"Unless you give your body the right amount of sleep, you will never, I repeat never, have the body and life you want to have", Shawn Stevenson, Sleep Smarter (2).
I was desperate and did not know where to start when I suffered from perimenopausal insomnia. I had never been around women who openly shared about their experiences of midlife. I had to learn how to cope and survive insomnia while going through it. In this article, I will share the simple dietary changes I made that continue to support my sleep.
The root causes of insomnia are many. A February 2019 WebMD article that provides "An Overview of Insomnia" identifies significant life stress, environmental factors, some medications, and interferences in our normal sleep schedule as some of the main causes of insomnia. In his book, The Sleep Doctor's Diet Plan: Lose Weight Through Better Sleep, Michael Breus writes: "The reality is that women face different situations in life that cause their weight gain - ranging from ongoing family or career stress to ignoring the importance of daily exercise to hormonal changes at midlife that pack on the pounds - and most will have a hard time reversing that weight gain .... I have discovered that there is a 'missing link'. That missing link is proper and adequate sleep [emphasis in original]" (4-5).
Therefore, I had to learn how to tame insomnia because for a while, it seemed to ignore the clues that I was ready for it to go and leave me alone. Insomnia, to me is on top of my list of wellness enemies. I could not talk myself out of it nor could I make any plans with it. Insomnia will not share its schedule with you, and it may be around for a while. And you may be wondering, what does "a while" mean exactly? A week? A month? A year? Longer? There is no easy answer, because every woman's experience of it is different. What I do know is that with midlife insomnia, anything is possible. It can last a year, or five, or even longer. "... [H]ot flashes occur in 60-80 percent of women during the menopausal transition and persist for 4-5 years on average. When hot flashes occur during the night, they frequently but not invariably awaken women from sleep," say Martica Hall et.al. in the online article referred to above.
My doctor told me that some women still suffer from night sweats and other menopausal symptoms through their 70s. I did not want to ask if that meant that insomnia could also continue until then as well. What if it did? I did not want to hear it! My hope was that this would not be the case for me. Oh, how I wish I had inherited my mom's genes! She once told me that she never had any trouble sleeping through the night. Perhaps she was referring to that particular season when I asked her the question about the quality of her sleep. Somehow, I cannot imagine that with all the stress in her life, she never experienced sleep problems. But who knows, and why question what she believed to be true?
I chose foods over sleeping pills because I have learned from experience that drugs have side effects that can be worse than the ailment I am trying to treat. Sleeping pills such as Zaleplon, Eszopiclone, Ambien or Lunesta, are known to be effective in treating acute insomnia but "…tolerance, withdrawal, dependence, and rebound insomnia” might be the end result after discontinuing them, according to Martica H. Hall, Christopher E. Kline, and Sara Nowakowski in a 2015 article on "Insomnia and Sleep Apnea in Midlife Women".
However, I knew that not sleeping well for an extended period of time has its side effects that I would want to avoid as well. So, I embarked on a long journey of trying to understand midlife and all the changes that women experience as they go through perimenopause. A disruption in sleep patterns is one of those changes. This search led me to appreciate sleep better than I previously did. In fact, I had taken it for granted because it used to come naturally. Not in perimenopause though. All hell broke lose for me. I was desperate to figure out what I could do to recover from insomnia. I knew that I could not survive without adequate sleep. In fact, sleep is essential for giving one a body that feels and looks good. “Sleeping well is the first step to living well,” notes the UCLA Sleep Disorder Patient Education page. Yet, insomnia affects as many as fifty percent of midlife women. How fortunate are the other half spared of this disaster? And insomnia has many side effects on physical, mental and emotional wellbeing.
The National Sleep Foundation (NSF) states on its website that “nearly 40 million American men and women suffer from sleep disorders." This means that nearly 10 percent of US population is not able to get proper sleep on a daily basis. The NSF adds that "sleep problems affect more women than men" in an article on "Women and Sleep." Insomnia is "an extremely common symptom of perimenopause", writes Cathy Garrard in a 2018 article on "10 Ways to Beat Menopausal Belly Fat."
