If you’re of an age where you’ve been googling things like “perimenopause always hungry why?!” and “hot flashes from spicy food,” you’ve probably seen your fair share of nutrition advice come and go throughout the decades—some of it useful and evidence-based, and some of it sheer nonsense.
As with many fields, what we know, believe, and share about nutrition is always evolving thanks to scientific breakthroughs, policy changes, cultural and societal norms, marketing, and the power of trends. Some of this information can help people make life-changing improvements to their health; on the other hand, nutrition misinformation can lead people to waste money, time, and energy on remedies that range from ineffective to downright dangerous.
With social media in the mix, it’s become even more difficult to separate nutrition facts from half-truths (or total fiction) so that you can eat in a way that’s enjoyable, nourishing, and supportive of your health goals. This is especially important during menopause, when bodies start doing unpredictable, unruly things, certain disease risks can rise, and it feels like everyone wants to sell you something to deal with it all.
Now…if you’re curious about perimenopause nutrition, you may be wondering about how much protein to eat, whether intermittent fasting is a good idea, or what foods you can add to round out a healthy diet during menopause, but let us give you one more thing to consider: heart health.
Taking care of your heart in midlife is super important, since heart disease remains the leading cause of death for women in the United States, and the risk of cardiovascular disease rises after menopause. Fortunately, there are ways to lower your risks, including taking medication (yes, statins work for women!), exercising (both cardio and resistance training are recommended), and getting plenty of quality sleep.
By the way: if you’re concerned about the seemingly ever-changing information about hormone therapy for menopause symptoms and cardiovascular disease risks, talk to your doctor! It’s a complex but worthwhile conversation and must account for individual needs and risk factors.
The final piece of the puzzle in a comprehensive approach to a healthy heart is, of course, nutrition. But there are longstanding myths around heart-healthy foods that can be tricky to make sense of, so where do you even start?
That’s where the professionals come in. Menopause nutrition counseling covers an amazing range of symptoms and conditions, and a Registered Dietitian Nutritionist can be one of your best allies when it comes to figuring out what to eat for your specific goals, needs, and preferences. We asked some of Gennev’s RDNs to tackle some of the most persistent myths and questions about nutrition for heart health during and after menopause.
Here’s what they shared:
Q: Should you avoid eggs if you have high cholesterol?
A: Like many other animal-based food sources, eggs do contain some saturated fat, which in excess can lead to elevated LDL cholesterol levels for some people. However, there is no need to completely avoid foods with saturated fat. For optimizing health and keeping LDL cholesterol levels within range, the American Heart Association recommends aiming for 6% or less of total calories from saturated fat. For someone following a 2000 calorie diet, this would equal around 13 grams daily. 1 egg, on average, has around just 1.5 grams of saturated fat.
For most people, eating an egg or two a day can be a great option—they contain many key nutrients such as choline, which is an important nutrient for brain health, along with several other vitamins and minerals. However, everyone’s needs are different, so talk with a dietitian for individualized recommendations.
Q: If you have high blood pressure, should you cut out sodium altogether?
A: Being mindful of sodium intake can be an important part of blood pressure management. However, sodium should not be cut out altogether, as it is a key nutrient/electrolyte needed for the body to function properly. The American Heart Association recommends aiming for 2300 mg of sodium per day or less for most people, while some may benefit from consuming around 1500 mg daily. Individual needs vary, based on medical history and physical activity level (for example, excess sweating can cause a greater release of sodium), and your healthcare provider can advise what approach would be right for you.
-Katie Linville
Q: Can you make up for the loss of estrogen (which has some protective benefits for your cardiovascular system) during menopause by eating more soy products?
A: Unfortunately, no. Phytoestrogens from plants are weaker than those made by the ovaries and are not equivalent to estrogen that the body produces when it comes to their cardioprotective properties. That said, soy products are a good source of plant-based protein in the diet, and for some women, their regular consumption may lead to a reduction in the frequency and/or severity of hot flashes.
Q: Could caffeine be making your hot flashes (and maybe blood pressure) worse?
A: Yes, caffeine can exacerbate hot flashes and it may lead to a brief rise in blood pressure as well. Caffeine has a long half-life and can take up to 12 hours to leave the body, so even an early afternoon cup of joe can negatively impact your sleep—and poor sleep is associated with higher blood pressure.
