Back pain, dry skin and insom­nia... ‘work­ing from bed’ is a flat-out dis­aster

From pressreader.com

By Alice Smellie

NOW that I no longer have school runs, I don’t have to live by my alarm clock.

Every morn­ing I let the dogs out at around 6.30am and then snuggle back down in bed for two or three hours with my laptop and my dead­lines.

This seems per­fectly sens­ible to me and I’m pleased to learn that, although I may be phys­ic­ally alone, I join mil­lions who’d rather work from bed than head down­stairs to a desk.

Mat­tress­nextday recently sur­veyed 1,000 UK adults and found that nearly half (48 per cent) of people who reg­u­larly work from home do so from bed.

And with chilly morn­ings mak­ing crawl­ing out from under the cov­ers even less appeal­ing, I sus­pect many more will be temp­ted to join us.

Unfor­tu­nately if, like me, you WFB (work from bed), you’ll be dis­ap­poin­ted to learn that there are poten­tial, and occa­sion­ally con­cern­ing, con­sequences for our health. From dry skin to heart­burn, here are some of the unin­ten­ded con­sequences of using our beds as an office exten­sion.

‘Bof­fice’ worker: Alice Smel­lie risk­ing her health as she types on her laptop in bed

INSOMNIA

SLEEP expert Dr Neil Stan­ley, author of A Sleep Divorce, is clear that doing even part of a day’s work from the com­fort of your bed is a ter­rible idea for qual­ity of sleep.

‘If you work in bed, your brain will start to asso­ciate bed with being awake and think­ing that it’s admiss­ible to be so,’ he says.

The only thing worse than WFB dur­ing the day is, Dr Stan­ley adds, WFB in the even­ings, something I’ve also been known to do.

He did a study show­ing that if you work in the hour before bed you’re going to have lower qual­ity sleep.

‘It’s not rocket sci­ence but it is sci­ence. The 35 to 45 minutes before bed should be spent relax­ing, not work­ing.’

That sounds famil­iar... whenever I’m stressed about work I front­load the night before, type frantic­ally till 10.30pm and then – sur­prise! – can’t drop off, and feel exhausted the next day.

DRY AND PUFFY FACE

SPENDING more time between the sheets can con­trib­ute to poor skin on the face and body.

Aes­thetic expert Dr Christine Hall points out that being in bed for long peri­ods of time is sub-optimal for your skin.

‘Being act­ive has a pos­it­ive effect on skin,’ she says. ‘Lack of move­ment and there­fore reduced cir­cu­la­tion will con­trib­ute to fluid reten­tion and puffi­ness.’ Bed­ding is key too: ‘The warmth of a duvet or stay­ing in bed increases trans epi­dermal water loss, lead­ing to dry­ness around the body,’ she says. ‘Should you have an exist­ing skin con­di­tion such as acne, get­ting hot and sweaty in bed may well exacer­bate this.’

There is, she points out, a big dif­fer­ence between stay­ing in bed and being in bed for sleep. ‘Sleep is import­ant for skin because it repairs itself at night. Lack of sleep means your skin doesn’t have so much time to optim­ise its own health.’

It’s hard to say if my drier skin is down to WFB or age­ing but, either way, I might con­sider spend­ing less time between the cov­ers and more time mois­tur­ising.

POOR MOTIVATION

TO my dis­ap­point­ment, I learn that what we wear may affect our motiv­a­tion.

Once I bother to get out of bed I always get dressed in clean and reas­on­ably smart clothes and do my hair and make-up. Till then, it’s comfy pyja­mas.

But cog­nit­ive beha­vi­oural research shows that the mind uncon­sciously shifts into a more pass­ive state when the body is hori­zontal. And by the same mech­an­ism, wear­ing pyja­mas is likely to make it even harder to focus. Stud­ies show we are more pro­duct­ive if we are dressed, and espe­cially if we’re smartly dressed.

One report observes that cloth­ing choices, even for home­work­ers, are ‘psy­cho­lo­gic­ally and organ­isa­tion­ally impact­ful’.

