menopause

Coping with Insomnia and Menopause

Most women have similar symptoms of menopause although they differ in severity; hot flushes, night sweats, fatigue, mood irritability, migraine headaches, depression, weight gain, and insomnia. In varying degrees of severity and frequency, it seems that insomnia and menopause are forever linked.

Like all symptoms of menopause, insomnia is caused by fluctuations of estrogen levels. Hormone replacement therapy (HRT) with “artificial” estrogen is a scary subject for most women, given its possible link to breast cancer. Increasing numbers of women are turning to natural herbal remedies for sleep disturbances, or prescription sleep medications on a short-term basis.

Insomnia that is related to menopause is characterized by difficulty falling asleep and/or staying asleep. It should be noted that this pattern of insomnia is exactly the same pattern that often results from clinical major depression. Thus, when treating a woman for sleep disturbance, it is a challenge for a physician to determine if the insomnia is menopause-related or a symptom of serious depression that must be treated with antidepressant medication.

Clouding the issue further is the distinct possibility that depression itself is a symptom of menopause. Regardless of the cause, insomnia is a very debilitating condition; ask most menopausal women what symptom of this phase of life is most maddening, and chances are they will say “I’d like to have a good night’s sleep.”

Treating the Insomnia of Menopause

Since menopause generally lasts for a year, longer with some women, imagine what it must be like to know that every night, you will do battle with your own body; this is the plight of menopausal women who are coping with insomnia. This merciless symptom causes both physical harm to a very fatigued woman and severe emotional distress as she tries – and loses- every night to stay asleep and fall asleep.

We have all had difficulty sleeping at times, but insomnia and menopause is chronic and creates a pathological sense of hopelessness among menopausal women. It is clear that menopause-related insomnia simply must be eliminated.

Many women obtain relief from insomnia with natural remedies such as valerian root and melatonin. These are safe remedies with no side effects of note. Another herb, wormwood, is also touted as a natural remedy for insomnia of all types; however, knowledgeable herbalists point out that wormwood is not a safe herb for human consumption and should be avoided.

Since menopause-related insomnia is so debilitating and common, physicians prescribe many medications to relieve this symptom, thus making the other symptoms of menopause easier to tolerate. Examples of these drugs that can be used for the insomnia of menopause are alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). These benzodiazepine drugs do induce sleep, but they are controlled substances due to their great potential for abuse and addiction. As horrible as chronic insomnia is, physicians are extremely cautious in prescribing these drugs.

Women who are plagued with chronic insomnia during menopause now have other prescription choices that are not of the addicting benzodiazepine class. Lunesta is a very effective treatment for sleeplessness; it works quickly and with most women its effects last at least 6-8 hours, providing a full, healing night’s sleep.

Lunesta is neither addictive nor does it have abuse potential. Another extremely effective non-benzodiazepine sleep medication is Ambien CR (controlled release), now the drug of choice for all types of insomnia including the insomnia of menopause. Ambien can be used long-term, is not addictive and has no abuse potential. It, like Lunesta, provides a full night’s sleep; the simple but elusive goal of every menopausal woman.


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