One of the first changes my patients notice during perimenopause (the five years or so before menopause) are changes in their sleep. Sleep is no longer so restful and restorative which can be responsible for many of the menopausal symptoms we experience such as lack of energy, anxiety, depression and weight gain and various pain syndromes.
Women are twice as likely as a men to have difficulty falling asleep and maintaining sleep that is called insomnia. Sleep disorders can be categorized as insomnia,(more common in women) circadian rhythm disturbances (shift workers), sleep disordered breathing (more common in men) and restless leg syndrome.
A recent article in the New York daily news sited a study from Michigan State University that showed an increased risk of breast cancer in women with sleep issues, particularly circadian rhythm disturbance which is linked to melatonin production in the brain. We have known breast cancer incidence is 30% higher in shift workers for several years and the most at risk are those women with fewer than three night shifts per week as they never can adjust to one schedule.
Underlying causes of insomnia in women are often due to hormonal changes, that is decreased estrogen and progesterone. Lower estrogen is associated with mood and emotional changes and affects brain wave frequency and core body temperature. The subsequent hot flashes often wake you from sleep. Taking progesterone can drastically decrease insomnia many in perimenopause and menopause. Weight gain around menopause does increase the incidence of sleep disordered breathing (think snoring and apnea).