Sleep Hygiene in Perimenopause
During perimenopause, the transitional phase before menopause, hormonal fluctuations can cause a variety of changes, including to your sleep. Symptoms such as insomnia, hot flashes, night sweats, and increased anxiety can disrupt your sleep, leaving you feeling tired and sluggish throughout the day. Improving your sleep hygiene can help to manage the sleep-related symptoms of perimenopause.
What is sleep hygiene?
Sleep hygiene is a term used to describe good sleep habits (CDC, 2022). It is a broad term that can refer to both your sleep behavior as well as your sleep environment. Having good sleep hygiene means that you have a bedtime routine and a sleep environment that promotes consistent, good quality sleep.
Medication for sleep disturbances such as insomnia medications, can be good for the short term, but relying on the pills can create a reliance on the medication without forming good sleep habits that will be effective in the absence of the medication (Center for Clinical Intervention, n.d.). Setting habits that reinforce themselves through improvements to your sleep will continue to benefit you for the long haul.
Improving your sleep hygiene has little to no cost and can help you get some good quality Zzzs.
How do you practice good sleep hygiene?
Setting up an ideal sleep environment
Your sleep environment should be comfortable and conducive to a good night sleep.
A mattress and pillow with good quality sheets and blankets will help you feel comfortable and ready to go to sleep. One study found that when people slept on a bed that they felt was ‘comfortable’, they had higher sleep efficiency, lower sleep latency, and woke up less throughout the night compared to people who slept on an ‘uncomfortable’ bed (Lee & Park, 2006).
The bed itself should be only used for sleeping and intimacy. This will help to train your body to be asleep when you are in your bed. If you’re doing a relaxing activity before bed, try doing it in another spot or limit the time that you’re going to do it (Suni & Vyas, 2023).
Investing in blackout curtains or an eye mask to block continuous light exposure will keep the room dark and ready for sleeping (Caddick et al., 2018).
Intermittent noises like a car horn or plane flying overhead can reduce sleep quality, while some individuals find that continuous noises are actually helpful for them to sleep soundly (Caddick et al., 2018). If you find yourself being woken up from noises at night, ear plugs may be helpful.
Sticking to a sleep schedule
Waking up and getting out of bed at the same time (or window of time) each day will train your body to have consistent sleep (Suni & Vyas, 2023). It is important to stick to your wake-up time even on weekends or days off (Suni & Vyas, 2023) .
Prioritizing going to bed at a reasonable time based on your set wake-up time will help your body keep to a consistent schedule. This will help you naturally feel tired when you should be going to bed, and helping you feel more awake when you do get up (Suni & Vyas, 2023).
Maintaining a consistent sleep schedule is easier said than done, because life happens! Adjusting on either end is fine if you got back later than expected from going out to dinner, or if you know you need to wake up earlier than usual. Swings larger than 60 minutes in bedtime and wake-up times can disrupt your sleep schedule and make it difficult to fall asleep and wake up (Paterson, Reynolds & Dawson, 2018).
Similarly, be conscious about your napping habits. A quick nap can be a great way to rest and reset during the day, but taking a nap that is too long can prevent you from falling asleep at night (Mograss et al., 2022). Naps less than one hour and in the early afternoon should be okay, but consider adding that extra hour of sleep into your nighttime sleep to maximize the restorative benefits of long, continuous sleep (Center for Clinical Intervention, n.d.).
Making a bedtime routine
In the same way that setting a sleep and wake-up time is important, having a consistent routine that you do before you go to bed will signal to your body that it is time to wind down from the day and hit the hay. A good bedtime routine begins around 30-60 minutes before you want to go to sleep (Suni & Vyas, 2023).
Phones and other electronics can distract you from falling asleep and emit blue light that interferes with your body’s melatonin production (Caddick et al., 2018). Turning off your phone, TV, tablet and other electronic devices 30-60 minutes before bed is a good place to start (Suni & Vyas, 2023; Center for Clinical Intervention, n.d.). Dimming the lights in the room can also help with simulating darkness to prepare your body for sleep (Caddick et al., 2018).
Doing relaxing activities before bed such as reading, light stretching, journaling, mindfulness, and breathing exercises is a good way to wind down (without a screen). Stimulatory pre-sleep routines such as playing games or watching a stressful TV show or movie can delay sleep onset and should be avoided (Oda & Shirakawa, 2014).
We’ve all had time when you’ve done your entire bedtime routine, but when it's time to actually fall asleep, you just can’t! If you’ve been lying awake in bed for 20 minutes, you should get out of bed (Suni & Vyas, 2023). To create a mental connection between being in bed and falling asleep, you should remove yourself from lying in bed (Suni & Vyas, 2023).
Doing a relaxing activity in dim lighting without a screen until you feel tired again will help you to feel tired and then you can get back into bed (Suni & Vyas, 2023). Even getting out of bed and going to sit on a couch in the dark is a good way to signal to your body that it is sleep time (Suni & Vyas, 2023).
