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Sleep also plays an important role in maintaining a healthy blood sugar level.
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 greater well-being and energy during menopause and how it can also affect sleep.
We talked with Susanne Liedtke, a graduate ecotrophologist and founder of the platform NOBODYTOLDME, about what can be done to improve sleep.
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 indication that hormonal changes have begun.
In the early phase of menopause, known as perimenopause, women often suffer from difficulty falling and staying asleep. The annoying night sweats usually appear later on and further exacerbate sleep disorders.
But it's not just hormonal changes that affect sleep. As we age, the sleep architecture naturally changes as well. Deep sleep and REM phases, during which we sleep most restfully, decrease. At the same time, the time it takes to fall asleep increases. This process also affects men, by the way.
So those who suffer from sleep disorders and are going through menopause should not hastily attribute it solely to hormones. Various factors play a role and must be considered to find restful sleep again.
A holistic view is important because good sleep is the foundation for health and well-being – especially in 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 disorders in perimenopause. If this were the case, all women of reproductive age in the first half of the cycle, where a physiological lack of progesterone exists, would 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 peaks – that is the follicle-stimulating hormone – or the strong fluctuations in hormone production during menopause could impair sleep quality.
Ovarian function undergoes major changes in this phase of life, which can affect the entire organism. The fact that oral administration of bioidentical progesterone improves sleep for many women is due to the conversion to allopregnanolone in the liver.
This metabolic product can have a sleep-promoting effect by docking to the GABA receptor in the brain. GABA is a neurotransmitter in the brain responsible for relaxation.
The declining estrogen level during menopause can also negatively impact sleep. On the one hand, the lack of estrogen promotes the occurrence of hot flashes and night sweats.
These sudden temperature spikes severely disrupt sleep, leading to frequent awakenings. Many women find it difficult to fall back asleep afterward.
The quality of sleep suffers from 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, estrogen influences the production and breakdown of neurotransmitters like serotonin and dopamine. When estrogen levels drop, this sensitive system becomes imbalanced.
The consequences can be mood swings, depressive moods, and sleep disturbances. The melatonin level is also affected by estrogen deficiency, which additionally promotes sleep onset problems.
How are blood sugar levels and sleep related?
Our sleep plays an important role in maintaining a healthy Blood sugar levels . 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. Additionally, the decline in estrogen leads to an increase in insulin resistance. This means two negative factors affect blood sugar levels: poor sleep and declining estrogen levels.
Just as sleep affects blood sugar levels, blood sugar levels can also affect sleep quality. A study with people with type 2 diabetes found that people with higher blood sugar levels sleep worse.
Another study found that 62% of people with blood sugar levels in the prediabetic range sleep worse compared to 46% of people with normal blood sugar levels.
It is therefore important, at the latest during menopause, to intensify everything that increases blood sugar levels can be reduced: an anti-inflammatory diet, mindfulness, and exercise. As part of Body Reset courses you will learn how to avoid blood sugar spikes by choosing the right foods.
© Helen Fischer
If sleep disturbances persist over a longer period, one should see a doctor.
What treatment options are available?
Hormones can be a helpful treatment option for sleep disorders in menopause, but there is no one-size-fits-all solution. Every woman responds differently to hormone therapy, so it's important to try different approaches and adjust individually.
Orally administered bioidentical progesterone can have a sleep-promoting effect on women. This is due to 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 disorders 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 individual symptoms.
Many herbal remedies can also be a gentle and effective help for sleep disorders during menopause. Valerian, hops, lemon balm, passionflower, skullcap, chamomile, and California poppy have proven effective. These medicinal plants have calming, relaxing, and sleep-promoting effects. Essential oils from lavender or lemon can also contribute to relaxation.
Teas made from lemon balm, passionflower, St. John's wort, or black cohosh can also provide relaxation in the evening and make it easier to fall asleep.
However, herbal sleep aids are not a quick fix: it may take some time for them to take effect and positively influence sleep. Additionally, there are no scientific studies on their effectiveness yet.
Can diet alleviate sleep disorders?
Proper nutrition and a sleep-friendly lifestyle can counteract sleep disorders during menopause. Good sleep hygiene is a crucial factor for restful sleep.
This includes first and foremost a cool and well-ventilated sleeping environment. The ideal room temperature is between 16 and 18 degrees Celsius. Those who tend to sweat at night can find relief with airy clothing made from natural materials.
Anyone who sleeps poorly should definitely try reducing caffeine consumption for a while. For some women, even just one cup of coffee in the morning can negatively impact sleep.
Fortunately, there are now many alternatives such as decaffeinated coffee from No Coffee, 'coffee' made from lupins from Loffee, or from chicory from Chikko-not-Coffee, or cocoa mushroom blends from Moonbrew. Unfortunately, tea—whether black, green, or white—also contains caffeine, so these are not really 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. They not only contain magnesium, which has a relaxing effect, but also tryptophan, which is needed for the production of melatonin. Carbohydrates plus tryptophan-containing foods for 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, vitamin D contributes to normal muscle function.
When should one see a doctor?
If sleep disturbances persist over a longer period and affect 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 can be 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
