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Sleep also plays an important role in maintaining healthy blood sugar levels.
February 7, 2025
Marianne von Waldenfels
Difficulties falling asleep, problems staying asleep – what can be done about it during menopause is explained by Susanne Liedtke, nutrition expert and founder of NOBODYTOLDME, a platform for women (not only) in menopause.
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Many women suffer from unpleasant symptoms during menopause such as hot flashes, bladder weakness, or sleep disturbances. In their highly acclaimed book "Somebody told me" Susanne Liedtke and Dr. Christina Enzmann describe, among other things, why nutrition can be a key to more well-being and energy during menopause and how it can also affect sleep.
We talked about what can be done to improve sleep, among other things, with Susanne Liedtke, a graduate ecotrophologist and founder of the platform NOBODYTOLDME .
What are the first signs of sleep disorders during menopause?
Sleep disorders can occur very early in menopause for some women, even before other typical symptoms like hot flashes or mood swings are noticed. For some, they are even the very first sign that the hormonal changes have begun.
In the early phase of menopause, known as perimenopause, women often experience problems falling and staying asleep. The annoying night sweats usually come later and further exacerbate sleep disorders.
But it's not just the hormonal changes that affect sleep. As we age, the architecture of sleep naturally changes. The deep sleep and REM phases, during which we sleep particularly restfully, decrease. At the same time, the time it takes to fall asleep increases. This process also affects men.
So those who suffer from Sleep disorders and are in menopause should not hastily blame hormones alone. Various factors play a role and must be considered in order to achieve a restful night's sleep once again.
A holistic view is important because good sleep is the foundation for health and well-being – especially during this challenging phase of life.
It is often said that a lack of progesterone is the cause of sleep disorders.
Contrary to popular belief, it is not the lack of progesterone that triggers sleep disturbances during perimenopause. If this were the case, all women of reproductive age in the first half of the cycle, where there is a physiological lack of progesterone, would have to suffer from sleep problems. The exact causes are not yet fully understood, but studies suggest that other factors play a greater role.
Experts suspect that FSH spikes – that is, follicle-stimulating hormone – or the strong fluctuations in hormone production during menopause could impair sleep quality.
Ovarian function undergoes major changes during this phase of life, which can affect the entire organism. The fact that oral administration of bioidentical progesterone improves sleep in many women is due to its conversion into allopregnanolone in the liver.
Read here: How perimenopause and depression are related
This metabolic product can have a sleep-inducing effect by docking to the GABA receptor in the brain. GABA is a neurotransmitter in the brain that promotes relaxation.
The falling estrogen levels during menopause can also negatively affect sleep. On the one hand, the lack of estrogen promotes the occurrence of hot flashes and night sweats.
These sudden temperature increases severely disrupt sleep and lead to frequent awakenings. Many women find it difficult to fall back asleep afterward.
The quality of sleep suffers from the frequent interruptions. During the day, exhaustion and concentration problems are the result. Hot flashes and night sweats are therefore among the most common causes of sleep disorders during menopause.
On the other hand, it affects estrogen the production and breakdown of neurotransmitters such as serotonin and dopamine. If the estrogen level drops, this sensitive system becomes unbalanced.
The result can be mood swings, depressive moods, and sleep disturbances. The melatonin level is also affected by the lack of estrogen, which additionally favors falling asleep problems.
How are blood sugar levels and sleep related?
Our sleep plays an important role in maintaining a healthy blood sugar level . Restful sleep can lower unhealthy blood sugar levels. If we sleep poorly, which affects many women during menopause, it impacts our blood sugar levels. Among other things, lack of sleep increases cortisol levels, which in turn raises blood sugar levels.
Lack of sleep is even associated with diabetes. Furthermore, the decline in estrogen leads to an increase in insulin resistance. This means two factors negatively influence blood sugar levels: poor sleep and declining estrogen levels.
Read here: The nutrition program for menopause
As sleep affects blood sugar levels, blood sugar levels can also affect sleep quality. A study of people with type 2 diabetes found that those with higher blood sugar levels slept worse.
Another study found that 62% of people with blood sugar levels in the prediabetes range were more likely to sleep poorly compared to 46% of people with normal blood sugar levels.
So it's important, especially during menopause, to intensify everything that can lower blood sugar levels reduce: an anti-inflammatory diet, mindfulness, and exercise. In the context of the Body Reset courses you learn how to avoid blood sugar spikes by choosing the right foods.
© Helen Fischer
If sleep disturbances persist over a long period of time, one should see a doctor.
What are the treatment options?
Hormones can be a helpful treatment option for sleep disturbances during menopause, but there is no one-size-fits-all solution. Each woman responds differently to hormone therapy, so it's important to try different approaches and adjust them individually.
Orally taken bioidentical progesterone can have a sleep-promoting effect in women. The reason for this lies in its conversion to allopregnanolone in the liver, which has a calming and sleep-inducing effect in the brain.
Are there alternative treatment methods?
Alternative treatment methods can also be used for sleep disturbances during menopause. Acupuncture, a traditional Chinese healing method, can regulate hormone balance and improve sleep quality. Homeopathy also offers various remedies that can be used depending on the individual's symptoms.
Many herbal remedies can also provide gentle and effective aid for sleep disturbances during menopause. Valerian, hops, lemon balm, passionflower, skullcap, chamomile, and California poppy have proven effective. These medicinal plants have calming, relaxing, and sleep-inducing effects. Essential oils from lavender or lemon can also contribute to relaxation.
Likewise, teas made from lemon balm, passionflower, St. John's wort, or black cohosh can promote relaxation in the evening and make it easier to fall asleep.
However, the herbal sleep aids are not a quick fix: it may take some time for them to work and positively affect sleep. Moreover, there are no scientific studies on their effectiveness yet.
Can diet alleviate sleep disorders?
The right diet and a sleep-friendly lifestyle can counteract sleep disorders during menopause. Good sleep hygiene is a crucial factor for restful sleep.
This initially includes a cool and well-ventilated sleeping environment. The ideal room temperature is between 16 and 18 degrees Celsius. Those prone to night sweats can alleviate this with airy garments made of natural materials.
Those who sleep poorly should definitely reduce caffeine consumption for a while. For some women, even one cup of coffee in the morning negatively affects sleep.
Fortunately, there are now many alternatives like decaffeinated coffee from No Coffee, 'coffee' from lupins by Loffee, or chicory by Chikko-not-Coffee or cocoa mushroom blends from Moonbrew. Unfortunately, tea – whether black, green, or white – also contains caffeine, so these are not real alternatives to coffee.
In the evening, light meals with complex carbohydrates and some protein are recommended, such as vegetable soups with legumes or quinoa with steamed vegetables.
A handful of cashews can also help. These not only contain magnesium, which has a relaxing effect, but also tryptophan, which is needed for the production of melatonin. Carbohydrates plus foods containing tryptophan at dinner are therefore a good combination for the body's own melatonin production and thus a good prerequisite for a good night's sleep.
A good supply of vitamins and minerals is also relevant. Vitamin B6, B12 (taken in the morning) and magnesium (especially magnesium glycinate taken in the evening) support the normal function of the nervous system and help with relaxation, and vitamin D contributes to normal muscle function.
When should you go to the doctor?
If sleep disturbances persist over a long period of time and impair quality of life, it is advisable to see a doctor. Together with the gynecologist or general practitioner, possible causes can be clarified and individual treatment options discussed.
Many more valuable tips and information on the topic of menopause and an exciting range of courses can be found at Nobodytoldme.com
This book enlightens and empowers through knowledge: "Somebody told me," Brandstätter Verlag