– Pamela Malo
Q: They say nuts are a heart-healthy food, but aren’t they high in fat? Should you skip those that are higher in saturated fat?
A: Most nuts are high in heart-healthy fat—monounsaturated and polyunsaturated. Heart-healthy fats like these can help improve cholesterol levels and lower the risk of heart disease. There are a few nuts that are higher in saturated fat—including Brazil nuts and macadamia nuts—although these can still be part of a balanced healthy diet if eaten in moderation. Other good reasons to eat nuts: they’re also a good source of vitamins and minerals like vitamin E, magnesium, manganese, zinc, and more.
Q: If saturated fats mostly come from animal-based foods, are vegetarians and vegans in the clear when it comes to heart health?
A: It’s not quite that simple. Heart health is important to everyone whether you choose a plant-based or animal-based eating plan. Genetics is a big determining factor in your overall risk of heart disease. Animal products tend to contain more saturated fat, which can lead to elevated cholesterol levels and therefore increase your risk for heart disease and other chronic diseases. Plant-based foods like fruits and vegetables are low in saturated fat and can help promote heart health and overall lower your chronic disease risk. Overall, physical activity and balanced diet of a variety of foods—lean protein, colorful fruits and veggies, and whole grains—are optimal strategies for decreasing your risk for heart disease.
-Beth Wolfgram
Q: If you have a family history of high cholesterol or heart disease and risks go up after menopause anyway, will a heart-healthy diet and exercise even help?
Genetics and family history of cardiovascular disease and how it influences your cholesterol varies. Because of this, how much diet and exercise affect cholesterol levels varies too. That doesn’t mean lifestyle behaviors don’t matter if cardiovascular disease runs in your family. But don’t start shaming yourself into doing them or blaming yourself if the lifestyle behaviors don’t affect your cholesterol levels like you’d hoped if you have high familial cholesterol.
Overall, diet and exercise have about a 20-30% effect on cholesterol, and consistency matters! Don’t go crazy with your fiber intake or exercise routine, thinking that your cholesterol will dramatically change if you can’t sustain those behaviors consistently.
The key to consistency is enjoyment. If you like how the exercise makes you feel during or after, you’ll do it more often. The same is true with food. Heart-healthy diets like the Mediterranean, DASH, Plant-based, and MIND diets all follow similar patterns and encourage heart-healthy eating. However, consistency matters more than the specific dietary guidelines you follow.
While these recommendations are a fantastic place to start if you’d like to eat more heart-healthy foods, you may want even more personalized guidance to meet your specific nutritional needs during menopause, especially if you’re navigating other health concerns. That’s where our clinicians shine. Learn more about working with a Gennev RDN, or book an appointment today.
We’ve all been here after a bad night’s sleep: we spend the day groggy, irritable, and unable to focus. Even minor mishaps throw us off our game. Our fuse feels shorter and it’s harder to self-regulate. When this is just an occasional occurrence, it’s usually possible to salvage the day through strong coffee, extra patience, and the promise of an early bedtime and the chance to try again tomorrow.
The impact of chronic sleep issues lasting weeks or months, however, is far more severe: long-term sleep debt and disrupted sleep can take a toll on physical and mental health over time, even going so far as to affect our interpersonal relationships and sense of self. If you’re constantly tossing and turning all night, especially during major life transitions like menopause, it’s not just your sleep quality that’s jeopardized; it’s your ability to thrive at work and at home each day.
The American Academy of Sleep Medicine (AASM) recommends that adults sleep seven or more hours per night to promote optimal health. While sleep needs vary from person to person and can change a bit with age, ideally we’re all getting enough to let our brains cycle through the different stages of sleep that help with memory, cognition, mood regulation, and more. Below, we’ll explore the emotional impacts of sleep problems and offer practical strategies to reclaim your rest and restore some much-needed emotional balance”particularly during menopause, when quality sleep becomes elusive and emotions can take you on a wild ride.
Sleep and mental health are intertwined in a complex, often cyclical relationship. Poor sleep can exacerbate existing mental health conditions such as anxiety and depression”and these mental health challenges can in turn make it harder to fall asleep, wake you up with racing thoughts in the middle of the night or early in the morning, or prevent you from reaching the stages of deep sleep you need to feel rested the next day. It’s a frustrating loop that can leave you feeling helpless and overwhelmed.
