Sleep may seem more elusive during midlife and menopause than any other time of life - even after having a new baby. Ninety-six percent of women in midlife say that poor sleep is one of their top three symptoms of menopause, according to a recent Gennev survey. To make matters worse, it seems like every day there’s another health problem attributed to a lack of sleep—weight gain, memory problems, decreased immunity, and increased risk of diabetes, heart disease, stroke, and even cancer. No wonder you can’t sleep!

“When sleep becomes a constant concern that a person is preoccupied by, that in itself can make it difficult to become a good sleeper,” says Sound Sleep Guru Meredith Broderick, M.D., who is board certified in sleep medicine and neurology.

So, the first step to better sleep is to stop worrying so much about your sleep. We know, easier said than done. That’s why we’ve created this guide to help you to stop obsessing about your sleep and start enjoying a good night’s rest. You may be surprised to find out that some of the most effective strategies are pretty simple. And even if you’re sleep isn’t perfect, there are things you can do to mitigate the negative effects of poor sleep on your health.

Why is a good night's sleep so important?

Sleep is your body’s rest and repair time. You may think you’re busy during the day, but a lot is going on inside your body at night. Cells are regenerating. Hormones are regulating. Memories are being stored. Your immune system is reinforcing itself. Muscles are getting stronger. Nerve cell connections are being made. All in an effort so you can perform at your best the next day.

To make all of this happen, your body cycles through two types of sleep throughout the night. If you use a sleep tracker like a Fitbit or Apple watch, you may be familiar with some of this. The first type is non-rapid eye movement sleep (non-REM), which includes light and deep sleep. The latter is a crucial time for growth and repair, and if you awaken during this stage, you’ll often feel groggy and disoriented for a while. The second type is rapid eye movement sleep (REM sleep), which involves more brain activity than non-REM. This type of sleep is essential for the processing and storing of information, including memories, in your brain. Overnight you cycle through the various stages, with each cycle lasting about 90 minutes and the REM stage getting longer the more you sleep.

How menopause interrupts sleep at night

There are lots of reasons women sleep poorly during midlife. Hot flashes. Worries. Night sweats. Restless leg syndrome. Pain. A never-ending to-do list. Urinary issues. Sleep apnea. Even if you don’t have trouble falling asleep, you may find yourself waking up more often throughout the night and having a harder time falling back to sleep. Unfortunately, sleep problems don’t usually disappear along with other menopause symptoms.

But a good night’s sleep doesn’t have to be a dream. Often, when you address underlying issues such as urinary problems or joint pain, you’ll sleep better. Treating menopause symptoms like night sweats and anxiety can also help. That’s why your first step should be to see a doctor with experience treating women in menopause. They will understand what you’re going through and have the most options for helping you. A serious sleep robber that needs immediate attention is sleep apnea. If your partner notices that you’re snoring or appear to stop breathing while you sleep, talk to your doctor about getting checked for sleep apnea. As estrogen levels decline, you’re more likely to snore and even experience sleep apnea, a serious condition that disrupts your breathing. Like other underlying conditions, treating sleep apnea will help you sleep better and wake up feeling rested.

What’s more important: quantity of sleep or quality?

As you’re trying to improve your sleep, you may get fixated on the number of hours you’re snoozing. If you wear a sleep tracker, you might obsess about how much deep versus REM sleep you’re getting. While both quantity and quality are important, Dr. Broderick says the most valuable endpoint is feeling rested throughout the day. “If you feel good, the numbers aren’t as important,” she says. “Feeling good and functioning well during the day are what I care about the most.”

And getting a good night’s sleep, so you wake up feeling rested, starts long before you turn in for the night. “What you do with the time you are awake and the quality of your waking hours has a dramatic impact on your sleep quality,” Dr. Broderick explains. “Being active, engaged, having a purpose, and connection are reasons why you get out of bed in the morning. They also keep you busy and help your body generate the need for deep, uninterrupted sleep.”

8 steps to getting a good night’s sleep

While you address any underlying causes that may be keeping you up at night, here are additional steps you can take to set your body up for a good night’s sleep. Some may even help with conditions like anxiety, joint pain, and hot flashes that can rob you of sleep.

1. Be active. The latest research shows that exercise can protect against the adverse health effects of poor sleep. All activity levels provide some benefit, and the more you do, the more protection you get. Exercise has also been shown to improve sleep so it’s a win-win.
2. Adopt a plant-based diet. A healthy diet is even more essential when you’re not sleeping well. A new Stanford University Medical School study found that when you incorporate more plant-based foods into your diet, the decrease in saturated fats and sugar minimized the side effects of sleep deprivation, such as brain fog, poor concentration, fatigue, and irritability. Other research suggests that high-carbohydrate diets may promote better sleep than high-fat diets, and foods like fish, fruits, vegetables, and milk products may also help.
3. Get out in the sun. Sunlight is one of the most potent ways to reset your body’s internal clock, your circadian rhythms, that dictate your sleep-wake cycle. It tells your body to stop producing melatonin, a hormone that promotes sleep. That’s why it’s best to get a dose of sunlight early in the day. A morning walk is a great way to do this and get some exercise for a double-dose of sleep medicine.
4. Wake up at the same time every day. It’s best if you have a consistent bedtime and wake-up time, even on weekends, to train your body and brain to know when it’s sleep time. If you can’t be consistent with both, at least keep a consistent wake-up time, which may make it easier to fall asleep at night than if you sleep in the prior morning.
5. Curb caffeine. You don’t have to cut it out entirely but cut off your caffeine consumption (coffee, tea, soda, chocolate) at least five hours before bedtime. The earlier, the better. Caffeine can stick around in your system for 12 hours or more. And even if you think it doesn’t affect your sleep, research shows that it can shorten valuable deep sleep time.
6. Pick up some weights. Cardio like walking, running, cycling, or swimming tend to be the go-to types of exercise. But a new study suggests that strength training may have an edge in promoting sleep. Because strength training can be more taxing to muscles and requires more recovery than cardio, it may make your body crave sleep, so you sleep more soundly.
7. Limit night lights. Bright artificial light and blue light from screens can disrupt your sleep hormones, making good quality sleep harder to get. Turn down overhead lights and limit screen time in the evening to signal to your body that bedtime is coming. Avoid screens for at least 30 minutes before hitting the hay.
8. Trade in your nightcap. A glass of wine or other alcoholic beverages may make you sleepy, but they can cause you to wake up more and get less deep sleep. Instead, sip golden milk or 100-percent tart cherry juice about 30 minutes before bed, recommends Gennev Health Coach Stasi Kasianchuk.

If you continue to have sleep issues, consider seeing a board-certified sleep specialist or a behavioral sleep specialist. They can provide cognitive behavioral therapy, which has been shown to be effective for chronic sleep problems.

When you notice a change in sleep pattern that may be associated with the menopause transition, especially if body temperature instability is part of the problem, consider an appointment with a Gennev doctor to address the role that hormonal shifts can play in your trouble sleeping.

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.