them to pour on the stress hormones, even though you need to be up at six. And there you are, wide awake and staring at the ceiling at 2, 3 and 4 a.m., tired already at the thought of dragging yourself through the next day, but unable to quiet your mind and rest. Even if you don’t awaken, this out-of-kilter feedback loop of high night-time cortisol interferes with your ability to access restorative REM sleep, where you dream and process psychic material from your day; it also opposes the secretion of growth hormone, which in adults permits tissue repair and regeneration – leaving you unrested and unrejuve- nated on every level. Why for many women do sleep issues begin or worsen during
menopause? The answer may lie in the fact that these brain cen- ters mentioned above, the hypothalamus and pituitary gland, are “command central” for our hormone systems, and they are work- ing hard during the perimenopause, receiving feedback from the ovaries about lowered hormonal output and sending out stimulating hormones (Follicle Stimulating Hormone and Luteinizing Hormone) in higher amounts as a response to the under-functioning ovarian situation. In fact, it’s thought that the mechanism of hot flushes/night sweats may relate to stimulation of temperature regulating centers in the hypothalamus, possibly as a side-effect of all this heightened communication to and through the hypothalamic and pituitary areas – “static” along the nerve pathways acting as a trigger for a hot flush. A similar mechanism may be a factor in menopausal sleep issues too – but what is being stimulated in this case is hyperactive, excessive and inappropriately timed stress hormone secretion by an already overworked, “trigger-happy” brain control center.
Running on Empty Menopausal women often drag themselves into my office, hol-
low of eye and haggard of face, after weeks or months (or occasion- ally years) of sleep deprivation which began or intensified during the perimenopause. It is a testament to their endurance and inner strength that they continue to function at a high level in their lives, meeting the needs of family, work and community, despite their state of deep exhaustion. It may also be a testament to our cultural and in- dividual tolerance of demands on women’s energy which can verge on inhuman, and to the multiplicity of roles in many women’s lives which contributes to their richness but which can also encourage a state of chronic overdrive.
The perimenopause is the time when underlying adrenal ex- haustion and the negative effects of long-term, unhealthy patterns of behavior begin to reveal themselves, like an iceberg rising out of the ocean. And like an iceberg, there’s a lot hidden beneath the surface – chronic lifestyle habits that drain reserves; ways of relating to oth- ers that facilitate over-commitment and diminish self-care; energetic and emotional wounds of longstanding, often stemming from child- hood, that over stimulate the adrenals by triggering a chronic stress response. These hidden vulnerabilities begin to emerge when the hormonal ebb and flow of perimenopause reveals them. This is also a time when the circumstances of life can conspire to create more than the usual burden of stress on us and our adrenals - the demands of growing children (teenagers!), aging parents, work and home - the “full catastrophe” of life, in the words of Zorba the Greek, a character in Nikos Kazantzakis’ novel of the same name.
An Invitation to Heal
Uncomfortable though some of its manifestations may be, the menopause is an invitation to heal those elements in our past life experience that no longer serve us, to do the deep work which true healing requires, and to move into the postmenopausal phase of life more healthy, more whole, and more fully ourselves, with more to offer to ourselves and others. Viewed from this perspective, the peri- menopausal phenomenon of impaired sleep is an opportunity to do important work of self-care and lifestyle change to heal the adrenal imbalance underlying disturbed sleep.
First Aid for Better Sleep
If you are a perimenopausal woman who has “hit the wall” of exhaustion because of lack of sleep or poor quality sleep, you’re des- perate for a better night’s rest. Most of the suggestions which follow directly or indirectly influence stress hormone levels and the balance of brain chemicals affected by adrenal stress hormones. These are “rapid response” natural sleep assists which are not addictive, but which augment the ways in which your brain naturally prepares you to go to sleep and stay asleep.
• Gamma amino butyric acid (GABA or 5-hydroxy GABA): this amino acid is one of the most effective sleep promoters. A calming neurotransmitter which your brain uses to balance the stimulating
18 Natural Nutmeg
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