Here are some of the ways that sleep deprivation can wreak havoc on your emotional state:
Given that good sleep is a necessity, not a luxury, make it a top priority to get sufficient, high-quality sleep every night, including weekends. It’s an act of self-care: by breaking the cycle of poor sleep, you can begin to reclaim your emotional balance. In addition to improving sleep hygiene”through a consistent sleep schedule, a relaxing bedtime routine, and an optimal sleep environment”try the following activities to help boost your mood:
Shifting your sleep habits often feels much easier said than done, so know that finding a solution is sometimes more than a matter of trying new routines. If you’re dealing with a medical condition, sleep disorder such as sleep apnea, or challenging menopause symptoms that can affect sleep, mood, and mental health as well, talk with a doctor for guidance. You don’t have to solve this all by yourself.
We know that our diet can affect our moods, our risks for diseases such as diabetes and cancer, and our cognitive functioning. But food is also connected to sleep. Growing research suggests that the quality of our diet (i.e. having sufficient amounts of key nutrients on a regular basis) can actually affect the quantity and quality of our sleep. That may explain why diets that are low in fiber, high in saturated fat, and high in sugar have been associated with poorer quality sleep. Another large study found that deficits in certain nutrients”including magnesium, calcium, and vitamins A, C, D, E, and K”are associated with sleep problems.
A quick word about sugar: don’t be too quick to write off all sources of sugar and carbohydrates as problematic. While there is good evidence for avoiding refined, processed sugars for all sorts of health benefits, our bodies need carbs to function, and even simple carbohydrates (which can get a bad rap at times) are found in foods that offer additional nutritional value, like fruits and some dairy products. Even though it’s recommended to eat complex carbs like legumes and whole grains for a slower release of energy and fewer blood sugar spikes, you don’t necessarily need to give up sweet treats like a piece of delicious after-dinner fruit just in the hopes of sleeping a little better. It’s full of fiber and other nutrients you need to thrive.
If you’re looking to improve your sleep quality, mood, and overall health through nutrition, Melissa Burton, Registered Dietitian Nutritionist at Gennev, offers the following framework for thinking about a healthy diet:
Carbs + protein and/or fat
Why this formula? Carbs provide energy and are the preferred fuel for your brain, protein supports muscle tissues, hormone regulation, and satiety (the feeling of fullness and satisfaction from eating), and fat helps protect your tissues and organs and assists with brain function, hormone production, and vitamin absorption as well as satiety.
Burton advises her patients to pay attention to their hunger and fullness cues before and after eating and to try to eat every 3-4 hours during the day, including having breakfast shortly after waking to fuel the brain and body for the day ahead. She also emphasizes consuming fiber, vitamins, and minerals from a variety of foods to round out a healthy diet and being mindful of fluid intake.
In addition to consuming necessary macro and micronutrients, building healthy food-related sleep habits can help too: for instance, limit caffeine intake in the afternoons and evenings; avoid alcohol before bedtime; limit or avoid large late-night meals; and consider experimenting to see if certain foods trigger (or relieve!) your hot flashes.
If you’ve been dealing with chronic sleep disruption that’s not responding to lifestyle changes, it could be time to investigate the possibility of a sleep disorder. During menopause, women are at increased risk for disorders like sleep apnea, but the good news is that relief is possible: with Complete Sleep, you can get screened for sleep apnea through an easy, accurate test that you can take from the comfort of home. And if you do have sleep apnea, Complete Sleep offers effective treatment with custom-fitted night guards.
If your sleep troubles have coincided with menopause and brought with them a whole host of new or more worrisome mental health concerns like anxiety, depression, even out-of-nowhere rage, know that while this is not uncommon, it’s not something you just have to live with until your hormones decide to even out.
You’re not alone, and there are resources available to help you manage the combined challenges of sleep loss, emotional distress, and menopause symptoms. Reach out to one of the menopause-trained clinicians at Gennev to discuss a personalized care plan to treat fatigue, brain fog, mood swings, and more.
There are a lot of reasons for sleepless nights during menopause: racing repetitive thoughts, a cocktail too close to bedtime, late-night demands from your bladderasseems like your body can come up with endless ways to avoid sleeping peacefully. While the occasional restless night isn’t usually something to worry about, sleep disorders and chronic sleep issues like insomnia, night sweats, and sleep apnea can show up or worsen during menopause. If you find yourself waking up too early or sleeping fitfully lately, you’re not alone. We’ll take a closer look at some of these sleep disturbances, the causes behind them, and what you can do about them.
