Have you been waking in the middle of the night since menopause?

Tuesday, November 2nd, 2010 @ 2:55PM

Last week I explained why, for most people, waking at 3 am is not a true sleep problem, it’s a blood sugar problem. (If you have not already done so, it would be a good idea to read that blog now. However, for many women, waking at 3 am begins at menopause. What’s going on here? Blood sugar fluctuations are still the root of the problem, but there’s another factor to consider now.

Menopause didn’t trigger the blood sugar roller coaster – you were probably riding that before the “change of life”  - it just wasn’t interfering with your sleep before. That’s because when peri-menopause arrives, the adrenal glands have to work harder. In countless women, this leads to adrenal fatigue. The adrenal glands are our main organs of stress response. Adrenal fatigue is a condition that occurs when we are under stress (even just the busyness of everyday life) for prolonged periods and the function of our overworked adrenals starts to lag.

Adrenal fatigue causes the adrenals to act erratically. This results in them not producing enough hormones when you need them (feeling tired and sluggish in the morning?) or too much hormone when you don’t need them, producing anxiety, a mind that races at bedtime, or a middle of the night adrenalin surge that wakes you up. In fact, except for hot flashes and night sweats, most of the symptoms we associate with menopause are really caused by adrenal fatigue. Symptoms like fatigue, mild depression, low libido, foggy, unclear thinking and irritability.

To recap, if you have been waking at 3 am since menopause you need to:

  1. Balance your blood sugar
  2. Support the function of your adrenal glands

I described how to balance blood sugar last week. This week: how to support adrenal gland function.

  1. Regular, mild to moderate exercise. Nothing too strenuous, which could further tax your adrenals. Exercise helps your body burn off excess stress hormones like adrenalin and cortisol.
  2. B-vitamins. Ever seen “stress tabs” at your local health food store? These are combos of B vitamins. The adrenals need B vitamins to make hormones.
  3. Adaptogen herbs. Mother nature has kindly provided us with a class of plant-based medicines that support adrenal gland function to help us cope with stress. Taking one or a combo of these will do great things for your physical and emotional well-being. Here are some a my favorite adaptogens:

*Ahwaganda (Withania somnifera) – Has been shown to optimize cortisol production.

*Siberian Ginseng (Elutherococcus senticosus) – Great for improving endurance, stamina and resistance to fatigue during stress.

*Rhodiola (Rhodiola rosea) – My favorite herb! Wonderful for boosting mood. Should not be used by people who have a bipolar disorder, as it may boost their mood too much.

*Lavender (Lavendula angustifolia) – Clinical trials show lavender supplements calm irritability and frustration.

*Licorice (Glycyrrhiza glabra) – Licorice should not be used if you have high blood pressure. On the other hand, it’s great if you have low blood pressure or a tendency for lightheadedness when you stand up.

*Maca (Lepidiou meyenii) – increases general well-being, mild libido enhancing effect ;)

  1. Adrenal glandular extracts. These are desiccated (dried) preparations of adrenal glands (usually from pigs) that you take in capsule or tablet form. Obviously not for the vegans in the crowd, but they do really help support adrenal function.

Occasionally women will report that when they wake at 3 am they have productive thoughts and they feel in tune with cosmic energies at that time. More power to you, if that is the case. However, if, after spending most of the night communing with the cosmos, you drift off to sleep moments before your alarm goes off and you’re exhausted for the rest of the day, then you should be getting more sleep. Stabilizing blood sugar and supporting adrenal gland function will get you there.

Please post your questions and comments!

Next up: Waking in the middle of the night: why 3:00?

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Categories: Insomnia

16 Comments to "Have you been waking in the middle of the night since menopause?" add comment
PJ Gibson
2011/01/17 at 3:12 pm

I think you saved my sanity. In fact I know you did. After listening to you speak at the Vitality show in Nov I made it my mission to fix my sleep problems that have plagued me my entire life. I now have a breakfast shake ever morning – even if I’m not hungry. I take PGX and drink soaked Chia seeds to increase my fiber in take so that I can keep my blood sugars level. I can now fall asleep with out the passion flower, hops, melatonin, 5 HTP etc that I have come to rely on. And if I wake up in the middle of the night I can fall back asleep because my heart isn’t racing from the shot of adrenaline. Thank-you, thank-you, thank-you.

