Sweet Dreams

When was the last time you had a good night's sleep?

If you’re a midlife mama, you may not be getting enough or quality sleep thanks to fluctuating hormones. Inconveniently, this is also a time when our bodies need adequate sleep to help manage perimenopause symptoms such as mood, energy levels and weight management.

As we’ve stated before here at Mama Beasts, perimenopause is a sneaky ho. However, there are some things to know — and do — to set yourself up for sleep success.

We chatted with sleep psychologist Dr. Daniella Marchetti about how we can improve our sleep in realistic ways on our own — and when it’s time to seek professional help.

Strive for consistency

What’s the number one thing Dr. Marchetti recommends for women to get their best sleep and the benefits that come with those z’s? Introducing regularity to our bedtime routines. This is often overlooked as many of us focus on how many hours of sleep we get versus consistency in our sleep schedule. When we rise and go to sleep at the same time, research shows our overall health improves and our risk for chronic illnesses decreases.

“The biggest (health) predictor for women isn’t necessarily the number of hours that you are sleeping,” she said. “It’s the regularity of your hours.”

That means a woman sleeping 12AM-6AM every night is going to be better off than someone who sleeps 10 hours on a night, 6 hours the next night, etc.

“Our bodies crave predictability, Marchetti said. “If we stick to a schedule, it’s less of a shock to the system and more predicative of long-term health and wellness.”

She recommends women choose a realistic bedtime they are likely stick with on the majority of nights that works for your work and home life. Also, the bedtime should be a time when you’re truly sleepy and doesn’t feel forced as that can create more insomnia.

Darkness, My Friend

We’ve all heard the term "sleep hygiene” thrown around, but what actually is it? Marchetti explains good sleep hygiene means paying attention to cues in your environment — and how they impact sleep.

There are a few basic sleep hygiene rules that everyone should try to follow. One that may seem obvious: sleep in a dark room. But it’s likely darker than you expect.

“It should be so dark at night that you can’t even see your hand in front of your face,” Marchetti said.

Not quite there? Consider black-out curtains or an eye mask. This is also the time we mention that watching TV, a tablet or scrolling on your phone isn’t going to do you any favors when it comes to falling asleep. That’s because these devices create blue light, which suppresses the production of melatonin, a hormone that regulates sleep-wake cycles. When exposed to blue light in the evening, the body perceives it as daylight and delays melatonin release. “You create competing messages in your body,” Marchetti said. If you must have screen time in the evening, watching TV is less disruptive than scrolling with a phone close to your face.

You also want to ensure your room is protected from sound pollutions. Adding a sound machine to your room can often take of this, Marchetti says. And while women experiencing night sweats may already have this one figured out, be sure to keep your room at a cool temperature as our body's temperature decreases before sleep. A cool room helps us settle into and maintain sleep throughout the night.

It’s also important to avoid nicotine and caffeine before you go to bed. Marchetti notes that caffeine can stay in your system for 10-12 hours and everyone tolerates it differently.

And while night caps often seem like a great idea and offer an initial dose of sleepiness - be wary. “Alcohol is a false friend,” Marchetti said. “It impedes your ability to get into REM sleep and creates more sleep maintenance issues. You may have more fitful sleep with more interruptions.”

Get Support

If you struggle with sleep, it’s not always about your sleep hygiene or something you can solve on your own. Insomnia is quite common in women especially.

“The lifetime risk of insomnia for women is actually 40 percent higher than it is for men,” Marchetti said. “One reason why is the hormonal changes as well as stress related causes, so it’s definitely not imagined.”

How do you know if it’s time to get professional help? If not getting enough sleep is affecting your daily activities, it’s time to speak with your doctor.

Women may be diagnosed with insomnia if they have difficulty falling or staying asleep for at least three nights a week. Insomnia is considered chronic (long-term) when it occurs three or more nights a week and lasts for three months or longer.

“Most of my patients come to me after years and years of insomnia,” Marchetti said. ”Many of us just think this is the way it is.” There are, however, options to treat insomnia that don’t involve upping your sleep hygiene game or medication.

Cognitive behavioral therapy for insomnia (CBT-I), which Marchetti says is the gold standard for treating insomnia, is a non-medication treatment that helps people improve their sleep habits and behaviors. “It’s more effective but doesn’t have the same marketing,” she said. “CBT-I gets to the heart of the issue versus medication which is just treating the symptoms.” Instead, CBT-I focuses on restructuring the thoughts, feelings and behaviors that are contributing to insomnia.

As with many ailments, women and mothers tend to chalk sleep woes up to being par for the course. After all, you can buy sweatshirts and mugs marketed to moms with “permanently exhausted” written on them.

“Women tend to be an understudied, underassessed undertreated group when it comes to sleep,” Marchetti said. “And I think part of that is because we might consider it normal to be struggling with sleep.”

But you don’t have to struggle alone. Check out our recent podcast episode with Dr. Marchetti or learn more how she works with patients virtually here.