Quality sleep is essential for supporting aspects of healthy brain function, such as cognition and memory, and physical health, like metabolism. When we don’t sleep enough, our mood suffers: we might feel cranky, impatient, short-tempered, sad, or generally unable to cope. Getting more (and deeper) sleep can help us feel more resilient, energized, and better able to tackle our days, whatever they might bring.
The primary culprit behind sleep problems during menopause is the fluctuating levels of hormones, particularly estrogen and progesterone, which play a critical role in regulating the sleep-wake cycle. As levels of these hormones shift and decline, it affects the signals your brain sends to your body, making it harder to fall asleep, stay asleep, or both. Here’s a closer look at the functions of each hormone:
Existing research indicates that these hormones may even help protect women against sleep apnea”but unfortunately, menopause can cancel out that benefit. Menopause influences the prevalence of sleep apnea, with postmenopausal women experiencing sleep apnea severity comparable to that of men.
While fatigue is a common menopause symptom, many people don’t realize that their sleep disturbances may be due to an underlying sleep disorder like sleep apnea. Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep, and if left untreated, it can lead to serious health complications such as high blood pressure, heart disease, and cognitive impairment.
The hormonal changes that occur during menopause”particularly the decline in estrogen and progesterone”can contribute to airway instability, making women more susceptible to sleep apnea. Additional risk factors include:
Women with sleep apnea may not have the same symptoms as men. While men often experience loud snoring and gasping for air, women tend to report more subtle symptoms, such as:
Ugh, sounds a lot like menopause too, right? Because these symptoms overlap with common menopause complaints, sleep apnea often goes undiagnosed in women. But since you can’t diagnose yourself with sleep apnea, it’s important to get tested. If you suspect you may have sleep apnea, consider a home sleep test to determine if further evaluation is needed.
There are three main types of sleep apnea:
The good news is that sleep apnea is treatable. Some use CPAP therapy, which relies on a machine that uses air pressure to keep airways open and facilitate breathing during sleep, while others prefer oral appliances such as custom-fitted night guards that help by gently repositioning the jaw and tongue.
In addition to sleep apnea, menopause can also increase the likelihood of experiencing other sleep disorders, such as insomnia, frequent night wakings, and restless leg syndrome.
Insomnia
Many women experience menopause-related insomnia, which differs from chronic clinical insomnia. While chronic insomnia is often linked to psychological factors, menopause-related insomnia is largely driven by hormonal changes. Symptoms include:
Cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment, with menopausal hormone therapy (MHT) as an option for some women. Some melatonin and serotonin-based medications may also provide relief to help regulate the sleep-wake cycle, but always check with your physician to see if these options are compatible with your needs and any other medications you may take.
Frequent Night Wakings
A common complaint among menopausal women is waking up between 3-4 AM and struggling to fall back asleep. While this can be classified as insomnia, it can also be a result of:
To manage these wake-ups, try practicing relaxation techniques before bed, keeping your room cool, and avoiding heavy meals or alcohol before sleep. If these disturbances happen often, Gennev Registered Dietitian Nutritionist Melissa Burton suggests that it could be a good time to have your Hemoglobin A1c (which measures your average blood glucose levels over the previous 2-3 months) tested to see if blood sugar regulation issues could be the culprit. Blood sugar levels are supposed to fluctuate throughout the day as your body carries out digestion and metabolism, but wild spikes and downswings at night can both affect hormones and contribute to night awakenings. While medications and/or menopause hormone therapy may be helpful in those cases, simple dietary changes can also help stabilize blood sugar overnight.
Restless Leg Syndrome (RLS)
Restless leg syndrome is a neurological condition that causes an uncontrollable urge to move the legs, particularly at night. Women going through menopause may notice their symptoms worsening due to:
Simple strategies like stretching before bed, taking iron supplements (if deficient), and practicing relaxation techniques may help alleviate these symptoms. Burton notes that while there is limited research into dietary supplementation for restless leg syndrome, some vitamins and minerals do show promise. Some of her patients have found relief for RLS and other sleep issues with magnesium, a key mineral that supports muscle, nerve, bone, and heart health in addition to helping with mood and sleep. If you’re tempted to try it, a few tips: there are different forms of magnesium, some of which can cause vivid dreams or digestive discomfort, so Burton advises first-timers to look for magnesium glycinate, since it can be gentler on the GI system. It’s also a good idea to take your first dose when you’re not facing a busy day, just to minimize the chance of an upset stomach disrupting your plans.