HEARTBURN AND WEIGHT GAIN

BREAKFAST is my favour­ite meal and best enjoyed from under a duvet; from eggs to por­ridge to yoghurt and ber­ries.

However, our digest­ive sys­tems work best when we’re upright, says Emma Bard­well, nutri­tion­ist and author of The 30g Plan

Cook­book. ‘Eat­ing in bed while work­ing might feel cosy but it’s not doing your diges­tion any favours,’ she says.

‘Lying down too soon after eat­ing, or half-lying in bed, can increase the like­li­hood of reflux and heart­burn because stom­ach con­tents are more likely to move back up towards the oeso­phagus.’

Oh dear. I am more than cap­able of lying down almost fully, laptop bal­anced on knees, and stom­ach acid going good­ness knows where.

What’s more, move­ment plays an import­ant role in diges­tion and blood sugar reg­u­la­tion.

‘Even light activ­ity after meals, such as walk­ing around the house or head­ing out­side for a short stroll, can help stim­u­late gut motil­ity, encour­aging food to move through the digest­ive tract more effi­ciently,’ says Bard­well.

‘Your muscles also act a bit like gluc­ose sponges after eat­ing, help­ing clear gluc­ose from the blood­stream and improv­ing blood sugar con­trol.’

As if all the above wasn’t bad enough, being sedent­ary may also con­trib­ute to weight gain.

‘You may think that the short walk from desk to the kettle makes no dif­fer­ence, but small exer­cise “snacks” really count and minutes add up,’ says author of the Feel Good Fix, Lav­ina Mehta MBE.

BACK PAIN AND POOR POSTURE

POSTURALLY, WFB is a bit of a dis­aster.

Physio­ther­ap­ist Nat­alie Gum­mer­son, at Pure Sports Medi­cine, says that the bed simply isn’t designed for being sat in upright for long peri­ods, even if you plump a mass of pil­lows behind you, as I love to do.

‘When we work from bed, we nat­ur­ally tend to slouch or round for­wards, pla­cing strain on the lower back and neck and encour­aging what’s known as a sus­tained flexed pos­ture. Over time, these pos­i­tions can con­trib­ute to disc irrit­a­tion, muscle strain and increased back pain risk.’

I cur­rently have a pil­low short­age, thanks to my three chil­dren pil­fer­ing loads to go to uni­versity, and I have noticed my middle back fre­quently feels stiff and sore.

Sad to say, I think it might be time to get out of my ‘bof­fice’. 

https://www.pressreader.com/uk/daily-mail/20261026/281960319746799

Dealing With Stress-Induced Insomnia? A Sleep Doctor Shares 8 Ways to Prevent It

From realsimple.com

By Sara Delgado

When stress keeps your brain on high alert at bedtime, small daily habits can help it power down 

Key Takeaways

• Stress can trigger our fight-or-flight response, which can make it harder to fall asleep and stay asleep, and worrying about sleep can become its own cycle.
• Daytime habits matter as much as bedtime ones. Wake up at the same time every day, even after poor sleep. Get morning sunlight, move your body, and limit caffeine and alcohol.
• Spend 20 to 30 minutes relaxing before bed and jot down worries earlier in the evening. If you’re awake and frustrated, get up and do something calm until you’re sleepy.

With the change of seasons in full swing and the clocks falling back soon, sleep is one habit that changes the most. Whether you’re struggling to wake up or fall asleep, many factors can affect a good night’s rest—and some of them aren’t even external. Case in point: stress.​

If you feel like your mind is your worst enemy when it comes to winding down and getting the proper rest your brain and body deserve, you might be dealing with stress-induced insomnia.​

“Stress often plays a big role in insomnia,” says Angela Holliday-Bell, MD, board-certified physician and certified sleep specialist. “When we’re stressed, our bodies activate the fight-or-flight response, increasing alertness and releasing stress hormones like cortisol and adrenaline. While this response is helpful when we’re facing a threat, it can interfere with sleep, especially when it stays activated.”​ To help you work through it—and still get adequate sleep during the cold, dark months—we asked a sleep doctor for some preventative tips.

