therapies, which specifically target the KNDy neurons in the brain. NC receptor antagonists are helpful in reducing hot flashes and night sweats during menopause, and some women may wake up less at night.
Other medications, such as certain antidepressants and anticonvulsants, may be helpful in relieving VMS. You may even consider cognitive behavioral therapies, which can help change negative thoughts and behaviors related to sleep.
When should you talk to your doctor about hot flashes and night sweats?
If you’re experiencing symptoms that are affecting your quality of life, it’s time to talk to your doctor. Pinkerton suggested having an annual conversation with your doctor once perimenopause sets in, even if you don’t yet have any major bothersome symptoms.
If you feel like your problems are not being addressed, or you are told that you are too young for perimenopause to be the cause of your symptoms, it may be helpful to see a doctor who is specifically trained in menopause. This way you can ensure you receive correct information. The Menopause Society has a section where you can find certified specialists by zip code. Be honest about your symptoms and how they affect you. There is no reason to be ashamed.
Every person deserves treatment for their hot flashes and night sweats during menopause. And no one should have to change their pajamas at night.
This educational resource was created with support from Astellas.
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