And of course, before trying any new vitamin or mineral supplement, check with your healthcare provider or a pharmacist to make sure there’s no risk of interaction with other supplements or medications you’re taking or contraindications with other health conditions you may have.
Time and time again, research shows that not getting enough sleep over a long period of time impairs our mental and physical health. Being sleep-deficient can interfere with our ability to work, drive, focus, remember things, make decisions, get tasks done, regulate our emotions, and be fully present for our children, family members, and friends. Our overall well-being suffers.
Sleep deprivation also increases the risk of chronic diseases such as diabetes and heart disease and serves as a kind of “warning sign” for other medical and neurological issues, such as congestive heart failure, osteoarthritis, and Parkinson’s disease. While sleep duration needs vary from person to person and do decrease a little bit as we age, sleep quality is still extremely important for short-term and long-term healthasso know that you don’t have to just power through poor sleep if you’re not getting the rest you need.
While sleep disturbances during menopause are common, there are steps you can take to improve your sleep quality:
If your sleep problems are severe or persistent, it might be time to consult a healthcare professional. They can help identify any underlying medical conditions, recommend appropriate treatment options, and rule out other possible causes of sleep disturbances. Potential solutions may include:
Sleep disorders during menopause are a common”but manageable”challenge, so it’s important not to give up hope. By understanding the underlying causes and building healthy sleep habits, you can start to reclaim your nights and enjoy more rejuvenating sleep. If you’re struggling to get deeper sleep no matter what you try, be sure to reach out to your healthcare provider for personal advice and support. “If you suspect your sleep is being affected by your hormones, take a home sleep test and talk to your physician regarding treatment,” says Mary Best, NP, Nurse Practitioner at Complete Sleep.
When it comes to treatment, there are a variety of options available depending on the cause of sleep disturbances. “Treatment options include hormone replacement therapy (HRT), SSRIs, and acupuncture, in addition to cognitive behavioral therapy,” Best says. And if sleep apnea is a factor, she explains, “manual devices to assist in airway support are also a viable and reasonable option without the risks of medication side effects.”
If you’re dealing with sleep apnea (or worried that you might be), Complete Sleep can help you get tested with easy, accurate testing right from the comfort of home. Even better, if you find out that you have sleep apnea, Complete Sleep offers a helpful, effective treatment with custom-fitted night guards.
You can also find support for sleep issues through Gennev. Our menopause-trained MDs and Registered Dietitian Nutritionists can help identify the root causes of your sleep concerns and address fatigue, night sweats, insomnia, racing thoughts, anxiety, and more via personalized care plans designed to help you find relief.
No matter what stage of menopause you’re in, know that support is available and that getting better sleep is absolutely possible.
With spring underway, we’re looking forward to warmer weather, longer, lighter days, and summer vacations to new places (and new time zones). As welcome as they are, all these seasonal shifts can cause disruptions to our sleep schedules that can take some getting used to due to changes in routines, environments, and even hormones.
If you’re already dealing with the fitful, inconsistent sleep that comes along with perimenopause and menopause, you might also wonder if seasonal time changes like Daylight Saving Time or jet lag from changing time zones while you travel could be hitting you harder than before.
Although we lack research on the specific connection between Daylight Saving Time and menopause symptoms, we do know that time changes of all kinds, whether from the biannual clock switch-up, travel, or working night shifts, absolutely affect how we feel and function. Throw the hormonal highs and lows of menopause into the mix and you may notice more sleep challenges than usual, even if time changes previously didn’t affect you much. It all boils down to the relationship between our hormones and our circadian rhythms.
“Circadian rhythms” might sound like a fun aerobic dance class from the eighties, but it’s just the scientific term for the body’s internal clock. That internal clock runs the roughly 24-hour cycle of processes that determine things like our core body temperature, digestion, mood, and when we’re naturally inclined to wake up, feel alert, and get sleepy throughout the day. Circadian rhythms are largely controlled by the part of the brain called the hypothalamus, which tells various organs to perform their functions at specific times based on environmental cues (like how much light we’re exposed to) or behavioral cues (like when we habitually eat and exercise). It’s a pretty sensitive system, as anyone who has spent their first days of a vacation groggy, cranky, and queasy might know.