In my case, since I was aware that the transition through perimenopause was part of the natural process of aging, I waited with the hope that in due time, my body would respond naturally to the diet and lifestyle changes I continued to make. So, I continued to educate myself and to apply whatever I learned because I knew that not doing anything was only going to compound the many side effects of insomnia on me. The dietary changes I have made that contributed to my recovery from midlife insomnia and continue to work to promote quality sleep today are:
Drinking enough water for my weight: I drink as much as or a little more than half my body weight in ounces of water. I have developed the habit of drinking a large glass of water first thing in the morning and then drinking the rest throughout the day to stay hydrated. When I wake up in the middle of the night, dehydration keeps me awake. Drinking even a little bit of water helps me fall back to sleep. When I drink enough throughout the day, I generally do not feel dehydrated at night and can sleep till early in the morning. Drinking water and embracing the rest of dietary steps that I outline below, I am able to achieve better quality sleep at night.
Eating to support stable blood sugar levels: To keep blood sugar stable, I try to eat before I feel too hungry and too weak from an empty stomach. I choose food carefully to prevent blood sugar hikes and that will be followed by a blood sugar crash whether during the day or at night. This is the reason why I manage my carb intake and serving sizes carefully. I alternate between different complex carbohydrates such as quinoa, brown rice, butternut squash, cassava, green bananas and sweet potatoes.
I make every effort that I can to eat three balanced meals to satisfy me without the need to snack between meals or before bed. Not eating enough can interfere with sleep. The UCLA Sleep Disorder Patient Education page summarizes it well: “Hunger from an empty stomach may keep you from falling asleep. It may also wake you later in the night” Others, including Michael Breus agree. In his 2017 blog post on the “Ideal Home Sleep Environment”, Breus states that "[i]f you're hungry at bedtime, you will have a harder time falling asleep thanks to the stimulating effects of the hormone cortisol, that your body will release. You're better off having a small snack ... that is no more than 200 calories .... Combine a small amount of protein … with a complex carbohydrate"
And I try not to skip meals, unless I have chosen to go on an intermittent fast, which means that I eat all the calories I need over an eight-hour period and fast the rest of the time. Skipping meals is not the best way to sleep better at night. It can create the opposite effect in fact and contribute to weight gain. When you skip meals, your blood sugar decreases, which stimulates cortisol (from the adrenals) to increase and it "turns body tissues (muscles from legs, buttocks and arms) into sugar fuel .... if this sugar is not completely burned up, it will be changed into fat and specifically deposited around your vital organs in the abdomen" (Berg 132).
Prioritizing dark leafy-greens, rich in several sleep-inducing vitamins: These are nutrient dense foods that support sleep. Dark leafy greens are high in potassium, magnesium and zinc as well as several of the B vitamins, which complement each other to promote sleep. Insomnia requires a higher intake of certain vitamins that are known to either help improve sleep or protect the body from harmful side effects of lack of adequate sleep. The B vitamins, as well as vitamins C, D, and E, are among those that are necessary for quality sleep and/or for minimizing side effects of poor sleep, according to Michael Breus in his blog post on "5 Vitamin Deficiencies that Can Affect Your Sleep." I eat a large serving of cooked leafy greens, such as spinach, spring greens, Swiss chard, kale, arugula, or any other local greens I can find.
Eating foods rich in Vitamin C: Crucifers such as broccoli, cabbage, Brussels sprouts, and cauliflower are among such foods. Broccoli is high in vitamin C. In fact, 1/2 a cup of cooked broccoli supplies about 50 milligrams of Vitamin C, according to WebMD in an article, "Foods with Vitamin C Besides Oranges." WebMD adds that women need about 75 milligrams of Vitamin C per day. Cruciferous vegetables are also known for their support in balancing hormones as well as helping to detoxify the liver.
Kiwi has also become one of my main sources of vitamin C. We hear often that "an apple a day will keep the doctor away" but we don't hear as much that kiwi offers similar benefits, if not more. In an article posted on the healthline.com website, the benefits of kiwi are succinctly summarized. These benefits include supporting digestion and preventing constipation due to its high fiber content, boosting the immune system with its high vitamin C content, managing blood pressure as well as protecting your eyes from vision loss. Vitamin C is therefore important for many health benefits it offers, one of which is promoting quality sleep.
Supplementing with fermented vegetables or a probiotic: Fermented vegetables and probiotics help to digest fats better, and support regular bowel movements. When II generally take less than the recommended dosage because I can never be certain that supplements have no side effects. Nonetheless, I know that any help I can give to my digestive system supports sleep as well. Generally, I take a probiotic only when I do not have access to fermented vegetables. Otherwise, I rely on real foods as much as I can.