2011/01/22 at 6:59 pm

You are most welcome, PJ! Thank you for taking the time to share your positive experience, I really appreciate it. I hope your story will inspire others who have been emailing me about the very same sleep problems. Kudos to you for taking the steps to improve your sleep and your health.

2012/01/02 at 10:34 am

Very interesting post. It reminds me of a book I recently read: “Stop the thyroid madness” by Janie Bowthorpe. Altough it’s a book about thyroid issues, there’s a chapter dealing with adrenal fatigue (and its potential impact on FT3 entry into cells). It would be interesting to know what’s your take on cortisol saliva test to assess adrenal function. Healthy Regards.

2012/01/02 at 10:41 pm

Yes, sometimes it’s challenging or even artificial to separate thyroid and adrenal issues since these glands influence each other so much. Cortisol testing can be useful, especially if you or your patient likes to visualize what’s going on. However, in my experience, it rarely reveals a trend that makes a big difference to the treatment plan, so I don’t usually bother.
I’ll be sure to check out that Bowthorpe book. Thanks, Laurent.

2013/09/16 at 4:59 pm

thank you sooo much for the articles. I will try all recommendations. Tired of tossing and turning for two hours. Race in my sleep. It gets old really fast. Your article makes sense. I knew there had to be a reason. There is a reason for everything in life…usually

John Belluardo
2013/11/20 at 1:00 pm

Dr. Kate, thank you for the work that you do and the information you provide. I am 48 yrs of age (male) and consider myself rather healthy and very active (weight training, swimming and running 5-7 times/wk). I have been diagnosed with severe osteoporosis. I have included grassfeed cheese, eggs, butter, natto(3-4/wk) and a 90mcg K2 supplimen to my diet. With a -2.7 score on a bone density test in June 2013, what changes can I expect a year later? Thanks you for your time.

2013/12/02 at 10:54 am

Hi John,
Most bone density studies are done over 3 years, but there are some 12 month studies. After a year I’d expect to see at least a stabilizing of your bone density (no worsening) and likely a small improvement. Add some homemade bone broth to your routine and a nettle infusion: 1/2 ounce dried nettle leaves in a 1 litre/quart size mason jar, fill with boiling water and dash of lemon juice. Steep for 4-6 hours and drink. Do this daily if possible of a few times per week.
You are young to have such low bone density. It would be worthwhile having your testosterone levels checked, as that can affect bone density.

2013/12/06 at 2:52 pm

Oh how I wish I’d known about you years ago! I had a spinal fusion surgery that put me into early menopause. I went into the OR having my monthly and came out to never have one again. I woke up for years at 3am and could NOT go back to sleep! I only had worker’s comp insurance and had no money for Dr’s or HRT. During this time all 3 of my kids were addicted to drugs. Then my youngest got clean and joined the service and was sent overseas. My oldest son was dating my new husband’s cousin and OD at her family’s home and her 5 yr old niece found him naked and dead in the bathroom. He was resuscitated but we were shunned by the whole family after that and his road to recovery was a rough one. My daughter got addicted to pain meds after a 5lb colon cancer tumor ruptured her intestines at 20 yrs old. She has been diagnosed with Lynch syndrome. These are just the highlights! I survived all the stress but I gained 70 lbs. I stopped eating grains and sugar Oct 1st. I began taking lots of supplements. I was constipated for years but now have the opposite problem. I’m trying to figure out what I’m taking that is causing this. I think it may be the adrenal cocktail I’ve been taking with cream of tartar/salt/lemon juice. I lowered the tartar down to nill and still had to run to the bathroom. Today I didn’t take it and I’m fine? Mystery solved I think!

