Sleep: When Rest Stops Being Restorative

There was a time when sleep was simple. I went to bed. I slept. I woke up.

I really didn't appreciate what a marvellous arrangement that was.

Then menopause arrived.

For me, it wasn't a gradual transition that I recognised at the time. With hindsight, I can see that perimenopause had quietly been making itself known for years, whilst Menopause itself was considerably less subtle.

The hot flushes came thick and fast and sleep pretty much disappeared with them.

And when I say sleep disappeared, I don't mean the occasional bad night. I mean the kind of disrupted sleep where you begin the next day already running on empty, then do what so many women do...

Carry on.

I had a business to run. Animals to look after. Responsibilities. Life.

So, I pushed through.

It was only later, when other things started unravelling, that I began joining some of the dots.

My body wasn't recovering the way it once had. An injury that I expected to settle didn't. I was tired. Stiff. Achy. My skin behaved differently. And stress seemed to have found it’s fifth gear also.

At first, these things all seemed separate.

Over time, through my work with skin and the experiences women were sharing with me in the clinic, I began to understand that perhaps they weren't.

Sleep doesn't sit in its own little box

This is something I've written about before. I had already learnt that skin doesn't change majorly because of one minor thing. Neither, it turns out, does much else.

Further study taught me our hormones, nervous system, immune system, metabolism, muscles, connective tissue, brain and skin are not operating as independent little departments that occasionally meet for morning tea.

They talk to one another constantly. And sleep is part of that conversation.

While we're asleep, the body isn't simply switched off. Sleep supports immune regulation, tissue maintenance and repair, metabolic regulation, memory and brain function.

Our circadian rhythm also helps coordinate the normal rise and fall of hormones and other biological processes across approximately 24 hours.

Deep sleep is associated with the release of growth hormone, which plays an important role in tissue maintenance and repair.

Then there are cytokines. These are signalling proteins used by the immune system, including in the regulation of inflammation. When sleep is repeatedly disrupted, inflammatory signalling can change and levels of some pro-inflammatory markers can rise.

In other words, poor sleep doesn't simply make us tired. Poor sleep can affect the very systems we're relying upon to recover. And that's the part I wish I'd understood much earlier.

Then there's cortisol...

Cortisol often gets described as the “stress hormone”, which makes it sound like something we should be trying to get rid of.

We shouldn't. We need it.

Cortisol normally follows a circadian rhythm, generally rising towards morning to help us wake and becoming lower towards night as the body prepares for sleep.

The problem is not cortisol itself. It's when our normal rhythms become disrupted by things such as chronic stress, irregular sleep and repeated night waking. And midlife can provide a fairly spectacular combination of all three.

Hormones are changing. Hot flushes and night sweats may wake us. Our brains can suddenly decide 3.17am is the perfect time to revisit something embarrassing we said in 1996.

Meanwhile many women are carrying work, families, aging parents, relationship changes, financial pressures and the general mental load of keeping everybody's lives functioning.

The nervous system doesn't necessarily receive a lovely clear message saying:

“All good. You can switch off now.”

And without enough restorative sleep, the following day starts with less in the tank.

My more recent study into Menopause Coaching, hasn't suddenly revealed to me that midlife affects the whole body. My own body had already taught me quite a lot about that. So had nearly four decades of working closely with women.

And my work as a Hairdresser, Skin Therapist and Cosmetic Formulator had already taught me to look beyond what I could see on the surface. I had seen what happened to skin when stress became chronic, sleep deteriorated and inflammation lingered.

I had already written about the relationship between hormones, the nervous system, inflammation, recovery and skin, including in ‘When The Rhythm Of The Body Changes’.

What my more recent study has done is add another layer.

Completing my Certification and, more recently, further study in Menopause & Joint Health has taken me beyond the skin and encouraged me to look more closely at how these same connections can affect the whole woman.

And somewhere along the way, my curiosity became a little bigger.

Not just ... “What is happening to our skin?”

But ... “What is happening to us?”

And perhaps more importantly ... “What can we reasonably do to support ourselves through it?”

So where do we start with sleep?

Probably not by just trying to create the world's most perfect bedtime routine.

There are some very ordinary places worth looking at first.

Our bodies like rhythm, so reasonably consistent sleeping and waking times can help support our circadian rhythm.

Light matters. Getting natural light during the day, particularly earlier in the day, helps provide timing signals to that internal clock.

Caffeine is worth considering too. It can remain active in the body for hours, so sometimes that afternoon coffee is less innocent than it looks.

Alcohol may make us feel sleepy initially, but it can disrupt sleep later in the night.

Bedroom temperature matters, particularly when our own internal thermostat has become somewhat unreliable.

And then there's what happens before we get into bed.

Going directly from emails, work, television, scrolling, worrying and mentally organising tomorrow into RIGHT, SLEEP NOW isn't necessarily much of a transition.

Sometimes a slower evening rhythm helps. Less stimulation. Gentle stretching. Reading. Belly breathing. A guided meditation. Whatever gives your body a little indication that the day's demands are coming to an end.

Not every suggestion will suit every woman. And not every sleep problem can be solved with lifestyle changes.

Persistent insomnia, significant snoring, gasping or breathing pauses during sleep, restless legs, or sleep problems that are seriously affecting everyday life deserve proper medical assessment.

If hot flushes, night sweats, mood changes or other menopause symptoms are contributing, they're also worth discussing with an appropriately qualified healthcare professional.

What I understand differently now

I used to think rest was what happened when I'd finished everything else.

There's a slight flaw in that system … everything else is never finished.

What I'm understanding now is that sleep and recovery aren't luxuries we earn once the work is done. They're part of how the body remains capable of doing the work in the first place. Perhaps that's why sleep feels like the right place to begin this next part of my own wellness journey. Not because I've suddenly discovered it on a course, but because I've lived what happens when it disappears.

I've researched it. I've written about pieces of it. I've watched some of those same patterns play out in women sitting in my clinic. And now further study is helping me put more of those pieces together.

I'm still exploring where this new direction may take me professionally. But whether it eventually becomes another service or simply makes me better at the work I already do, I'm learning something I wish I'd understood years ago.

Sometimes supporting the body isn't about asking it to do more. Sometimes the first thing it needs is enough opportunity to recover.

And that starts with sleep.