How Stress Can Impact Sleep

Credit:

Alvaro Medina Jurado / Getty Images

Stress keeps our brains on high alert, so instead of naturally winding down as the day ends, we can feel just as alert as we are during the day. “It can make it harder to fall asleep, cause more frequent night-time awakenings, and make it difficult to fall back asleep,” Dr. Holliday-Bell explains. “Over time, people can even begin to associate bedtime with stress and frustration, creating a cycle where worrying about sleep becomes another reason they can’t sleep.”​

If you naturally stay awake during stressful spells, try to avoid frustration. “Some people have a naturally higher level of what we call sleep reactivity, meaning their sleep is more sensitive to stress,” Dr. Holliday-Bell says. “Genetics, a history of insomnia, anxiety, and certain personality traits (like excessive worrying) can all increase someone’s vulnerability. One of the easiest ways to recognize whether you’re at risk is to pay attention to how your sleep responds to stressful situations. If even relatively minor stressors consistently cause you to have trouble falling asleep or staying asleep, you may have higher sleep reactivity.”

Dr. Holliday-Bell says another warning sign to pay attention to is noticing whether “sleep difficulties continue even after the original stressor has resolved,” as that “can indicate that you’ve developed habits or thought patterns that are keeping the insomnia going.”

The good part? No matter where you fall, a handful of easy tips can help you combat stress-induced insomnia. “The goal is to create habits that help your mind and body transition into sleep more easily, even during stressful periods,” Dr. Holliday-Bell says. Below, we break down eight expert-backed tips that can help improve your sleep journey.

8 Tips to Prevent Stress-Induced Insomnia

Create a Consistent Sleep Routine

Even when you’re having trouble falling asleep, the first step toward fighting insomnia is creating a consistent sleep and wake-up routine that signals to your internal clock when to wind down and when to become active again.

“[An] important habit is waking up around the same time every morning, even after a poor night of sleep,” Dr. Holliday-Bell says. “This helps regulate your internal clock and makes it easier to maintain a consistent sleep pattern.”

If you have had a particularly bad night and feel the need to stay in bed all day the next day, try to fight it. “Resisting the urge to spend extra hours in bed trying to make up for lost sleep is key [to] building a routine,” Dr. Holliday-Bell adds.

Get in the Right Mindset to Go to Bed

If you want to go to sleep, you need to signal your intention to your body and mind. If you tend to stay super active until the minute your head hits the pillow, your brain is still hyperaroused.

As part of the aforementioned routine, Dr. Holliday-Bell says you should pay attention to the “wind-down” process and dedicate an entire portion of your night routine to it. “Spending even 20 to 30 minutes doing something relaxing before bed, like reading or listening to calming music, can help signal to your brain that it’s time for sleep,” she says.

Create a Safe Environment

If you’re having trouble falling asleep, it might be because you don’t feel comfortable where you are. Dr. Holliday-Bell says one thing people overlook the most is their sleep environment. If your room is particularly messy or stuffy on any given day, it can affect you more than you think.

“Keeping your bedroom cool, dark, and quiet can help minimize unnecessary sleep disruptions,” she adds. Another factor to consider, especially in rental spaces, is your mattress. “An uncomfortable or unsupportive mattress can contribute to physical discomfort and frequent night-time awakenings,” Dr. Holliday-Bell says. If you can’t find a comfortable position, consider investing in a mattress that “provides proper support and helps maintain a comfortable sleep temperature,” she suggests.

Get Things Out of Your Head Before Bed

If you have long to-do lists or things weighing you down, your brain can easily hyperfocus on them while you are trying to sleep, leaving you feeling wired (even if you’re tired). If you know you are prone to overthinking, set aside time to get anything that might disrupt your sleep out of the way before you try to unwind for the day.

“I recommend setting aside about 10 to 15 minutes earlier in the evening to write down anything that’s worrying you, along with what you can do about it tomorrow,” Dr. Holliday-Bell says. “This can help reduce those racing thoughts that tend to show up as soon as your head hits the pillow.”

