I slept badly last night. To be more accurate, I hardly slept at all.

I went to bed and couldn’t fall asleep, dozed but by 2am it was clear that the more I lay there the more frustrating it would become.

Time to get up and do something. For me that’s make a milky drink, get a book, soothing music and dim light – light enough to read by but not dazzling, a warm, soft light that is comfy and cozy. Curl up on the sofa with a blanket in a position that if I fall asleep there then I won’t be uncomfortable or wake up cold.

I read a good few chapters of a new book – maybe that was the wrong choice. Maybe I should have carried on reading the Lancet menopause series – interesting as it is, at 3am it is more likely to send me to sleep than a epic set in Japan in the 1500s. But the Lancet series was on a computer screen and that would not help sleep. At 5.30 am, I finally went to bed and slept until 9am which is not a great start to a work day but at least I had some proper sleep.

Elusive sleep has been a part of my life for many years for various reasons. It is probably more pronounced now that I am most definitely in the menopause transition. Poor sleep is a very commonly cited problem for menopausal women and it must be even harder if you have generally slept well to this point in your life. I feel your pain!

Sleep is essential to our well-being and general health. When we are deprived of sleep we are not able to rest and recuperate, our brain doesn’t get the range of different sleep phases that allows our brain to consolidate the information it gets exposed to every day, prolonged lack of sleep can increase our blood pressure and affect our mental health. We make poorer choices about the food we eat and we become far less motivated to be active and move. I know after a bad spell, my ability to regulate emotion is lower,  my work is less satisfactory to me and I really don’t feel productive. I have strategies to lessen the impact.

Why does sleep worsen through menopause? There are lots of reasons. Oestrogen is connected to serotonin which in turn affects melatonin needed for us to feel sleepy. Menopause can impact the number of times we need to get up to empty our bladder, interrupting sleep. Menopause can impact anxiety which can make sleep harder, a racing mind full of thoughts is not conducive to sleep. Women are more prone to restless legs syndrome. This uncomfortable sensation can really impact sleep quality and is more common in perimenopause.

Here are some of my personal strategies for dealing with poor sleep:

• If there is something whirring around in my head then I get up and write it down – preferably pen and paper, there is something satisfying about the physical and tactile nature of pen and paper with the absence of a screen and it’s light. It externalises the thoughts and captures what is whirring, by doing so often allows me to switch off because it is now there on paper. The annoying fluttering thoughts are now words on a page – safely stored until I can do something with them.

• Read or do something meditative before bed, I like the tactile nature of crochet or knitting – the counting the stitches and the feeling of the fabric forming from the yarn is soothing. Some people like to meditate but I find I need something to focus on that is meditative by nature.

• I like a milky drink before bed and there seems to be a bit of science behind the mix of protein and carbs allowing the tryptophan needed for melatonin production to be more available – I also think there is some psychology at play. Milky drinks were the stuff of bedtime rituals as a child – a sign that it was soon time to go to sleep.

• If I am awake and it seems that sleep is not going to come soon then I get up. I do something, I make myself comfortable and do something that lends itself to relaxation and sleepiness. Listening to a podcast with someone who has a calming and soft voice, reading a book, listening to music or sometimes it is simply making myself comfortable in a different place is enough to allow me to doze off. (Shameless plug of Laura’s – my co-author’s podcast, really fascinating so might not put your to sleep in the middle of the night but on the other hand Laura does have a lovely calming voice.)

• There is no point in battling it – the more frustration and worry about not sleeping the less likely sleep will come. I also know that a night’s poor sleep is likely to affect my day in some way but by being kind to myself about that is key. Taking a refreshing walk outdoors when the fatigue and lack of concentration hits is better than fighting a losing battle to concentrate. Stop. Pause. Reset. It’s often not easy to do but when I do it is a real boost.

• If I am having a burst of poor sleep then I will sometimes take melatonin about half an hour or so before bed – it can help but it is not a silver bullet. A doctor of mine has recommended I take a magnesium supplement to help with some medication I take. I do think that when I sleep my sleep is better quality but I still have sleepless nights. Sleep quality is multi-factorial – nothing is the elusive silver bullet.

Laura and I have included a whole chapter in Eating Well for Menopause on sleep because it is so important and that so many women ask about it. There are other things related to food that may help. I wanted to share my experience – I hope it helps.