Daily Habits
Incorporating daily habits that support your circadian rhythm will improve your sleep.
Sunlight is one of the most powerful drivers of the circadian rhythm, telling your body that it is time to be awake and alert (Blume, Garbazza & Spitschan, 2019). Getting sunlight right after you wake up by going outside or opening your curtains will help to kickstart your day.
Exercising outside is a great way to get multiple benefits for your circadian rhythm. Physical activity helps to regulate your circadian rhythm and improve your sleep, specifically among people who have diagnosed insomnia (Kline, 2014).
Smoking is linked to multiple sleep conditions because nicotine stimulates the body, making it more difficult to wind down and go to sleep (Riedel et al., 2004). If you are a frequent smoker, talk to your healthcare provider about quitting.
Similarly, caffeine is another stimulant that can make falling asleep difficult (Pacheco & Cotliar, 2024). It is tempting to use caffeine, especially after a night where you did not get enough sleep (Pacheco & Cotliar, 2024). However, it can create a vicious cycle of relying on caffeine to make up for poor sleep, and in turn the caffeine can cause poor sleep (Pacheco & Cotliar, 2024). Avoid drinking caffeine in the evening.
While alcohol seems like it would help you sleep, the metabolism of alcohol disrupts your sleep and causes poor sleep quality (Pacheco & Singh, 2024). Avoid alcohol later in the evening, monitor your intake, and consider talking to your healthcare provider if you feel you have an alcohol dependence (Pacheco & Singh, 2024).
Practicing good sleep hygiene is important during the menopausal transition because it sets habits in place that will remain even as hormones fluctuate and disrupt your sleep.
In conclusion, sleep hygiene is important for establishing habits that are conducive to a good night’s sleep. You do not have to try every single tip at once, but adding a few new relaxing practices or even just committing to turning off your phone an hour before bed can make a big impact on your sleep.
If you sleep in bed with your partner, consider having an open and honest conversation about how your sleep has changed during perimenopause and how you want to try some things to improve your sleep hygiene.
Disclaimer: Fetch Gazette strives to provide valuable and reliable health information through our blog. We believe in empowering individuals to make informed decisions about their health and well-being. However, it is important to understand that the content on our blog is not intended to replace the advice, diagnosis, or treatment provided by a qualified medical professional.
Sources
Blume, C., Garbazza, C., & Spitschan, M. (2019). Effects of light on human circadian rhythms, sleep and mood. Somnologie, 23(3), 147.
Caddick, Z. A., Gregory, K., Arsintescu, L., & Flynn-Evans, E. E. (2018). A review of the environmental parameters necessary for an optimal sleep environment. Building and environment, 132, 11-20.
Center for Clinical Intervention. (n.d.). Sleep Hygiene . Sleep Hygiene. https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Sleep/Sleep---Information-Sheets/Sleep-Information-Sheet---04---Sleep-Hygiene.pdf
Center for Disease Control. (2022, September 13). Tips for better sleep. Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html
Kline, C. E. (2014). The bidirectional relationship between exercise and sleep: implications for exercise adherence and sleep improvement. American journal of lifestyle medicine, 8(6), 375-379.
Mograss, M., Abi‐Jaoude, J., Frimpong, E., Chalati, D., Moretto, U., Tarelli, L., Lim, A., & Dang‐Vu, T. T. (2022). The effects of napping on night‐time sleep in healthy young adults. Journal of sleep research, 31(5), e13578.
Oda, S., & Shirakawa, K. (2014). Sleep onset is disrupted following pre-sleep exercise that causes large physiological excitement at bedtime. European Journal of Applied Physiology, 114, 1789-1799.
Pacheco, D., & Cotliar, D. (2024, January 9). Caffeine’s connection to sleep problems. Sleep Foundation. https://www.sleepfoundation.org/nutrition/caffeine-and-sleep
Pacheco, D., & Singh, A. (2024, January 5). Alcohol and sleep. Sleep Foundation. https://www.sleepfoundation.org/nutrition/alcohol-and-sleep
Park, S. J., & Lee, H. J. (2006). The relationship between sleep quality and mattress types. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 46, No. 6, pp. 745-749). Sage CA: Los Angeles, CA: SAGE Publications.
Paterson, J. L., Reynolds, A. C., & Dawson, D. (2018). Sleep schedule regularity is associated with sleep duration in older australian adults: implications for improving the sleep health and wellbeing of our aging population. Clinical gerontologist, 41(2), 113-122.
Suni, E., & Vyas, N. (2023, December 8). Mastering sleep hygiene: Your path to quality sleep. Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene
Riedel, B. W., Durrence, H. H., Lichstein, K. L., Taylor, D. J., & Bush, A. J. (2004). The relation between smoking and sleep: the influence of smoking level, health, and psychological variables. Behavioral sleep medicine, 2(1), 63-78.