Creating a healthy sleep environment will help ensure you get a restful night’s sleep. It can play an outsized role in managing symptoms of menopause. (For Health Beat)

If you’re going through perimenopause or menopause—and all the changes that come along with it—there’s one thing you desperately need: A good night’s sleep.

But that can be a challenge.

Whether it’s night sweats or anxiety, many factors can make good sleep elusive for menopausal women, according to Kelly Waters, MD, a Corewell Health neurologist specializing in sleep medicine.

During menopause, a woman’s ovaries stop producing estrogen and progesterone, causing menstruation to stop.

This hormone loss can cause symptoms such as hot flashes, night sweats, anxiety and depression.

On top of menopause symptoms that can disturb sleep, changing hormones alone may contribute to restless nights. Not to mention stresses that can come along from circumstances in midlife, such as adolescent children, an empty nest, aging parents or more responsibility at work.

Dr. Waters encourages women experiencing menopause to seek help to overcome challenges and, hopefully, ease the transition.

“Sleep is restorative. There’s not a substitute for good sleep,” Dr. Waters said.

Depending on the severity of the sleep problems, seeking menopause symptom treatment can be a good first step, Dr. Waters said. Some women are candidates for hormone replacement therapy, while others might not be.

Some may benefit from selective serotonin reuptake inhibitors, medications commonly used for depression.

These are treatment decisions that women must discuss with their physician and not take lightly, Dr. Waters said.

Beyond that, women can review their sleep habits and begin new evening practices. Things that never mattered before can suddenly make a big impact for women, Dr. Waters said.

“If you have been riding along and have been an OK sleeper, now it might be that you are more sensitive to those things,” she said. “We do have to optimize whatever factors we can.”

Some ways to start that process:

Create a cool sleeping environment

Many women may have spent their whole lives running a bit cooler and needing the heat turned higher at night. So they might be confused when, all of a sudden, their internal thermometer goes haywire, Dr. Waters said.

Try to counteract hot flashes and night sweats with anything that will help keep you cool.

“You shouldn’t bundle on all the covers and the warm sweatshirt anymore,” she said.

In fact, Dr. Waters tells all her patients—not just menopausal women—about four guidelines for a good sleep environment: cool, calm, dark and quiet.

Keeping cool might mean using a programmable thermostat set a few degrees lower at night. Loose clothing also can help.

Routine, routine, routine

Midlife and all that comes with it can wreak havoc on a woman’s schedule and ability to carve out time for herself, Dr. Waters said.

But healthy habits and a routine at bedtime will help create a good night’s sleep, she said.

Establish a consistent routine by trying to get to bed and then waking up at the same time every day. This will help your body’s circadian rhythm.

If you’re lying in bed unable to sleep, don’t force it, Dr. Waters said.

Instead, take time out of bed and have another spot designated where you can get sleepy. Get comfortable, dim the lights and sit quietly.

Also consider making a to-do list to take tomorrow’s tasks off your mind. Other helpful mind-clearing practices include journaling, listening to quiet music, breathing deeply, doing a guided meditation or practicing progressive muscle relaxation.

One thing not to do: look at your personal electronics. Blue and blue-green light from screens—including televisions, tablets, smartphones and laptops—can keep you awake.

When you’re tired, go back to bed.

Watch what you eat and drink

You might not be able to eat and drink the things you used to and still ease into sleep, Dr. Waters said.

Avoid excessive alcohol, large meals and spicy food near bedtime. Try to schedule your last large meal at least three hours before bedtime.

Consider cutting off caffeine intake earlier in the day.

Watch for sleep apnea

A woman’s risk of sleep apnea worsens after menopause.

Women may have more protection from health risks such as heart disease, high blood pressure and sleep apnea before menopause, but this changes after menopause, Dr. Waters said.

“A lot of health risks start to equalize with men,” she said.

Tell your doctor if you or your sleep partner notices snoring or stopped breathing while you sleep, or if you experience daytime sleepiness or grogginess.

Lead a healthy lifestyle

Healthy practices during the day can contribute to a good night’s sleep.

  • Exercise at regular times every day, but not too close to bedtime.
  • Drink plenty of water, but not too much right before bedtime so you are not awakened by bathroom needs.
  • Eat a balanced diet with plenty of fiber and minimal sugar.
  • Take care of your mental health with practices to help calm anxiety.

Carve out time for yourself so you can weather midlife challenges with good sleep, Dr. Waters said.