Help! Is lack of sleep contributing to my weight gain in menopause?

Sleep problems are frequently reported by women during their menopause years, particularly starting in perimenopause and often continuing into the postmenopause period. Getting adequate and good quality sleep can be a real struggle. Symptoms such as hot flushes and night sweats can be a cause, but many other factors can also play a role in insomnia. One very common complaint in menopause is weight gain, and here, we are going to explore the connections between sleep disturbance and weight gain in menopause, the consequences for health and what you can do about it.

Why sleep is important for health

Sleep is the foundation of our health, having many health benefits including lowered risk of chronic diseases such as type 2 diabetes, heart disease and high blood pressure, as well as improved memory, mood, immunity and energy levels. Our sleep-wake cycle is very closely connected to our metabolism, which can be more or less active at certain times during the night. Metabolic health is crucial for our overall wellbeing and is connected to various chronic diseases and disabilities. Our body’s energy metabolism plays a fundamental role in every biological process.

We can think of metabolism as a balance between two essential processes: one that breaks down substances to provide energy for our body and mind, and another that builds up essential materials (like glucose, fatty acids, and amino acids) for repairing, maintaining, detoxifying, and storing. This balance is carefully regulated by our body’s internal clock (circadian rhythms), our nervous system, hormones, and our immune system. Rest and repair go hand in hand, and when metabolism is slowed during our sleep, the repair work begins. If we aren’t getting enough good quality sleep throughout the night, we are at risk of the repair work not being done efficiently, leading to poorer health and quality of life.

The aim for good quality and amount of sleep for adults to achieve good health is between 7-9 hours per night, with the average being about 7.5 hours per night. Most adults are only getting between 5-6 hours per night, and for menopausal women, it could be much less given that 61% experience sleep disturbance.

The sleep and weight connection in menopause

Sleep problems become more common and worse from the time perimenopause begins through the post-menopausal years. They are often connected to menopause related issues such as vasomotor symptoms (hot flushes and night sweats), insomnia, sleep disruptions, and mood disorders.

Hot flushes and night sweats are common during menopause. Before a hot flush, the body warms up, and blood flow increases, creating a sensation of heat that can wake women up. Hot flushes can be energising due to increased body heat and adrenaline, making it challenging to fall back asleep.

Menopausal sleep problems are often linked to feelings of depression and anxiety. Oestrogen plays a role in the metabolism of brain chemicals like serotonin, which affects our sleep-wake cycle, it helps regulate our nighttime body temperature, promoting better sleep and having an antidepressant effect. With lower oestrogen levels in menopause, women may experience higher nighttime body temperature, lower-quality sleep, and a poorer mood.

Our sleep-wake cycle is regulated by our circadian rhythm, which affects the regulation of our weight, as it has a significant impact on our appetite hormones, ghrelin (which stimulates hunger) and leptin (which signals fullness). When we don’t get enough sleep, ghrelin levels rise, making us feel hungry, while leptin levels drop, reducing our feeling of fullness. This can lead to increased snacking, having meals at irregular times and choosing foods high in saturated fats and sugar as our bodies try to deal with the tiredness. Alcohol and caffeine intake increase in an attempt to have more energy, all affecting sleep. Consuming more saturated fat and less fibre is also associated with lighter and less restful sleep. Additionally, a diet with higher levels of both sugar and non-sugar carbohydrates can lead to more frequent awakenings during the night.

It’s a double whammy – the hormone changes in menopause affect the sleep-wake cycle, which can affect our appetite hormones, affecting the types of foods we choose to eat, the time of day and how often we choose to eat.

Tips to improve sleep, symptoms and weight gain

Getting good sleep is imperative to addressing the issues related to weight gain in menopause. If your symptoms such as hot flushes and night sweats are unrelenting and you are surviving on very little sleep, please see your GP for further advice. Symptom control is really important to get a good night’s sleep. Here are some tips that will help with getting better sleep quality and quantity, which will help alleviate the fatigue that leads to disrupted appetite hormone regulation.

As much as you probably don’t feel like doing it, light exercise will help with your sleep. Choose something you enjoy and keep it light, such as walking, yoga, pilates, so that you are expending some energy and tiring yourself out.
The sleep-wake cycle can be recalibrated by getting sunlight in your eyes first thing in the morning. In the first hour of waking, go outside and get some light in your eyes to recalibrate sleep-wake hormones.
Avoid foods high in saturated fat and sugar to give you that energy rush – when you notice that you are wanting these types of foods because you are tired, stop yourself and choose more nourishing foods. Be aware of how your lack of sleep is impacting your choices.
Avoid caffeine and alcohol as these both disrupt the sleep-wake cycle.
Stay hydrated throughout the day by drinking water, as dehydration can affect sleep.
Try to stick to your normal meal and snack times throughout the day, and again, if you notice that you are eating at irregular times, try to stick to your usual eating routine.
Have the same night time routine every night, go to bed at the same time each night, and wake at the same time each day.
Keep your bedroom temperature cool, as our body temperature drops as we relax into sleep, and a hot environment can make it hard to get to sleep and stay asleep.
If hot flushes and night sweats are causing you to wake, wear light cotton bedclothes and consider using a fan in your bedroom

If you aren’t getting good sleep regularly, are experiencing vasomotor symptoms and have noticed weight gain, working on getting good sleep may be the answer to improving your weight and symptoms that are preventing sleep. Weight gain in menopause is caused by varying factors, with sleep and dysregulated appetite hormones being part of the story.

References:

1 Gennev, Menopause Fatigue: Why Am I so #$%@ing Tired?!

https://www.gennev.com/education/menopause-and-fatigue

2 Jean Hailes for Women’s Health, Help! I’m too tired to exercise

https://www.jeanhailes.org.au/news/help-im-too-tired-to-exercise

3 Kravitz H et al, Sleep, Health and Metabolism in Midlife Women and Menopause: Food for Thought, Obstet Gynecol Clin North Am, 2018, Dec;45(4):679-694

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338227/

4 Papatriantafyllou E et al, Sleep Deprivation: Effects on Weight Loss and Weight Loss Maintenance, Nutrients, 2022,14,1549

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031614/

5 Sharma S and Kavuru M, Sleep and Metabolism: An Overview, Int J Endocrin, 2010, ID 270832

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929498/pdf/IJE2010-270832.pdf

6 Sleep Foundation, Menopause and Sleep

https://www.sleepfoundation.org/women-sleep/menopause-and-sleep