Try to Actually Relax

I know this sounds like the most cliché tip ever, but Dr. Holliday-Bell confirms that trying to stay as relaxed as possible throughout the day can actually help when it’s finally time to go to bed.

“Practicing techniques like deep breathing or progressive muscle relaxation can help calm your nervous system, especially when your body feels tired but your mind won’t shut off,” she says. “Taking short breaks throughout the day to practice deep breathing or mindfulness can help prevent stress from building up until bedtime.”

Move More During the Day

“One of the biggest misconceptions about sleep is that improving it starts at bedtime,” Dr. Holliday-Bell says. “In reality, what we do throughout the day plays a major role in how well we sleep at night.”

If you want to help your circadian rhythm to auto-regulate and create a clearer distinction for your brain and body at bedtime, the best thing you can do is move throughout the day.

“I always recommend getting natural sunlight in the morning because it helps regulate our internal clock, while regular physical activity can reduce stress and improve sleep quality,” Dr. Holliday-Bell says.

Avoid Known Sleep Disruptors

If your brain already acts as its own sleep disruptor, you don’t need any other external factors that could potentially make it even harder to fall asleep. “I’d recommend limiting caffeine later in the day and avoiding alcohol as a sleep aid,” Dr. Holliday-Bell says. “Several factors in our environment and daily routines can interfere with sleep, including irregular sleep schedules, excessive caffeine, alcohol consumption, and even exposure to bright lights before bed.”

Don’t Blame Yourself

Last but definitely not least, it’s important not to be too hard on yourself. “If you’re lying awake at night feeling frustrated, don’t force it,” Dr. Holliday-Bell says. “It’s better to get out of bed, do something quiet and relaxing in dim lighting, and return when you feel sleepy. This helps prevent your brain from associating your bed with wakefulness and frustration.”

“It’s also important to recognize that certain medications, chronic pain, hormonal changes, and underlying sleep disorders can contribute to insomnia,” she adds. “If someone continues to struggle with sleep despite making changes to their habits and sleep environment, I recommend speaking with a healthcare professional to identify the underlying cause.”

https://www.realsimple.com/how-to-prevent-stress-induced-insomnia-12190188

Scientists Have Identified a New Type of Depression Responsible for 1 in 4 Cases

From prevention.com

A surprisingly common trigger might be behind it 

Key points 

• Circadian depression is an emerging subtype of the mental health disorder.
• Up to 25% of people with depression may have circadian depression, according to a new study.
• More research on this type is warranted, since treatment may be slightly different from that of traditional depression.

There are a lot of different factors that can fuel depression, from genetics to trauma. But new research suggests that there’s a lesser-known element that may play a role, too: changes in your circadian rhythm, or your body’s 24-hour internal clock.

In fact, so-called “circadian depression” may actually account for nearly one in four cases of depression, according to the findings, which were published in the British Journal of Psychiatry.

For the study, researchers analysed clinical and genetic data from more than 10,000 Australians with depression who participated in the Australian Genetics of Depression Study, a large-scale scientific research project that looks at the factors that impact depression. These included self-reported data on the following:

• social jetlag, or a mismatch between someone’s internal clock and their social schedule
• seasonality, or how much someone’s mood varies among seasons
• delayed sleep midpoint, or when the halfway point of sleep is later than expected
• whether people were night owls
• how tired they felt in the morning
• whether they experienced excessive daytime sleepiness

After analysing the data, the researchers found that 23% of the participants had a circadian subtype of depression. The findings support the “validity and potential clinical utility of a circadian subtype of depression as a clinical profile,” the researchers wrote in the study. The possible benefit? Defining this “may support more personalized care options,” they wrote.

Circadian depression is an emerging subtype of depression, so it’s not yet in the DSM-5, the handbook used by mental health professionals to diagnose psychiatric conditions. Much of our understanding is still preliminary until more research can be done. But here’s what we know about circadian depression so far, plus the factors that influence it—and how to get relief.