Many of the processes governed by our circadian rhythms, like our sleep-wake cycle, depend on the production and regulation of hormones like melatonin, cortisol, and serotonin. When the levels of these hormones ebb and flow at times we’re not used to, it’s a recipe for disorientation and dysfunction.
A time change of just an hour, like when we spring forward or fall back for time changes, doesn’t sound like much compared to jet lag after traveling across multiple time zones, but as we are reminded twice a year, it can feel surprisingly disruptive.
Many of the circadian rhythm disruptions we experience during the spring and fall time changes happen because of how our bodies respond to light. Natural light is the body’s cue to run the sleep-wake cycle by releasing and modulating levels of melatonin and cortisol, two of the hormones that help control when you get sleepy at night and begin to wake up in the morning.
As the days get longer after the “spring forward” time change, even a little more light later in the evening can delay melatonin production, meaning sleep onset might happen later too. This, of course, also affects when our bodies send wake-up signals”not just the ones that pull you from sleep without an alarm clock, but the ones that determine what time of day you’re likely to feel awake and alert instead of groggy.
In a less scheduled world, where we could allow our bodies time to gradually sync up with shifting levels of sunlight throughout the seasons and follow our unique circadian rhythms (also called chronotypes), we might not feel time change effects as much. Unfortunately, just because the time on the clock has changed doesn’t mean work, school, commute times, or business hours start any later.
For many of us, that means sleep loss”according to the Sleep Foundation, the average person gets 40 minutes less sleep on the Monday after Daylight Saving Time begins. There’s actually a term for the mismatch between one’s circadian rhythms and scheduled, time-bound obligations like work or school: it’s called social jet lag, and it’s not great for us!
Social jet lag can make you feel fuzzy-brained in a meeting or cause you to give your equally sleep-deprived and irritable teenager a run for their money, but it has also been linked to more serious health concerns. The American Academy of Sleep Medicine notes that chronic social jet lag is associated with higher risks of obesity, metabolic syndrome, cardiovascular disease, and depression.
While chronic social jet lag is more of a concern if you have to stick to a long-term schedule that’s not compatible with your natural sleep needs, the switch to Daylight Saving Time gives everyone a little jolt of short-term social jet lag, and the consequences can be surprisingly serious.
Studies have found that the days after Daylight Saving Time are associated with a range of fascinating but troubling occurrences, from increased risks of heart attacks, strokes, and atrial fibrillation (a type of irregular heartbeat), to higher rates of work and school absences, medical errors, traffic accidents, and suicide.
Of course, these increased risks are due to complex knots of physiological, social, behavioral, and environmental factors, but there is good evidence that the jarring effects of sleep loss and disrupted circadian rhythms can touch just about every aspect of our lives.
As the weeks go on, most people acclimate to Daylight Saving Time enough to not notice the effects quite so profoundly. But what about those who already struggle to get consistent, quality sleep? Those who wake up at all hours sweating, ruminating, or with a startling snore, thanks to menopause? Does menopause mean every time change from here on out is about to feel a whole lot worse?!
Frankly, we don’t have much data exploring the relationship between Daylight Saving Time effects and menopause symptoms”at least, not enough to say that women in midlife are consistently more or less affected by the time change compared to the general population.
Whether menopause affects circadian rhythms at all is another story altogether. We do know that estrogen is among the hormones that help regulate circadian rhythm-driven processes like the sleep-wake cycle, appetite, digestion, and metabolism, and body temperature fluctuations. When it declines during menopause, the effects are just as noticeable as the short-lived effects of a time change”often worse. Our brains and bodies like to stick with the patterns they’re accustomed to, and when those patterns change due to internal factors like hormone swings or external factors like a new time zone, the adjustment process can be slow and uncomfortable.
The menopause transition can introduce all kinds of sleep struggles: Irregular sleep patterns, insomnia, waking up in the middle of the night, never feeling fully rested no matter how much you sleep, daytime fatigue…to say nothing of vasomotor symptoms like hot flashes and night sweats, which aren’t triggered by the sleep-wake cycle but can still keep you from a good night’s rest. Poor sleep, of course, can lead to or worsen mental health symptoms that may have already reared their heads during menopause, like brain fog, irritability, anxiety, and depression, which in turn can lead to”you guessed it”even more trouble sleeping. It is truly a vicious cycle.