Adding lean protein to each meal: I try to have a serving of protein with each meal. Two eggs in the morning, one to two chicken legs, or a serving of a lean cut of beef (about 4 ounces) are what works best for me, especially for lunch or dinner. Almonds and an apple are a quick grab and go breakfast that keep my blood sugar stable until lunch. These lean proteins keep me full and protect me from a quick drop in blood sugar that would come from eating mostly carbs, unless I am precise in the amount I consume to not exceed my immediate needs for energy. I eat beef much less frequently, limiting it to once a week or even once every two weeks because it is higher in saturated fat and it is harder to digest. I avoid beef especially at night. Generally, meat is harder to digest at night when the body needs all the energy to focus on sleep and not digestion. That is why I try to have a bigger lunch and a smaller dinner as often as I can, as well. Fatty fish such as salmon and sardines are, however, good sources of Vitamin D and Omega-3 fatty acids that promote sleep. A serving of fish (about 4-6 ounces) helps.
Prioritizing vitamin D-rich foods and taking a supplement: I eat sardines and salmon regularly because both are good sources of Vitamin D, which support sleep. In the summer months in particular, I spend time outside when the sun is out. Doing this helps to activate Vitamin D, which triggers production of serotonin, a precursor for melatonin. "Vitamin D affects both how much sleep we get and how well we sleep," writes Michael Breus in his 2019 blog post on "5 Vitamin Deficiencies that Can Affect Your Sleep." I take liquid vitamin D3 under my tongue regularly as well to support my body to produce the right sleep hormones. I started taking Vitamin D3 to address a diagnosed vitamin D deficiency, not knowing then that it also would benefit sleep.
You can get other suggestions on how to improve sleep in this article. In my book, Belly Fat in Midlife: Practical Steps to Revitalize Your Changing Body, you will also find a lot of additional suggestions that will guide you on ways to improve sleep and even recover from midlife insomnia.
Sleep Well, Be Well.
Rose Kadende-Kaiser, Ph.D./
Integrative Nutrition Health Coach.
Berg, Eric. The 7 Principles of Fat Burning: Get Healthy, Lose Weight and Keep It Off. KB Publishing, 2010.
Breus,Michael. "Ideal Home Sleep Environment." 14 March 2017, https://thesleepdoctor.com/2017/03/14/ideal-home-sleep-environment/. Accessed 29 March 2020.
Breus, Michael. "5 Vitamin Deficiencies that Can Affect Your Sleep.” 12 February 2019, https://thesleepdoctor.com/2019/02/12/5-vitamin-deficiencies-that-can-affect-your-sleep/. Accessed 29 March 2020.
Breus, Michael, with Debra Fulghum Bruce. The Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep. Rodale, 2011.
Garrard, Cathy. "10 Ways to Beat Menopausal Belly Fat." 6 September 2018, https://www.everydayhealth.com/menopause-pictures/ways-to-beat-menopausal-belly-fat.aspx. Accessed 28 March 2020.
Hall, Martica H., Christopher E. Kline, and Sara Nowakowski. “Insomnia and Sleep Apnea in Midlife Women: Prevalence and Consequences to Health and Functioning.” 26 March 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447062/. Accessed 28 March 2020.
Healthline. "7 Health Benefits of Kiwi." https://www.healthline.com/health/7-best-things-about-kiwi. Accessed 29 March 2020.
Stevenson, Shawn. Sleep Smarter: 21 Essential Strategies to Sleep Your Way to a Better Body, Better Health, and Bigger Success. Rodale, 2016.
National Sleep Foundation. "Women and Sleep." https://www.sleepfoundation.org/articles/women-and-sleep. Accessed 28 March 2020.
UCLA Sleep Disorder Center. “Sleep and Health.” https://www.uclahealth.org/sleepcenter/sleep-and-health. Accessed 28 March 2020.
WebMD. "Foods With Vitamin C Besides Oranges." https://www.webmd.com/food-recipes/ss/slideshow-vitamin-c-sources#:~:text=Broccoli,seem%20to%20keep%20inflammation%20down. Accessed 30 November, 2020.