Why Can’t I Sleep And What Can I Do About It?

 Brain Health Expert: Patricia Faust

If you made it to midlife, you are very familiar with sleep deprivation. You may be asking yourself “why can’t I sleep”?

Menopause is a beast when it comes to interrupting our sleep. With our hormones going up and down and up again, women experience a whole laundry list of sleep problems. Not only do we feel these changes physically, but our brains are not able to perform their sleep duties!

3 Most Common Menopause and Sleep Issues:

“Prior to the hot flash, a woman’s body temperature rises..”

1. Hot Flashes:

The first menopause issue that affects sleep is hot flashes. These are the sudden and unexpected sensations of heat all over the body accompanied by sweating. Hot flashes that occur at night are often referred to as night sweats. Prior to the hot flash, a woman’s body temperature rises, and blood flow increases to the face, creating a heating sensation that wakes them up.

As if that isn’t enough to deal with, it becomes difficult to fall back to sleep. Even if a woman can fall back to sleep quickly, her sleep quality suffers due to the frequent awakenings and discomfort, causing fatigue the next day. Nearly 44% of menopausal women meet the criteria for insomnia.

2. Insomnia:

Insomnia describes a chronic problem of falling asleep and staying asleep that occurs more than three nights a week. The insomnia experience includes restless sleep, miss out on overall sleep, wake up early, and often feel sleepy and tired during the day. Sleep deprivation from insomnia can increase feelings of anxiousness and irritability, impair focus and memory, and increase headaches and inflammation.

3. Sleep-Disordered Breathing:

Snoring and sleep apnea are more common and severe in postmenopausal women. Obstructive sleep apnea is a sleep disorder characterized by temporary pauses in breathing, which can lead to gasping, snoring, and choking sounds, and lower sleep quality.

“These disorders are associated with involuntary leg movements..”

Other Mood and Sleep Disorders:

Involuntary leg movements, such as, restless leg syndrome, and periodic limb movements disorder may develop during menopause. These disorders are associated with involuntary leg movements that cause uncomfortable sensations and disrupt sleep.

Other Impacts of Sleep Deprivation:

Being tired and emotional due to lack of sleep can have major consequences in everyday life. In one sleep study, sleep-deprived participants experienced greater stress and anger than rested control participants when asked to complete a simple cognitive test.

Getting enough sleep helps with mood and emotion regulation. All areas of the brain are connected and working together. But when sleep is disrupted, you might feel cranky, irritable, or emotionally out of sorts.

It was revealed through brain imaging studies why sleep deprivation can lead to irrational responses. The amygdala, the emotional center of the brain, showed a sixty-percent increase in activity levels over rested participants when shown emotionally negative images.

“You can sometimes feel colder because sleep is essential for body temperature regulation.”

The Amygdala Function:

Sleep deprivation disrupted the connection between the amygdala and the medial prefrontal cortex. The medial prefrontal cortex regulates amygdala function. When this happens in sleep deprivation, the amygdala overreacts to negative stimuli because it is disconnected to the brain areas that would regulate its response.

Researchers have also discovered that sleep deprivation may be a contributing factor for several psychiatric conditions – not just one of their symptoms. Sleep problems contribute to the development of depression and reduce the efficacy of the treatment, and may be involved in bipolar disorder, anxiety disorders, and ADHD.

Physical Effects of Sleep Deprivation:

Not only has the brain stopped functioning effectively, but the body also takes a hit too. You can look more aged! Consistently missing sleep can lead to premature wrinkling and sagging of our skin. This happens because cortisol, the stress hormone, is released when you are sleep-deprived and breaks down collagen. You can sometimes feel colder because sleep is essential for body temperature regulation.

Your heart can suffer. Sleeping less than six hours per night increases your risk of developing high blood pressure and increases your risk of developing cardiovascular disease.

Unwanted Weight Gain:

Your appetite can go into overdrive. When you don’t get enough sleep, you are hungrier than usual and crave comfort food. Your ability to feel full is also affected. Now if stress is keeping you up at night, it is easy to understand your unwanted weight gain. You not only end up with a stress belly, but it is made worse by the sleep-deprived belly.

And this effect is quite dangerous right now. When you are tired and even moderately sleep-deprived, your immune function is compromised. This can leave you vulnerable to colds, the flu, and puts you at a higher risk of contracting COVID. It takes longer and is harder to recover from infections and wounds.

“The Glymphatic System is made up of glial cells and cerebral spinal fluid.”

Memory Function and Normal Maintenance of the Brain:

The hippocampus Is the center of learning and memory in the brain. While we sleep, the hippocampus is very busy consolidating and encoding memories. When we lack sleep for even one night, the ability to memorize new information drops dramatically. Research revealed that when memorizing a set of pictures, sleep-deprived participants showed less activation in the hippocampus.

Glymphatic System:

Our brains get a good cleaning while we sleep. The Glymphatic System is made up of glial cells and cerebral spinal fluid. While we sleep the glymphatic system flows throughout the channels of our brain and cleans out amyloid, cell debris, toxins, and other general brain debris.

This function is critical because anything that isn’t cleaned out can continue to cause problems and leave us with a high risk of developing dementia and Alzheimer’s. The glymphatic system is one of the protective systems we must allow our brains to continue to function on a high level. If we don’t sleep, we don’t clean our brains!

6 Steps Towards Good Sleep Hygiene:

Help yourself with good sleep hygiene:

1. Set a time and get prepared for sleep
2. No TV in the bedroom
3. Shut off electronic devices 30 minutes before bed
4. Avoid stimulating activities at night
5. Avoid certain sleep agents – diphenhydramine or other benzodiazepines – sleeping pills
   • These medications may take the edge off and get you to sleep, but not provide restful sleep
   • Recent studies suggest that overuse of some of these medications may be associated with an increased risk for dementia and Alzheimer’s disease down the line
6. Caffeine during the day, early in the day, may not be a problem, but after 1 or 2 pm, may interrupt sleep and wake cycles

References:

Here’s How Sleeping Too Little Literally Transforms Your Brain.  Retrieved from https://futurism.com/heres-how-sleeping-too-little-literally-transforms-your-brain/
How Losing Sleep Affects Your Body and Mind.  Retrieved from https://sleep.org/articles/how-losing-sleep-affects-your-body-mind/
Isaacson, R. (April 6, 2018). Cognitive decline associated with middle-age sleep problems. Medscape.  Retrieved from https://www.medscape.com/viewarticle/894519?src=wnl_edit_tpal&uac=3422EY
Pacheco, D. (January 22, 2021). Menopause and sleep. Retrieved from https://www.sleepfoundation.org/women-sleep/menopause-and-sleep
Tamminen, J.  (October 17, 2016). How a lack of sleep affects your brain, from your personality to how you learn.  Retrieved from https://www.independent.co.uk/life-style/health-and-families/how-a-lack-of-sleep-affects-you-brain-from-your-personality-to-how-you-learn-a7366216.html

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About the Author:

Patricia Faust is a gerontologist specializing in the issues of brain aging, brain health, brain function and dementia. She has a Masters in Gerontological Studies degree from Miami University in Oxford Ohio. Patricia is certified as a brain health coach and received a certification in Neuroscience and Wellness through Dr. Sarah McKay and the Neuroscience Academy. My Boomer Brain, founded in 2015, is the vehicle that Patricia utilizes to teach, coach and consult about brain aging, brain health and brain function. Her newsletter, My Boomer Brain, has international readers from South Africa, Australia, throughout Europe and Canada. She has also been a frequent guest on Medicare Moment on WMKV and Cincy Lifestyles on WCPO.

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