Going through the perimenopause? Here’s how to minimise the impact it has on your sleep

Welcome to Stylist’s Sleep Diaries, where we’re taking a deep-dive into one of the most important (and elusive) factors in our day-to-day lives: sleep. To help us understand more about it, we’re inviting women to track their bedtime routines over a five-day period – and presenting these diaries to sleep expert Dr Nerina Ramlakhan for analysis.  

In this week’s Sleep Diaries, a 42-year-old small business owner learns about the key changes she can make to deal with her perimenopausal insomnia.

A little about me:

Age: 42

Occupation: owner of a small management consultancy and wellbeing business

Number of hours sleep you get each night: 7-9 hours

Number of hours sleep you wish you got each night: 7-9 hours

Any officially diagnosed sleep-related problems (insomnia/sleep apnea): perimenopausal insomnia (prescribed HRT but have recently swapped to a different form of HRT to help with this)

Do you grind your teeth/have nightmares: no

Do you measure your sleep in some way (e.g. using your phone or wearable): no

How much water do you drink on average per day: 2.5-3 litres

How much exercise do you do on average per week: 5 hours 

Day 1

I do some yoga first thing in the morning and make my way into town for the first time in a while. I do a lot of walking but notice I don’t drink as much water as normal, probably two litres rather than three litres that I would normally drink.

I have a late dinner around 8:15pm – spicy homemade chickpea and lentil daal, followed by a sourdough crumpet with butter and a glass of water. I then sit down to watch TV and aimlessly look at my phone until 10:15pm.

I leave my phone downstairs (where it always stays) and have some vitamin sprays (multi-vitamin, D12, K and iron) as well as a perimenopause powder that is mixed with roughly 100ml of water. I go to bed and read until 10:30pm after which I fall asleep easily.

“I do a mobility workout followed by a run and a stretch.”

Day 2

I wake up at 6:45am to my alarm. I’m feeling exhausted because I had severe back pain which woke me up a few times throughout the night, but I get up and look after the kids. I then do a mobility workout afterwards followed by a run and a stretch.

I drink two homemade hazelnut milk lattes which I finish by 10:30am. I also have some porridge with oat milk for breakfast after the coffee. 

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I have a day full of meetings (including an interview for a podcast) and when I finish work I head out to dinner. I opt for a roasted kale and shallot dish with a glass of red wine and some water. However, I’m so exhausted that I’m home by 8:30pm.

I go to bed and read until 10pm after taking my vitamins and supplements.

Day 3

I wake up feeling better today – I feel like I slept soundly. I have a pint of water before doing some yoga, after which I get the kids sorted and have two hazelnut lattes, which I finish by 10am. I have breakfast after that, which is porridge with quinoa and oat milk topped with some banana, cinnamon and peanut butter.

I have quite a few meetings today, but I manage to get out for a walk early in the morning. I have a lunch meeting followed by a relatively easy afternoon of work.

By the evening I feel exhausted, and make some soup for dinner around 8pm. I pair it with some sourdough bread. Later on in the evening, about 9pm, I have some chia seed pudding (made with chia seeds, coconut yogurt, frozen raspberries and a dollop of peanut butter).

I watch TV until about 10pm and then take my vitamins and supplements before heading to bed. I read in bed until 10:30pm and fall straight to sleep. 

“I take my vitamins and supplements before heading to bed.”

Day 4

Today is my son’s birthday and I wake up early without my alarm feeling very exhausted after a night full of night sweats and lots of tossing and turning. I manage to go for a run in the morning but between birthday planning and work I’m busy all day. However, I do manage to drink two litres of water throughout the day to keep me hydrated.

We have champagne and cake around 4pm and then head out for an early dinner where I have vegetarian pasta with a glass of red wine. We head home and after putting the kids to bed we sit to watch some TV for a couple of hours. I have another glass of champagne followed by some chia seed pudding.

I go to bed around 10:30pm after having my vitamins and supplement. It takes a while for me to fall asleep.

Day 5

Although I was tired when I went to bed last night, I didn’t sleep brilliantly and woke up at 7am. I have a coffee and some banana oat pancakes around 9am, before going out on a long bike ride.

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After that I help at a school fair and attend a kids birthday party. I feel absolutely shattered all day but I’m going on a night out with my best girlfriends, so I do a quick 15-minute meditation around 6pm to try and get some energy for the night ahead.

The night consists of around one litre of water, champagne cocktails, red wine and decaf espresso martinis with a lot of food, including nibbles, veggie lasagna and a cheese, chocolate and fruit grazing board.

I don’t get to bed until 2am and sleep terribly all night.

So, what does it all mean? A sleep expert offers her thoughts

Dr Nerina Ramlakhan, sleep expert and professional physiologist, says: “You have some great habits, which is not surprising given that you work in wellbeing, but a few changes might help you to navigate the perimenopause and then menopause stages with more ease. 

“During these years, changing levels of the steroid hormones oestrogen, progesterone and testosterone can really affect the nervous system making you more prone to insomnia, night sweats, anxiety, joint pain and exhaustion, so self-care is really important. What you did before this age might no longer be helpful – for example, hard endurance exercise can actually cause increased levels of the stress hormone cortisol, which then exacerbates all the symptoms mentioned above. The key is good nutrition and hydration and balancing rest and activity levels.”

Sleep expert Dr Nerina Ramlakhan

Dr Nerina continues: “You really needs to allow yourself time to rest and recover with more meditation and gentle yoga and even the odd daytime power nap – no more than 20mins taken at some point between 2pm and 4pm but no later. 

“Your two lattes before breakfast aren’t great – check out my 5 non-negotiables – can you have a small protein-rich snack, eg a banana with some nuts, soon after rising and before your caffeine? This will help to minimize your cortisol levels. Ideally, you should then have your coffee after you’ve had a more substantial breakfast. 

“You’re also eating too late given you’re often in bed around 10pm – but you probably know this. Finally, alcohol is the killer of good, restorative sleep – and we all know this don’t we?!”

If you would like to take part in Stylist’s Sleep Diaries, please email us at [email protected] with your name and age, using ‘SLEEP DIARIES’ as the subject. We look forward to hearing from you.

Lead image design: Ami O’Callaghan

Other images: Getty

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