Wide Awake at Midlife
What keeps us awake? The list is long. Stress. Anxiety. Flickering screens. Demanding workdays that overflow into the nighttime hours. Worries about teenage kids or elderly parents. Noise. Hormones.
Insomnia might rear its ugly head as the inability to fall asleep, stay asleep or fall back to sleep if you wake during the night.
“We see it across the age span,” said Margaret Loewen, CNP with Avera Medical Group Functional Medicine. “Most often it’s a product of our busy lifestyles.”
Numerous factors can make those precious ZZZZs even more elusive at midlife. “Hormone imbalance at perimenopause and menopause can lead to sleep disturbances,” said Jessica Morrell, CNP with Avera Medical Group Functional Medicine. Rather than being the underlying cause of sleeplessness, it might be that one factor that makes everything else too much to handle. In addition, hormonal hot flashes might disturb sleep.
Loewen and Morrell, along with Patricia Peters, MD, at Avera Medical Group Functional Medicine are Certified Functional Medicine Providers (IFMCP).
A racing mind will not let you sleep. “Think of your brain as a computer and you have all these windows open… you’re sending emails, making lunches and folding laundry up until bedtime, and you’re not doing anything to close those windows,” Loewen said.
Many Factors Make You Restless
Your body’s metabolism can also cause difficulty sleeping. Eating a lot of carbs late in the evening or drinking alcohol can cause a glucose drop that stimulates your body to wake up.
Another sleep disorder experienced by both men and women is sleep apnea, in which breathing stops momentarily due to airway blockages, and you unknowingly wake yourself up to breathe. Snoring and gasping is a sign of this disorder which causes your oxygen levels to drop. “You’re not getting that good REM sleep that your body needs,” Morrell said. Those who might have sleep apnea are referred for a sleep study, and often the treatment is use of a CPAP.
Sometimes, the reasons for lost sleep isn’t all in your head – it’s all in your bladder – when you have to get up to “go” multiple times during the night.
“This happens more as we get older for several reasons. Women who have had babies can experience greater weakness in their pelvic floor,” Peters said. Or, if you have varicose veins and fluid collects around your ankles, this fluid can move up toward your kidneys when you lie down.
Many women cope by not drinking any water after supper. “But then you dehydrate yourself, and by morning you are well behind on fluids,” Peters said.
Instead, she advises women to do Kegel exercises to strengthen the pelvic floor, and also try to retrain the bladder by waiting as long as you can to urinate. When you do urinate, empty your bladder completely. There are also medications that can help. If the problem is still not resolved, women can be referred to Avera Medical Group Urogynecology for specialty care.
If sleep problems persist, see your doctor. While a prescription sleeping pill is a last resort, sometimes it’s needed to get you back on track. Bioidentical hormone replacement therapy can help ease hormone imbalance or hot flashes. “We do hormone testing to give you the least amount of what you need for the shortest possible time,” Morrell said.
These tips for you to follow throughout the day can lead to a better night’s rest:
- Get regular exercise to burn off excess energy plus stimulate serotonin release.
- Expose yourself to natural daylight to regulate your sleep/wake cycle.
- Eat a healthy, balanced diet that emphasizes fruits and vegetables, protein and complex carbohydrates.
- Avoid foods that are high in carbs and sugar at night.
- Limit caffeine, especially in the evening.
- Find ways to quiet your mind before bed, for example, meditation or light reading.
- Avoid screen time in the evening because the blue flickering light of computer, tablet and phone screens cues our body to stay awake.
- Turn down the thermostat – the best sleeping temperature is 68 degrees.
- Go to bed and get up at the same time every day. Sleeping in on Saturdays or taking long naps won’t help your cause.
- Go to bed when you’re naturally tired – 10 to 10:30 p.m. for most people. If you miss that window, you might get a “second wind,” and it’s even harder to fall asleep.
- Don’t depend on alcohol to put you to sleep. While it initially makes you feel sleepy, it can cause you to wake during the night.
- Supplements might help you, for example, chamomile tea, l-theanine or melatonin (no more than 3 miligrams.)