Sleep tight

May 2009

Women are inherently more prone to sleep disturbance than men. Around menopause the proportion of women with sleep difficulty increases and this is related to changing hormones. Medical research has linked this to estrogen and the simple answer would be to supplement with estrogen – hormone replacement therapy (HRT). But of course we know now there are other hazards associated with HRT long term.

Menopausal women are also at increased risk of sleep apnoea, where breathing is interrupted repeatedly during sleep, causing oxygen deprivation and increased risk of heart disease.

It seems to me quite clear that when a woman going through menopause is having disturbed sleep she is also at greater risk of depression. Just think of how bright the world looks when you have had a good night's sleep. It is a totally different feeling from the sluggishness you feel when you drag yourself through the day after only a few hours of sleep. The world looks bleak and everything is an effort.

Add to this other pressures women may be experiencing from family and work, and it is little wonder that anti-depressants are increasingly prescribed to help them cope.

But is it the best answer? As reported in "The Age" recently, Harvard Professor of Psychiatry Robert Stickgold believes that sleep deprivation actually causes major psychiatric disorders in people:

• major depression
• bipolar disorder
• Attention Deficit Hyperactivity Disorder (ADHD) in children.

He bases his theory on studies of US children with ADHD and sleep apnoea, caused by enlarged tonsils. Once the tonsils were removed, improving their sleep, the ADHD improved dramatically as well.

He also found that sleep apnoea was 5 times more common in people with major depression and suggested that many people would never have been diagnosed with depression if they were able to get a good night's sleep.

Menopause is not a mental disorder but many women feel depressed at this time. If Professor Stickgold is right than this depression could be cured with a good night's sleep. Easier said than done, if you are plagued by hot flushes, night sweats and palpitations, waking you through the night. Many women also find their sleep disturbed by vivid dreams, even nightmares. Plus, there is the increased incidence of sleep apnoea in menopausal women.

How do you know if you have sleep apnoea?

Here are some basic clues:

• snoring – you may not be aware of it so ask your partner
• feeling tired during the day, falling asleep while reading or watching TV
• waking suddenly, choking or gasping for air
• still tired after a full night's sleep
• waking with a headache.

If you suspect sleep apnoea see your GP for a referral to a sleep clinic. If it isn't the problem but you are still sleeping poorly there are alternatives to anti-depressants and HRT to help you get a good night's sleep and a sunny mood.

Herbal medicine from St John's Wort has an anti-depressant action that has been well validated by clinical research for mild depression. One of its traditional uses is also for insomnia, especially dream disturbed sleep and waking in the small hours.

Implementing the hormone balancing diet helps to ease the adjustment to lower hormone levels and is supportive of good health at menopause.

For more information about the hormone balancing diet, please contact Elizabeth Blomberg at mind body insight. You can also schedule a consultation online.

Also read: The midnight hour