How Can I Improve My Sleep and Nutrition During Menopause?

What causes sleep problems during menopause, and how can they be managed?

Catherine Winslow, MD: Hormonal shifts, hot flashes, night sweats, stress and underlying medical conditions often disrupt sleep during menopause. Treating hot flashes with hormone replacement therapy (HRT) or other treatments can help you wake up less at night.

What habits or over-the-counter options are effective for improving sleep?

Catherine Winslow, MD: Good sleep habits are important. This includes avoiding alcohol consumption (especially at night), avoiding caffeine late in the day, keeping your bedroom cool, getting up at the same time every day, avoiding napping and doing something relaxing before bed. Limit processed foods as these can affect sleep quality. Focus on foods high in nutrients like fiber, protein, Omega-3 fatty acids and magnesium for improved sleep. 
 

Medical treatments for hot flashes, like hormone therapy, can also improve sleep. Cognitive Behavioral Therapy (CBT), including online programs like Sleepio or mobile apps like iREST, can help too.
 

I do not recommend using over-the-counter sleep aids or supplements unless recommended by a health care provider.

Read: How Much Sleep Do I Really Need? Getting Your Sleep Routine Right

How can exercise improve sleep quality during menopause?

Catherine Winslow, MD: Regular exercise can help you sleep better. Avoid exercising too close to bedtime. Exercising within three hours of bedtime can make it harder to fall asleep.

When should I see a doctor for sleep problems related to menopause? 
See your doctor if you have difficulty falling asleep, staying asleep or wake up early in the morning, especially if this is causing stress or excessive daytime sleepiness. 

There are other sleep disorders that may develop around the same time as the menopause transition, and some patients need a full sleep evaluation. If you have these symptoms, you may need sleep testing:
•    Loud snoring
•    Excessive daytime sleepiness that is unexplained
•    Waking up throughout the night
•    Abnormal behaviors or movements in sleep 
•    If somebody observes that you stop breathing in your sleep

What nutrients are most important for women during menopause?

Catherine Winslow, MD: During menopause, your body needs:
•    Protein: To keep muscles strong, eat 1.0–1.2 grams of protein per kilogram of your weight each day, or about 20% of your calories.
•    Calcium: Get 1,000–1,500 mg a day from food or supplements to keep bones healthy.
•    Vitamin B: These vitamins help your nervous system and are important during menopause.
•    Healthy fats: Omega-3s (in fish), Omega-6s (in nuts), and Omega-9s (in avocados and olive oil) are great for your health.    

How can diet help with hot flashes or mood swings?

Catherine Winslow, MD: There is evidence that certain types of diets may improve vasomotor symptoms (VMS) like hot flashes or mood swings. These include Mediterranean diets, vegan diets and low-fat diets.

Watch: Q&A: Navigating Perimenopause and Menopause

How can I keep a healthy weight during menopause when my metabolism slows down?

Catherine Winslow, MD: Do moderate exercise for 150–300 minutes a week or intense exercise for 75–150 minutes a week. Strength training 2–3 times a week helps to reduce the muscle loss that naturally occurs with aging and keeps muscles strong, which can support a healthy metabolism. 
 

Weight gain is a common concern during the menopause transition. This weight gain is partly due to metabolism changes. This can lead to obesity, meaning a BMI of 30 or higher. Very often, lasting weight loss cannot be achieved with diet and exercise alone. 
 

If you have a BMI of 30 or higher, or if your BMI is 27 or higher and you have any weight related medical condition such has hypertension or gastric reflux, you may be a good candidate for treatment with anti-obesity medications or bariatric surgery.  These medications drastically improve the odds of successful weight loss with lasting results.

Read: Navigating the Perimenopause and Menopause Transition

How does alcohol or caffeine affect menopause symptoms and sleep?

Catherine Winslow, MD: Both alcohol and caffeine can make sleep problems during menopause worse.

Should I take supplements during menopause? 

Catherine Winslow, MD: Nutrients should come from a variety of healthy foods whenever possible. Your health care provider may recommend multivitamin supplements in certain circumstances such as a restricted diet or medical conditions that cause trouble absorbing nutrients. 
Consider calcium supplements if you don’t consume dairy products. Calcium intake should be 1000-1500 mg/day between food and supplemental sources. Vitamin D supplementation may be recommended if there is concern for low absorption of vitamin D.

How can I handle sugar cravings or increased hunger during menopause?

Catherine Winslow, MD: Eating protein, healthy fats and fiber can help to reduce hunger. Eating a healthy breakfast every day is another way to prevent excessive hunger later in the day.
 

Struggling with perimenopause or menopause symptoms? A Trinity Health physician can help! Make an appointment with your Trinity Health gynecologist.

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