Insomnia

  • Sleep Health

    Menopause and insomnia: What is the link?

    • Comments Off on Menopause and insomnia: What is the link?
    • by

    Original Post | Medical News Today

    After menopause, a person’s ovaries produce much lower amounts of certain hormones, including estrogen and progesterone. For some, this transition comes with sleep disturbances.

    Insomnia refers to the difficulty falling or staying asleep. It is a commonTrusted Source experience in menopause and may occur as a result of hormonal changes.

    It may also be a secondary result of the other symptoms of menopause, such as hot flashes.

    Read on for more information on menopause and insomnia, including why it happens, how long it may last, and what medical treatments and complementary therapies are available.

    Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

    Can menopause cause insomnia?

    The exterior of a large apartment building at night. Bright light illuminates one of the windows.
    Colin Anderson/Stocksy

    Yes – insomnia is a frequent occurrence during perimenopause and menopause. Some people only experience mild or occasional sleep disturbances, but for others, the insomnia can be severe.

    According to a 2018 article, 26%Trusted Source of people going through perimenopause and menopause experience insomnia that affects their daily activities.

    In females, the rate of insomnia increases with age. According to the Study of Women’s Health Across the Nation (SWAN)Trusted Source, the prevalence of sleep disorders is as follows:

    • 16–42% in premenopause
    • 39–47% in perimenopause
    • 35–60% in postmenopause

    Why does menopause cause insomnia?

    Research on the exact cause of insomnia during menopause does not point to one clear cause. Several things may contribute to it, including:

    Hormonal changes

    Some evidence suggests that low hormone levels can increase the likelihood of insomnia during menopause.

    According to the SWANTrusted Source, previous longitudinal studies have found a correlation between lower levels of estradiol and poorer sleep. This is especially true if the decline in hormones happens quickly, as it does after a person undergoes surgery to remove the ovaries.

    Hot flashes

    Sometimes, insomnia happens during menopause because of hot flashes or night sweats. These symptoms can disrupt sleep, causing frequent waking.

    Hot flashes, which are one of the so-called vasomotor symptoms, are common in menopause, affecting 75–85%Trusted Source of people going through menopause.

    Hot flashes cause a sudden sense of heat around the face and neck and often occur with sweating and a fast heartbeat.

    Reduction in melatonin

    Melatonin is a hormone that plays a key role in the sleep-wake cycle, helping keep people asleep. It is especially important at the start of sleep.

    However, melatonin levels appear to decrease with age, which may cause sleep disturbances.

    It is not clear whether there is a link between menopause and a decline in melatonin. Some evidenceTrusted Source suggests that there is and that individuals during postmenopause have less melatonin than those during premenopause.

    Mental health

    For many people, menopause signals a major change. It is also a sign that a person is getting older. This, along with the symptoms of menopause, can have an impact on an individual’s mental health.

    Many mental health conditions, including anxiety and depression, affect sleep. However, insomnia can also make depression more likelyTrusted Source. The relationship between sleep and mood is bidirectional, and changing hormone levels can also play a role.https://a76fa006e565d376844b91a5d5a8864a.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

    How long will insomnia last?

    How long insomnia lasts during and after menopause depends on many factors. Every person who goes through menopause has a different experience. Some will find that the symptoms last longer than they do for others.

    A person’s hormone levels can start to change 7–10 yearsTrusted Source before a person’s last period. After this point, people can continue to have symptoms such as hot flashes for several years.

    Estradiol levels continue to decline for the first 1–6 years in early postmenopause, which may result in continued symptoms.

    It is of note, however, that there are treatments and therapies available that can reduce sleep difficulties. It is also important to address any other factors that may be contributing to poor sleep quality.powered by Rubicon Project

    Medical treatments for insomnia during menopause

    The main treatment for menopause-related insomnia is hormone therapy. This works by replacing the lost hormones, which can improve many menopause symptoms. People may find that they sleep better and experience fewer hot flashes while using this treatment.

    Hormone therapy is available in topical gels, creams, and patches. People can also take it internally via tablets or an implant.

    Another potential treatment is a low-dose selective serotonin reuptake inhibitor (SSRI).

    Doctors typically prescribe SSRIs for mental health conditions, but these medications can also reduce the frequency of hot flashes, which may help with sleep. However, it is of note that insomnia can also occur as a side effect of SSRIs.

    For those who are experiencing mood changes, anxiety, or depression, talk therapy may help them understand and cope with these feelings. Lessening the impact of mental health conditions may also benefit sleep.

    Doctors rarely prescribe sleeping pills to treat insomnia, as these can have serious side effects. Many are also addictive and are not suitable for managing a long-term sleep problem.

    Natural and complementary therapies

    According to a 2019 review, no study has found that herbal or dietary supplements consistently help with menopause symptoms. However, there are many other ways people can try to make sleep easier during menopause.

    Below are some evidence-based approaches:

    Avoiding caffeine, nicotine, and alcohol

    Smoking, consuming caffeine, and drinking alcohol can all make it more difficult to sleep. While it may seem that alcohol makes people drowsy, even a small amount reduces overall sleep quality.

