Sleep, rest, and hormones are interconnected in ways that many may not really understand. If you struggle to fall asleep, find yourself wide awake in the middle of the night, or if tossing and turning keeps you from getting the quality of sleep you need, you may find some valuable information below including practices and tips for how to get more consistent and deep sleep.

The 4 top most influential hormones we love to work with in the sleep/wake cycle are cortisol, melatonin, progesterone and insulin.

1. Cortisol

Cortisol is the main sleep/wake regulator, and is produced by the adrenal glands (small pyramid-shaped glands located on top of the kidneys). It generally begins to rise an hour or so before waking, which is an important role because it literally gets us out of bed and motivates us to start our day! Then, cortisol normally peaks around 2 hours after rising, and gradually falls through the day to a nighttime low level to facilitate sleep and recovery.

Stress, lifestyle habits and blood sugar fluctuations can significantly impact cortisol levels, which in turn impacts sleep. By the time we’re in perimenopause most of us have accumulated at least a couple of decades of stress so our cortisol balance and sleep can start to suffer as we move through our 40s and 50s.

If you want to go deeper on this one, read more from our cortisol-focused article here:

https://womensvitalitycenter.com/get-the-sleep-you-need-so-you-can-start-your-day-refreshed-and-ready-to-go/

2. Melatonin

The next major hormone that regulates our sleep-wake cycle is melatonin.

Melatonin has the opposite effect of cortisol, supporting onset of drowsiness and sleep. Like cortisol, melatonin is produced in a day and night pattern and responds to the amount of light coming into the eyes. Low light encourages melatonin production, whereas brighter light (including light from computers, cell phones and TV) suppresses it.

Tips for boosting melatonin: If you’re having trouble falling asleep and getting deep, satisfying sleep, try turning off your screens and dimming the lights in your home, including the bedroom and bathroom, for 2 hours before bed. You can even consider getting blackout curtains if you have light coming into your room at night. Conversely, if you’re having trouble waking up, we recommend opening your curtains, or ideally getting outside and exposing your eyes to bright light first thing in the morning. If you need to get up before the sun rises, turn on indoor lights or consider getting a lightbox if you’re feeling groggy in the morning. Being more “up” and alert in the morning helps to create the rhythm that helps you go “down” and get sleepy at night.

Melatonin has super powers! In addition to regulating sleep, melatonin has important anti-inflammatory and immune-regulating properties, and has been used supplementally to improve outcomes in various chronic conditions including endometriosis, MS, Alzheimer’s and cancer.

Contrary to popular belief, current research does not show supplemental melatonin suppresses our own natural production. We feel very comfortable recommending melatonin as support for sleep and antioxidant therapy, and can help our patients find a dose that is appropriate for them.

3. Progesterone

Progesterone is one of our favorite hormones! If the doctors at The Women’s Vitality Center had to choose a desert island hormone, it would be progesterone. So many times we’ve seen this one hormone turn women’s lives around literally overnight.

If you experience anxiety and sleepless nights (especially before menses), irritability, short cycles (periods coming more than once a month), spotting between cycles, or headaches or migraines, you may be low in progesterone.

Progesterone is produced by the ovaries after you ovulate. If you’re perimenopausal, aren’t ovulating every month, or having “weak” or suboptimal ovulations, your progesterone levels may suffer.

Why is progesterone important?

helps maintain a healthy uterine lining for implantation and pregnancy
counterbalances estrogen levels
supports brain and bone health
acts in the brain as a neuro-steroid, calming mood and supporting sleep

What can I do?

There are many things we can do to support healthy progesterone levels in the body, but rest assured that good nutrition and adequate rest and relaxation are always a part of the plan. Vitex, aka Chaste Tree Berry, is an herb that can also be helpful to regulate the cycle and encourage higher levels of progesterone, or you could simply take bioidentical progesterone itself. We love helping people figure out which hormones are most important for them to address via symptom tracking and lab testing, and progesterone is often one of the most immediately impactful on the quality of life for perimenopausal women.

4. Insulin

Insulin is the final of the four hormones we wanted to include in this conversation about sleep, and it truly is one of our most important metabolic regulators. As you may know, insulin delivers glucose from the bloodstream into the cell where it can be used for energy. When we eat a high sugar/high refined carb diet and blood sugar levels are routinely higher than optimal, we can develop insulin resistance (pre-diabetes) or diabetes. The rollercoaster of blood sugar ups and downs can disrupt sleep.

Conversely, disrupted sleep can also impact insulin sensitivity and blood sugar control. In fact, one night of poor sleep is enough to create insulin resistance the next day. Sleep deprivation has been associated with increased risk for diabetes, obesity, high blood pressure and heart disease, not to mention the short-term effects of fatigue, irritability, poor memory and cravings.

Therefore, one of the simplest and most effective strategies for sleep support is keeping your blood sugar stable. Regular meals with protein, fat and fiber are one of the keys to good sleep, believe it or not. If you fall asleep relatively easily, but often wake up again between 12-3 am, it’s possible your blood sugar is dropping overnight. Try having a small protein snack before bed – ie a hard-boiled egg, non-dairy, unsweetened milk with cinnamon and 1-2 scoops of collagen peptides, a small handful of almonds, and see how your sleep quality changes.

We hope this information supports you in nurturing your sleep. For those of us in perimenopause, disrupted hormones can kind of feel like the name of the game! With these targeted strategies for balancing hormones for your sleep we hope you will find your way to consistent, deep, nourishing rest.