What is circadian depression?

Circadian depression is an emerging subtype of depression that researchers believe is distinct from the traditional kind. It’s marked by circadian disruption, which is when your body’s internal 24-hour clock is out of sync with your external environment.

People with circadian depression have disrupted sleep-wake cycles, reduced daytime activity, low energy, and weight gain during episodes, according to the researchers. They also tend to become depressed at an earlier age and are more likely to experience “bipolar-like features,” including mania.

Why might circadian disruptions raise the risk of depression?

Your internal clock helps to coordinate sleep, alertness, hormone release, and your metabolism, says Thea Gallagher, Psy.D., clinical associate professor at NYU Langone Health and cohost of the Mind in View podcast. “When that timing falls out of sync with our daily lives, it can disrupt sleep and the biological processes that support mood,” she says.

That can become a “reinforcing cycle”: Disrupted sleep makes it harder to regulate your emotions and stay engaged in daily life, while depression can make sleep and routines more irregular, Gallagher says.

This is commonly seen in sleep medicine, and has gotten a lot of attention recently with the daylight saving time debate, according to W. Christopher Winter, M.D., a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine. “While some may prefer more evening light, research overwhelmingly supports the adoption of permanent standard time because of its improvement of daylight in the morning,” he says. “This has a massive impact on psychological health and depression.”

What’s more, circadian disruption doesn’t just seem to be a risk factor for depression—it also may affect attention disorders and other medical issues, Dr. Winter says.

Dr. Winter stresses that circadian disruption is not the same thing as simply not getting enough sleep—the repercussions of it are likely more pronounced. “I think it is safe to say that consistent sleep timing that is a bit inadequate in amount is less harmful than the situation of getting a perfect seven to eight hours, but the timing is all over the place,” he says.

Symptoms of circadian depression

Because it’s not yet a formal diagnosis, there aren’t yet any established symptoms of circadian depression. Still, the study uncovered a few things that may signal someone is dealing with circadian depression over another form of the condition.

Justin Paget//Getty Images

Patients with circadian depression were more likely to be night owls and deal with insomnia. They were mostly female (80%) and were more likely to have more severe symptoms of depression like mania, suicidal thoughts, psychological distress, and physical symptoms such as pain or fatigue. They were also more likely to have weight gain during depressive episodes and didn’t respond as well to antidepressant medications.

People who fell into the category of circadian depression were also more likely than those with different forms of depression to have these conditions, too:

• ADHD
• Anxiety
• Bipolar disorder
• Obesity or overweight
• Insulin resistance

How is circadian depression diagnosed and treated?

If you think you may have depression, Gallagher says it’s important to see a mental healthcare provider for an evaluation instead of trying to diagnose yourself based on your sleep patterns. “Being a night owl or waking up tired does not, by itself, mean you have depression,” she says. “A brief diary of sleep timing, mood, energy, and seasonal changes can help a clinician see patterns and assess other explanations, including a sleep disorder.”

There is no set treatment for circadian depression, given that it’s technically not yet a diagnosis. “‘Circadian depression’ is still a proposed profile,” Gallagher says. “This study doesn’t establish that people fitting that profile should receive a different medication or stop their current treatment. It suggests we should pay closer attention to sleep and circadian timing alongside established depression treatments.”

However, the study’s researchers noted in their university’s press release that standard antidepressants like SSRIs or SNRIs tend to be less effective in people who have circadian depression and come with more side effects.

As a result, it’s possible that treatments that affect the body’s internal clock, like light therapy and melatonin, may be more helpful, though more research is needed. In fact, the researchers wrote in the study that folks with circadian depression may benefit from “chronotherapies,” or approaches that seek to reset or align the body’s internal clock.

“This is precisely where melatonin shines,” Dr. Winter says. “I use and recommend the use and timing of melatonin to help reinforce proper sleep timing.”

That doesn’t mean you should pop a melatonin nightly if you feel that your mood is off. Instead, Dr. Winter suggests viewing melatonin as an “anchoring beacon when everything else is off,” like you’re constantly traveling across time zones or struggling with changing schedules.