    A person can try to reduce or avoid any of these, especially in the afternoon and evening.

    Aromatherapy

    Aromatherapy may be helpful in inducing relaxation and reducing hot flashes.

    In a clinical trial involving 100 women, researchers found that after 12 weeks of lavender essential oil inhalation, the participants had 50% fewer hot flashes.

    Other studies have also found that aromatherapy together with massage was more effective than massage or aromatherapy by themselves.

    Hypnosis

    A 2019 review notes that there is evidence that hypnosis may reduce the frequency and severity of hot flashes by up to 50%.

    Moreover, for people whose insomnia results from hot flashes, hypnosis may be a helpful complementary treatment.

    Yoga

    Some studies have found that yoga has a beneficial impact on the psychological symptoms of menopause. If a person is having difficulty sleeping due to stress or anxiety, yoga practice may help reduce these symptoms.

    However, the results of other studies on yoga have been mixed. This is partly because there are many styles of yoga and numerous ways of practicing, which may lead to inconsistent results.

  • Sleep Health

    Insomnia, Disrupted Sleep Linked to Severe COVID-19

    • Comments Off on Insomnia, Disrupted Sleep Linked to Severe COVID-19
    • by

    Original Article Posted by Sleep Review Staff | Mar 23, 2021 | Insomnia, Sleep & the Body

    coronavirus

    Insomnia, disrupted sleep, and daily burnout are linked to a heightened risk of not only becoming infected with coronavirus, but also having more severe disease and a longer recovery period, suggests an international study of healthcare workers, published in the online journal BMJ Nutrition Prevention & Health.

    Every 1-hour increase in the amount of time spent asleep at night was associated with 12% lower odds of becoming infected with COVID-19, the findings indicate.

    Disrupted/insufficient sleep and work burnout have been linked to a heightened risk of viral and bacterial infections, but it’s not clear if these are also risk factors for COVID-19, say the researchers.

    To explore this further, they drew on the responses to an online survey for healthcare workers repeatedly exposed to patients with COVID-19 infection, such as those working in emergency or intensive care, and so at heightened risk of becoming infected themselves.

    The survey ran from 17 July to 25 September 2020, and was open to healthcare workers in France, Germany, Italy, Spain, the UK, and the USA.

    Respondents provided personal details on lifestyle, health, and use of prescription meds and dietary supplements plus information on the amount of sleep they got at night and in daytime naps over the preceding year; any sleep problems; burnout from work; and workplace exposure to COVID-19 infection.

    Some 2884 healthcare workers responded, 568 of whom had COVID-19, ascertained either by self-reported diagnostic symptoms and/or a positive swab test result.

    Infection severity was defined as: very mild – no or hardly any symptoms; mild – fever with or without cough, requiring no treatment; moderate – fever, respiratory symptoms and/or pneumonia; severe – breathing difficulties and low oxygen saturation; and critical – respiratory failure requiring mechanical assistance and intensive care.

    The amount of reported nightly sleep averaged under 7 hours, but more than 6. After accounting for potentially influential factors, every extra hour of sleep at night was associated with 12% lower odds of COVID-19 infection.

    But an extra hour acquired in daytime napping was associated with 6% higher odds, although this association varied by country.

    Around 1 in 4 (137;24%) of those with COVID-19 reported difficulties sleeping at night compared with around 1 in 5 (21%;495) of those without the infection.

    And 1 in 20 (5%;28) of those with COVID-19 said they had 3 or more sleep problems, including difficulties falling asleep, staying asleep, or needing to use sleeping pills on 3 or more nights of the week, compared with 65 (3%) of those without the infection.

    Compared with those who had no sleep problems, those with three had 88% greater odds of COVID-19 infection.

    Proportionally more of those with COVID-19 reported daily burnout than did those without the infection: 31 (5.5%) compared with 71 (3%).

    Compared with those who didn’t report any burnout, those for whom this was a daily occurrence were more than twice as likely to have COVID-19. Similarly, these respondents were also around 3 times as likely to say that their infection was severe and that they needed a longer recovery period.

    These findings held true, irrespective of the frequency of COVID-19 workplace exposure.

    This is an observational study, and as such, can’t establish cause. And the researchers acknowledge several limitations to their study.

    These include subjective assessment of exposure levels, sleep issues, and infection severity, all of which may have been incorrectly remembered. And the sample included only cases of very mild to moderately severe COVID-19.

    By way of an explanation for their findings, the researchers note: “The mechanism underlying these associations remains unclear, but it has been hypothesized that lack of sleep and sleep disorders may adversely influence the immune system by increasing proinflammatory cytokines and histamines.”

    And they point to studies linking burnout to a heightened risk of colds and flu as well as long term conditions, such as diabetes, cardiovascular disease, musculoskeletal disease and death from all causes.

    “These studies have suggested that burnout may directly or indirectly predict illnesses by occupational stress impairing the immune system and changing cortisol levels,” they write.

    And they conclude:”We found that lack of sleep at night, severe sleep problems and high level of burnout may be risk factors for COVID-19 in frontline [healthcare workers]. Our results highlight the importance of healthcare professionals’ well-being during the pandemic.”