All of this is to say, if you’re dealing with sleep disturbances during menopause and feel more sensitive to your symptoms after experiencing a time change, that’s valid! Your already irregular circadian rhythms suddenly have to adjust to new cues. It’s also perfectly valid if you have these symptoms without the influence of a time change. Menopause sleep problems are common and sometimes complex, but in many cases, they are treatable. And seeking care is not just about feeling better; it’s about investing in your long-term health. Both menopause and chronic sleep issues are linked to increased risks of cardiovascular conditions like high blood pressure and atrial fibrillation, metabolic dysfunction, and body composition changes (i.e., where we gain and hold on to body fat).
Lifestyle changes, medications (including hormone therapy, when appropriate), cognitive behavioral therapy, and solid sleep hygiene routines can go a long way toward resolving chronic sleep concerns. Gennev’s menopause-trained doctors and Registered Dietitian Nutritionists can help address sleep issues like night sweats and fatigue, so if you’re struggling, don’t hold back”make an appointment today. If you suspect something more serious is keeping you from sleeping well, consider a sleep study to check for disorders like sleep apnea. You can even do an assessment from the comfort of your own bed through a company like Complete Sleep, which offers easy, at-home sleep apnea screenings and treatment via custom-fitted night guards.
Even if you don’t usually struggle with sleep, a restless night can happen to anyone, whether from travel, stress, seasonal time changes, illness or menopause symptoms, or just a fun evening out. Here are our top tips for bouncing back when sleep just did. not. happen.
Hydrate: “
The fatigue, brain fog, and malaise that wallop you after a bad night’s sleep might not be due to reduced sleep time or quality alone”they could also be signs of dehydration. While it’s normal to lose some fluids overnight through breathing and sweating, some research has found that adults who slept six hours or fewer had up to a 59% higher risk of dehydration compared to those who regularly slept longer. Even if you are getting more than six hours of sleep, menopause-triggered night sweats could mean that you’re waking up more dehydrated than you realize. This can worsen your symptoms of both sleep deprivation and menopause, so rehydration is a must.
Plain water is a quick and easy option, but for extra flavor you can add a squeeze of citrus, sliced fruit or cucumbers, or crushed herbs like mint, lemon balm, or basil. Electrolytes can help too; you can get these key minerals from fruits and veggies, or in the form of supplemental tablets, powders meant to be mixed with water, or DIY recipes. Gennev’s Registered Dietitian Nutritionists advise patients to look for ones without excess sugar, artificial sweeteners or caffeine, particularly if you plan to consume them later in the day, as these can lead to digestive distress and further trouble sleeping. Sugar alcohols like erythritol are used in some electrolyte formulas as sweeteners, but many people don’t digest these well and there is some research linking high levels of erythritol to blood clots; when in doubt, go for unflavored electrolytes or look up a recipe for a homemade version instead.
Gennev RDN Melissa Burton also cautions that since electrolyte formulas can be quite high in sodium and potassium by design, they might not be suitable for those with high blood pressure or kidney issues. If you’re dealing with hypertension or kidney concerns, check with a doctor or RDN before trying electrolytes.
Move:
Gentle movement, especially in the morning, can help you shake off sluggishness and set yourself up for better sleep that night. Physical activity is one of the cues that regulate your circadian rhythms, so if you’re woozy after a time change or jet lag, a bit of exercise could help you feel back to normal faster.
If lack of sleep has left you too foggy to function, it’s fine to skip the workout class that calls for complicated footwork or slinging heavy weights around”a walk is a great lower-impact choice instead. Here’s how to get the most out of your walks.
See the sun:
Or natural light, at the very least. Morning light and fresh air feel good no matter what condition you’re in, but if you’re sleep-deprived, light exposure shortly after you wake up can help you feel more alert. It’s another one of those signals that circadian rhythms depend on, meaning that not only will it make you feel a little livelier during the day, it will also prepare your brain to produce the hormones that make you drowsy in the evening. Think of it like pre-ordering better sleep for the night to come.
Caffeinate cautiously:
While your daily coffee or tea can taste extra satisfying after a rough night, more is not always better when it comes to caffeine. There’s no need to skip your coffee or switch to decaf if you haven’t slept well (nobody likes a caffeine withdrawal headache!) but drinking more than usual won’t make up for the missed hours. It could tip you from slightly energized to jittery and anxious before you know it”not ideal if you’re already dealing with menopause-related anxiety or irritability. Caffeine has a half-life of 4-6 hours and traces of it can stay in your system even longer, so any extra caffeine you consume in the afternoon could still contribute to keeping you awake that night if you’re sensitive to it.
