Broken sleep, morning aches and menopause
Dr Nicola Tik
You wake at 3am too warm, throw off the covers, then lie there running through tomorrow’s to-do list. By the time your alarm goes, you feel stiff and heavy before the working day has even started. There is a real link between those broken nights and how your body feels the next morning, and some small changes in the evening can help.
Broken sleep is one of the most common parts of the menopause transition, affecting around half of women at some point. Night sweats are a big reason. For many people they come and go over several years, and they often wake you just as you have settled.
But hot flushes are not the whole story. Some people wake without one at all. Broken sleep can also build its own momentum, because napping or lying in to catch up can make the next night harder.
In one well-known study, researchers kept people awake for a night, then tested how sensitive they were to pain. After the sleepless night, people felt pain sooner. Brain scans showed the areas that sense pain became more active, while the areas that switch on the body’s natural pain relief became quieter. When the researchers followed people in everyday life, even a slightly worse night than usual was linked with more aches the next day.
So if you ache more after a rough night, it does not mean anything has been damaged overnight. Your nervous system has turned the volume up for a while. Lying still for long periods while trying to get back to sleep can add to that morning stiffness too.
Many people find that keeping cool makes waking less likely and getting back to sleep easier. Some options to try:
Some people notice that a glass of wine, spicy food or a hot drink late in the evening makes night sweats more likely, so it can be worth seeing whether anything stands out for you.
The approach with the strongest research behind it for menopause-related sleep problems is called cognitive behavioural therapy for insomnia, or CBT-I. It focuses on your sleep habits and the thoughts that keep you awake. In one trial with women who had both hot flushes and broken sleep, CBT-I improved their sleep around twice as much as general menopause advice, and the benefits tend to last.
You can borrow some of its core ideas:
When a hot flush wakes you, it is easy to start worrying about how you will get through tomorrow’s meetings. This kind of thinking is very common, and it can keep you awake long after the flush has passed. Reminding yourself that the flush is temporary, and that you have coped with tired days before, can take some of the pressure off.
If you have been awake for what feels like a while, you could try getting up and doing something calm in low light, like reading. Head back to bed once you feel sleepy. This helps your brain keep linking your bed with sleep.
After a broken night, a little movement can help before you open your laptop. Once you are up, you could try a minute of marching on the spot, slow shoulder rolls, and gently circling your hips with your hands on your waist. A warm shower afterwards can loosen things further.
If you would like a guided stretch to start your morning, VIDA has short videos you can follow at your own pace. Many people find their mornings feel easier as their nights become steadier.