If you have insomnia, cognitive behavioural therapy for insomnia (CBT-I) may also be helpful, Gallagher says.

“Light timing and exercise scheduling are also essentials,” Dr. Winter says. “Finally, when you have the choice, choose sleep. Not the red-eye. Not the next episode. Not the nightcap. Choose sleep.”

https://www.prevention.com/health/mental-health/a74220816/circadian-depression-study/

"I had insomnia long after menopause ended - here's what finally helped me sleep through the night"

From womanandhome.com

By Debra Waters

More than half of women going through menopause have sleep issues, and without the right attention, these can linger for longer than expected 

While many women experience insomnia in menopause, many also expect the problem to get better with time as hormones adjust. But for some, it's the start of a new nightlife.

“I didn’t have insomnia before perimenopause,” says Julie*, on the grey Saturday morning that I spoke to her on the phone. “The changes began over 10 years ago, when I was in my late 40s. My sleep hadn’t been great since I had children, but then it got significantly worse, and I started waking regularly in the early hours.”

* Name has been changed

Julie is one of up to 60% of women who experience insomnia or disturbed sleep during the menopause transition. Given that more than a billion women worldwide are menopausal or post-menopausal, that’s millions of women struggling. Not only at night, but during the day, when a lack of sleep can cause tiredness, sluggishness, poor concentration, mood swings and irritability.

“Chronic insomnia is a recognised condition when sleep problems last for three months or longer, and affect how you feel or function in the daytime," explains Dr Zoe Schaeldel, a GP, menopause expert and sleep specialist at Myla Health.

"Women are twice as likely to have insomnia as men for several possible reasons, including hormonal changes during the menstrual cycle, pregnancy and the menopause transition," she says. Unfortunately, these are periods in a woman’s life when restful sleep is crucial.

(Image credit: Getty Images)

During perimenopause, “fluctuating hormones can influence systems that regulate sleep and body temperature. Hot flushes and night sweats can interrupt sleep, while anxiety, low mood, aches and pains, and needing to pass urine at night can also disrupt sleep", she says.

Then there’s the added pressure of midlife responsibilities. “From work to caring for children or ageing parents, these factors can combine to make sleep more vulnerable. Night-time caring responsibilities, particularly looking after babies and children, can also play a part,” says Dr Schaeldel.

This was certainly true for Julie. “After I had children, my sleep got worse, and I became more anxious and on alert,” she says. It’s a vicious cycle, as anxiety can also be detrimental to sleep. Coupled with hormonal shifts, it’s no surprise that sleep disorders become a hindrance for women in midlife, through menopause and beyond.

That heady mix of hormones and sleep deprivation can also trigger mood swings, which not only make life harder for sufferers, but for loved ones bearing the brunt. “My husband noticed them,” she says. “There was a change in my behaviour, and I realised something was going on.”

While Julie’s husband was understanding, it became obvious that she needed medical intervention. Yet, 10 years ago, we weren’t having conversations about menopause the way we are now, and information was scarce. Fortuitously, she was thrown a lifeline.

“I heard a programme about menopause on the radio, and it was a massive eye-opener,” she says. “I had no idea menopause could have such an effect! It wasn’t discussed or understood then. People mostly talked about hot flushes, so I didn’t connect my symptoms with menopause.”

Does HRT help insomnia in menopause?

In previous years (and, to some extent, now), countless women in menopause didn’t get the right medical attention. For example, Julie was offered SSRIs, often prescribed as antidepressants, before HRT.

“I went to my GP about my sleep and was prescribed an antidepressant that was meant to help with mood and sleep,” she says. “I tried it, but I don’t think it helped.” In 2019, a scandal erupted about the over-prescribing of antidepressants to treat menopausal symptoms when the What Women Want at Menopause Survey found that nearly 40% of women were prescribed antidepressants, despite 80% feeling this was ‘inappropriate’.