The FDA’s recommended safe daily limit for caffeine is 400 milligrams before unpleasant side effects set in, but everyone processes it differently and caffeine content can vary between types of teas, energy drinks, and even coffee blends. If you’re curious about how much caffeine you could be consuming, check out this chart of caffeine content in popular products.
Other vices to skip? Alcohol, processed sugar, and long naps”alas. It’s tempting to take the edge off with an afternoon snooze, a sweet treat, or a nightcap, but they can all interfere with sleep quality, mess with circadian rhythms, and aggravate symptoms of menopause. If sugar-induced hot flashes sound like a special kind of indignity you’d like to avoid, fresh fruit and decaf tea (like ginger, rose, or hibiscus) can tick the boxes for something sweet and hydrating.
Stick to your schedule:
Shouldn’t the remedy for not getting enough sleep be…more sleep? Not in the way you might think. Sleep experts like those interviewed in this episode of NPR’s Life Kit caution against long naps too close to bedtime and sleeping in later than usual. As good as they feel, both practices can further throw off your circadian rhythm and confuse your brain so it doesn’t send the sleep-wake signals when it should. A better solution, if you really need some sleep to get through the day, is a brief nap: no more than an hour long, and at least six hours before you plan to go to bed.
The holiday season is full of joy, connection, and tradition, but it can also bring stress, overwhelm, and sensory overload. Amid the hustle, it’s easy to lose sight of our own needs as we focus on others. This is where interoception”the ability to sense, acknowledge, and interpret bodily signals”becomes a powerful tool for self-care.
Interoception refers to the practice of noticing and understanding the signals your body sends, such as hunger, fullness, satisfaction, thirst, or even tension in your shoulders. It’s a foundational part of Intuitive Eating, a self-care framework created by two dietitians in 1995 that integrates instinct, emotion, and rational thought to help individuals foster a healthier relationship with food.
In Intuitive Eating, interoception helps you connect with your body’s cues to gauge hunger and fullness, and to determine what truly satisfies you. But during the holidays, with their abundance of sensory input”sights, smells, sounds, textures, people, and activities”interoception can extend far beyond eating.
The holiday season is rich with opportunities for sensory and emotional experiences. It’s a time to connect with loved ones, enjoy delicious meals, and reflect on the year. But it’s also a time of heightened busyness, which can make it challenging to care for yourself. Cultivating interoception can help you navigate the season with more intention and balance.
Consider these two levels of interoception:
Take a moment to step back and reflect on how the holidays make you feel.
Positive Emotions: What activities, moments, or traditions bring you joy, energy, or peace? Lean into these experiences. Allow them to become part of your personal emotional reservoir”resources you can draw upon when you need a boost.
Negative Emotions: What leaves you feeling sad, anxious, or exhausted? Notice your reactions and instincts. Instead of reacting impulsively, pause to explore strategies that might make these moments less overwhelming.
By labeling your emotions”whether positive or negative”you gain insight into how to approach each situation in a way that aligns with your needs.
Zoom in on specific experiences, such as food, drink, or activities, and observe how they affect you.
Acknowledge how novelty might influence your reactions: Do you feel the urge to try everything, risking overindulgence? Or do you set strict limits that leave you feeling restricted?
Pause and check in with your body. Notice your breathing, jaw tension, or whether you feel hungry, thirsty, tired, or overwhelmed.
The practice of pausing, reflecting, and choosing your next step can be a game-changer during the holidays.
Pause: Stop and tune into your body. What signals is it sending?
“
Evaluate: Are you content with the current sensation, or do you want to change it?
“
Act: If you want to continue, keep going and set a time to check in again. If you want to make a change, identify the feeling you want to achieve (calm, focus, satisfaction, etc.). Consider what you need to support that change”relaxation, energy, compassion”and take action.
Repeat this cycle throughout the day to navigate moments of hunger, fullness, satisfaction, and even emotional highs and lows with greater clarity and intention.
Whether it’s savoring your favorite holiday dish, managing a packed social calendar, or navigating tricky family dynamics, interoception offers a pathway to balance. By noticing and responding to your body’s signals, you can take better care of yourself while sharing the joy of the season with those around you.
This holiday season, let interoception be your guide to both giving and receiving”starting with yourself.
“