Is poor night sleep sign of menopause?

How do you know that you are about to reach menopause? The age at which women reach menopause is quite variable and can be from as early as 30 years or as late as 60 in some rare cases. But the commonly accepted age is any time between 45 and 55.

For that reason I will assume that you are in or approaching this age range.

SO, WHAT MIGHT CAUSE INSOMNIA IN A WOMAN IN THIS AGE RANGE? AND WHAT MIGHT ONE DO ABOUT IT?

Before we tackle that matter, let us get one or two things out of the way just in case they confuse some readers. The first is the fact that menopause is not something that “catches you one night”. For most women, it comes gradually and therefore there is a phase that is perhaps best described as pre-menopause. During this stage, gradual but definite changes take place in the woman, in many ways. The changes include physical, psychological and emotional spheres. Hot flashes are the most obvious outward sign of the changes taking place, but other changes also take place and can, for some women be most distressing.

Insomnia is a classical one but mood swings that occur can be very difficult for the woman to explain to herself or to those close to her.

Poor sleep comes with its own complications, and often make the depression and the anxiety of the menopause even worse. To add injury to insult, this is often a time when other changes are taking place in the woman's life.

For some, children are on their way out to university and the empty nest and all its well known complications are knocking at the door. To add to this mix are new responsibilities that could include worry about imminent retirement, for self or spouse that could translate to financial worries. For many the health of parents adds their own pressure to a plate.

Two years ago we saw a woman who had many of the things we have alluded to, thus far. At the age of 52 years, she had been in the pre-menopausal for two years. At first it was difficulties in sleeping but in time she had wild mood swings that she was unable to control. She shouted at her domestic staff often and fired them, only to regret later. She had experienced severe anxiety, and once or twice had come close to a panic attack while driving in heavy traffic. She had an elder sister who had gone through a similar phase but no amount of explanation could give her any comfort.

At first she dealt with the lack of sleep with a glass or two of wine. In time she found the wine also helped her calm the nerves and got her to relax in the afternoons after lunch.

To help her deal with the guilt of daytime drinking, she contacted different girls she had met from high school, university and most recently from her work place and made sure she had lunch or an early drink with a different friend each day. When she got home she would “top up” before going to bed.

Not surprisingly, her relationship with her husband deteriorated. Other than the mood swings that he did not understand, she did not seem interested in family life, and ignored not only the children, but had no interest in intimacy, something she had enjoyed all their life and something both she and her husband held very dear to their relationship.

She came to our attention one night after she was involved in an accident on her way home. It was clear from the outset that we were dealing with a person who was very depressed.

Lack of sleep and the abuse of alcohol were complications that happened during her menopause. Both her sister and the priest she had seen about this “demon” that was attacking her failed to recognise the depression for what it was.

On closer examination, it was discovered that this was in fact the third episode of depression in her life. The first was when she was 17 and had attempted suicide at school, and the other one was when a boyfriend she had been very close to died in a car crash. In both instances, lack of sleep was a prominent symptom.

She was in hospital for three weeks during which time she went though cognitive therapy in which she was taught how to deal with the symptoms she had presented with. She was also given antidepressants that helped her to sleep, but more importantly dealt with the depressive illness that had presented as insomnia.

At the end of the day, all you should know is that insomnia can be for causes other than menopause.