As she was able to do so, Julie decided to pay and go private for her menopause care. “I saw Professor Studd, who told me it was menopause and prescribed gel. It was transformative,” she says. “He gave me testosterone soon afterwards, too. HRT changed my life. I think I’d be a completely different person without it.”

HRT alternatives may be a better option for those who don't want to - or can't - be on hormone replacement therapy (HRT).  (Image credit: Getty Images)

HRT enabled Julie to return to work full-time. “It changed everything for me. My symptoms held me back, but once I got on top of them, I felt much more able to pursue my career.”

That's not to say HRT doesn't have side effects - or that it's a cure-all. It helps some women with symptoms, including poor sleep, but not others, and not everyone can have the therapy.

“My main issue is that I’m intolerant to progesterone, which I don’t think is discussed or taught about enough," says Julie. "I suspect this sensitivity may be more common than people realise, or more common than it’s diagnosed."

When Julie takes too much progesterone, she actually develops insomnia, anxiety, and depression. “It may help me fall asleep, but a few hours later it wakes me up,” she explains. “If I hadn’t understood what was happening, I wouldn’t have known what was going on.”

She now takes less than the official dose. “Most GPs wouldn’t be happy with that, but my specialist is willing to prescribe oestrogen with less progesterone, while carefully monitoring my levels and arranging regular scans.”

If you feel like your doctor isn't listening, get a second opinion. There are more menopause clinics than ever. Your GP can refer you, or you can go private (though this is pricey). Specialist care is more likely to provide nuanced, in-depth support. As both menopause and insomnia are multifactorial, some tweaks to your treatment are to be expected, so expect a bit of trial and error.

Insomnia in post-menopause

At 59, Julie thinks she is “well past menopause, although I’m not sure because I’m on HRT.” Her sleeplessness is largely under control, although she recently had a “funny few months with insomnia” that she can’t explain. Was HRT the answer to her menopausal nightmares?

“I may need to stay on HRT for the rest of my life,” she says. “I see someone from the London Menopause and PMS Clinic every six months, and I’m still taking testosterone. My specialist encourages me to keep my level up. It’s great for my sex drive, which is good for my relationship, and it contributes to my get-up-and-go. I plan to stay on it. A friend of my mother, who’s in her 90s, still takes it. She looks so young - she’s an advert for it!”

While only a small percentage of women on HRT also take TRT (testosterone replacement therapy), there’s an indication that TRT can improve women’s mood and cognition, as well as help both women and men with sleep. Currently, testosterone is regarded as ‘off-label’, but it’s available from GPs to treat menopausal symptoms on a specialist’s recommendation.

Disclaimer

This article is for general interest and is not intended to suggest a course of action that might be suitable for you. Always consult a licensed healthcare professional before making decisions concerning your health and wellbeing.

How to help yourself

Over-the-counter insomnia treatments didn’t work for Julie, although therapy helped her anxiety. Dr Schaeldel recommends a particular type of cognitive behavioural therapy for insomnia, called CBT-I. “It’s the first treatment for chronic insomnia, as it helps address the thoughts and behaviours that keep sleep difficulties going.”

Dr Suzanne Wylie, GP and medical adviser for IQdoctor suggests that you:

• Keep a regular time for getting up, including weekends. A consistent waking time helps reinforce the body's sleep-wake rhythm.
• Have a cool, dark, comfortable bedroom, and wear breathable nightwear.
• Avoid caffeine later in the day and limit alcohol, particularly close to bedtime.
• Take daytime exercise in natural light.
• Allow time to wind down before bed rather than moving directly from work, screens or household tasks.
• If you lie awake for a long time, get up briefly and do something quiet in dim light until you feel sleepy.
• Don’t assume that poor sleep is something you have to put up with because you’re menopausal.

If sleep has been persistently poor for several weeks or is accompanied by significant snoring, gasping or choking during sleep, restless legs, low mood or anxiety, speak to a GP, suggests Dr Wylie.

Together, you can work out whether the problem is menopausal, an insomnia disorder or sleep disorder, or a combination of these.

https://www.womanandhome.com/health-wellbeing/menopause/insomnia-in-menopause/