2014/01/10 at 9:46 am

I found this site by accident but am so grateful. I am 58 years old and have been having issues with menopause. I watch my sugar intake very carefully because I have terrible hot flashes from any kind of sweetener-even raw honey but at times it is hard because of the cravings. I eat mostly a Paleo diet, so have given up wheat and most grains. I have always tried to stick with alternative methods as I have Alport’s Syndrome and the side effects of even an NSAID might not be good for me. I had a check up 2 months ago and from my own research I explained to my doctor that I felt that I was having sugar issues. I explained the waking up in the middle of the night feeling nauseated and having racing thoughts. I also have the sugar cravings at night as well. She really blew me off and stated it was my acid reflux and not a sugar issue. I tried to explain that I had been working to control my acid through diet but she insisted and sent me home with more meds that I will not take. I am grateful someone has brought this to the forefront. I have my racing thoughts under control by using Pantothenic acid but I still feel there is a sugar issue and will get your book. Thank you.

2014/01/10 at 12:34 pm

Glad you found validation and some useful info in this post! Good for you for trying to educate your doctor about nocturnal hypoglycemia. My book doesn’t go into this specific topic, although you will read that vitamin K2 helps with insulin sensitivity, which will ultimately help with this problem. Pantothenic acid will strengthen your adrenal gland to moderate their response: less adrenalin jolt means less racing thoughts. I hear from MANY people who have the racing thoughts/racing heart phenomenon at night.
Chromium will help stabilize your blood sugar as will PGX – a blend of soluble fibres that I have found to be very useful for this problem. Keep me posted.

Carol Love
2014/09/09 at 3:15 pm

I read your book about Vit K2 and the calcium paradox. Convinced my osteopenia would be helped I started taking 200 mcg as suggested by my cardiologist but… I noticed I have more palpitations than I did before taking it. (I have mild mitral valve pro lapse) I would like the benefits of this vitamin but worry about the amount and what it is doing to me. I cannot sleep as a result. I am going off it ,then will try the 90 mcg and see how that goes. What dose is essential and what about this side effect? Thanks

2014/09/10 at 12:53 am

Carol, a few people – I am aware of about 4 cases now – seem to have a sensitivity to vitamin K2 (possibly just MK-7, but this is not certain) that causes these symptoms. Lara Pizorrno writes about it in the 2nd edition of her book Your Bones. When I spoke to her about it she was only aware of one case. It isn’t common, but it sounds like your situation. When you go back on it take it less frequently, you may in fact need very little to get your levels up, or you could try an MK-4 product.

Carol Love
2014/09/10 at 8:36 am

Thanks so much for your swift reply!
From my reading, it sounds like the Vit K M-4 is not the same at the M-7 and does not work in a similar fashion. I was thinking of stopping the M-7 for a week or more, as it seems it takes awhile to be eliminated from the system (is this correct?), then try a 90 mcg and then another a few days later OR try the lowest dose I can find, 45 mcg. What do you think? I have osteopenia and do not want it to develop into osteoporosis.I eat properly and exercise almost daily, as well as play a lot of golf and do weights. I do take two calcium pills with D3, an Alive multi vitamin with 100 units Vit D3 , an additional D3 of 1000 units, and a cod liver oil pill daily. I thought the K2 would really help divert the calcium away from my arteries. I am anxious to hear from you once again. Thank you so much, Carol

Johanne Møldrup
2015/10/06 at 6:02 am

I had been taking adrenal glandular extract, and siberian ginseng for 2 month because of adrenal fatigue. Then I started to have a period of many extra heart beats shortly after going to bed. A little bit of execise seem to help. I stopped the adrenal glandular extract and the ginseng, of course, but hope to start with the AGE again. I am used to one or two extra beats when i am very tired, which I am every evening, Am going for a Holter Monitoring in November.
Johanne, Denmark

Anna Williams
2015/10/21 at 8:31 pm

Regarding menopause and waking in the middle of the night. Do you recommend a brand of supplement that includes the herbs listed above?

2015/10/26 at 10:56 am

Natural Factors Serenity Formula contains these herbs. I have seen good results with this product.

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