  • Uncategorized

    “Insomnia-Like” Sleep Patterns Can Predict Future Stress

    • Comments Off on “Insomnia-Like” Sleep Patterns Can Predict Future Stress
    • by

    As part of our outreach efforts to our clients, we will often share informative articles related to sleep and sleep apnea. The following is an insightful piece written for Sleep Review by Sree Roy.

    Inverse: New research suggests fragmented sleep patterns contain a critical message.

    Dipesh Chaudhury is the study’s lead author and an assistant professor of biology at New York University Abu Dhabi. He tells Inverse that this study deepens our understanding of how stress and sleep are related. Typically, we assume that stress leads to poor sleep. But things could also work the other way around, with poor sleep dampening resilience to stress at the same time.

    “Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.

    A BAD NIGHT’S SLEEP COMES WITH A HOST OF CONSEQUENCES, some of which aren’t obvious right away. This is especially true when stressful situations — like a year defined by a pandemic — hit. Research suggests specific abnormal sleep patterns may decrease one skill that’s crucial to weathering the storm.

    In a mouse study published Tuesday in Frontiers in Neuroscience, scientists found fragmented sleep patterns – a pattern of sleep marked by more awakenings and shorter bouts of non-rapid eye movement sleep –could predict how mice responded to future stress. Mice with regular sleep patterns were resilient to bullying, while those with fragmented sleep patterns weren’t equipped to deal with the abuse.

    WHAT DOES A “DISRUPTED SLEEP PATTERN LOOK LIKE?

    “Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.

    Chaudhury’s study was based on the sleep and stress patterns of 22 mice who had electrodes implanted into their brains. Those electrodes could measure the amount of time each mouse spent in each stage of sleep.

    Like humans, mice move through sleep stages including rapid eye movement sleep (REM) — when most dreaming happens in humans — and lighter, non-REM stages.

    Every mouse was exposed to chronic social defeat — 15 consecutive days of being attacked by aggressive mice identified at the outset of the study. The researchers found that they could break the mice up into two groups: mice who were resilient, bouncing back from bullying ready to socialize, and ones that succumbed, and retreated from others.

    WHAT WAS DISCOVERED

    The scientists found there were significant differences in the sleep patterns of each group of mice beforethey were exposed to the bullying.

    The mice in the non-resilient group showed signs of fragmented non-REM sleep. They woke up more during sleep periods (mice sleep during the day) and had were shorter NREM bouts, on average, than those seen in the resilient mice.

    “In essence, the susceptible mice exhibit insomnia-like traits even before exposure to stress,” Chaudry says.

    Ultimately, these patterns could predict which group the mice ended up in with about 80 percent accuracy, suggesting that it could have been one reason they were less resilient when stress took hold.

    WHAT DOES THIS MEAN FOR HUMANS?

    This study taps into a robust area of research on human mood disorders. Depression and sleep are intertwined in a way that makes it hard to distinguish cause and effect. Disturbed sleep is often seen in depressive patients, but those who experience insomnia are also more likely to develop depression in the first place.

    Though this study focuses on stress, it suggests that sleep may pose an even more central role in mood disorders – or in this case, resilience to stress. Before the stressful situation occurs, sleep patterns may contain early warning signs.

    These results are early-stage, Chaudhury cautions. A mouse brain (and a mouse’s stress) is quite different from a human’s. But he is optimistic that the idea that sleep signatures could be a prediction of stress — specifically the way the brain transitions in and out of non-REM sleep — will hold true in humans.

    He imagines monitoring the sleep patterns of people who have particularly high-stress jobs, like first responders or frontline workers. Even if signs of stress have yet to show themselves, a disrupted sleep pattern could be the sign of a vicious cycle (stress leading to worse sleep, leading to less resilience to stress) about to go awry.

    “By having simple non-invasive markers of stress susceptibility, such as EEG sleep patterns, it may be possible to develop strategies to protect the more vulnerable people,” Chaudhury says.

    Abstract: There is a tight association between mood and sleep as disrupted sleep is a core feature of many mood disorders. The paucity in available animal models for investigating the role of sleep in the etiopathogenesis of depression-like behaviors led us to investigate whether prior sleep disturbances can predict susceptibility to future stress. Hence, we assessed sleep before and after chronic social defeat (CSD) stress. The social behavior of the mice post stress was classified in two main phenotypes: mice susceptible to stress that displayed social avoidance and mice resilient to stress. Pre-CSD, mice susceptible to stress displayed increased fragmentation of Non-Rapid Eye Movement (NREM) sleep, due to increased switching between NREM and wake and shorter average duration of NREM bouts, relative to mice resilient to stress. Logistic regression analysis showed that the pre-CSD sleep features from both phenotypes were separable enough to allow prediction of susceptibility to stress with >80% accuracy. Post-CSD, susceptible mice maintained high NREM fragmentation while resilient mice exhibited high NREM fragmentation, only in the dark. Our findings emphasize the putative role of fragmented NREM sleep in signaling vulnerability to stress.