Dr. Nicole Sundene, NMD
"I can't sleep. Why can't I sleep? Is it my hormones? What is the best natural cure for insomnia in women? Why is my husband snoring away and sleeping more soundly than me?"
Tracy M, Scottsdale, AZ
Insomnia for women is often related to hormone imbalance. Conditions such as menopause, perimenopause, hypothyroidism, adrenal fatigue, anxiety, depression and postpartum depression can all trigger sleepless nights. In menopause estrogen deficiency is the primary trigger for sleepless nights. In perimenopause, it is generally progesterone causing the patient to wake up at 3am and not be able to fall back asleep. Especially when women feel over-heated. If you are suddenly waking up at 1-3am and then unable to get back to sleep, you need to contact me for hormone testing!
Your husband is sleeping just fine while you toss and turn all night because men have a ton of testosterone in their tanks which converts to estrogen naturally as it is being detoxified by the body so they generally have at least 40 points of estrogen in their system. When women develop menopause their levels generally go lower than that and trigger insomnia, hot flashes, anxiety, negative mental health, and brain fog.
While I can certainly prescribe a bunch of bioidentical hormones, herbs, and supplements for insomnia, the best way to get a solid night's sleep for most of my female patients is to eat a properly balanced bedtime snack with lots of flaxseeds!
Flaxseeds especially can help when women need something natural and non-hormonal to help them sleep during menopause. A proper bedtime snack as I will discuss today along with proper hormone testing and balancing via herbal medicine and nutrition often is all women need to help them get a restful night's sleep.
Many of my menopause patients don't need much more than that. We do have to dose the flaxseeds to match the severity of symptoms. If a woman has severe hot flashes and thinks 1 tsp of flaxseeds will be sufficient that is the equivalent of taking a click of estrogen cream once a month and is simply not realistic.
Flaxseeds fail when not dosed high enough. Most patients need 1-2 Tbl per day but some will need 3-6 Tbl per day and other supporting herbs. Be sure to check in with your doctor around menopause and have your blood pressure, cholesterol and thyroid checked. While it is not always necessary for women to be on hormones for menopause they should still not neglect other basic blood chemistry that can be impaired by menopausal or perimenopausal changes.
While everyone always assumes I am going to give them an herb or hormone as a Hormone Doctor to help them sleep that will not always be effective if we are not addressing the Root Cause of the insomnia. While it is normal for women to occasionally have a night of missed sleep, many days in a row can trigger chronic fatigue, chronic pain, inability to concentrate, brain fog, anxiety, and depression.
Generally I see this daytime fatigue pattern results in my patient reporting they "Feel like a Zombie" and no longer having the energy to exercise which is critical for proper sleep, and the pattern just worsens due to lack of physical and mental exercise the brain needs each day to feel tired enough to sleep.
Often retired patients struggle with this because they are no longer working and while they may have the time to exercise, they are deficient in enough brain exercises to "wear out their brains for sleep" and need to do some crossword puzzles, Jeopardy, reading, or Sudoku to give their brain a work out.
While I don't recommend eating a big meal right before bed, I do recommend some of the following healthy bedtime snacks for better sleep.
Only 200-300 calories for your snack is required. Otherwise, food just “sits there” and doesn’t optimally digest when we are inactive, as the peristaltic contractions of our gut are enhanced by exercise and movement. Still some people insist they can’t sleep without a bedtime snack. I actually might argue that some people might NEED a bedtime snack. Those that struggle with low blood sugar issues or “hypoglycemia” typically wake up in the middle of the night because of it.
Once awake, they can’t get back to sleep, and can’t figure out why.
I see insomnia as three different tedious breeds. There is the insomnia typically caused by stress when you can’t fall asleep (Adrenal Fatigue.) The insomnia when you wake up in the middle of the night and can’t get back to sleep (Estrogen and Thyroid Deficiency), and the insomnia that wakes you up much earlier than the actual time you care to start your day such as in Progesterone Deficiency.
You can also be amongst the “lucky ones” and have a combo pack of the three. This unlucky triad is typically the result of high stress, daytime inactivity, alcohol, too bright of a bedroom, and low blood sugar.
The best bedtime snacks are high in protein, fiber, complex carbs, minerals, and the amino acid tryptophan. To ensure a good night’s sleep, be sure to eat a light snack about 90 minutes before your anticipated bedtime. Shoot for 8:30pm if you typically go to bed around ten.
In the presence of carbohydrates, the amino acid tryptophan is able to pass the blood brain barrier, where it is then made into serotonin (the neurotransmitter that makes us happy) and in a dark atmosphere serotonin then converts to melatonin (the hormone that makes us sleepy). Boosting serotonin levels is also beneficial for those with anxiety or depression.
The WORST bedtime snacks for women are: #1 Alcohol #2 Sugar/Candy/Carbs #3 Toast
Remember that alcohol especially red wine causes women to have hot flashes which interfere with sleep as well as impact blood sugar which also interferes with sleep. Hypoglycemia is the enemy and that is exactly why women need a healthy bedtime snack designed to balance their blood sugar, neurotransmitters, and hormones.
If you have menopausal hot flashes keeping you up at night you might especially benefit from the ground flaxseeds as the lignans have a phyto-estrogenic effect, and the omega-3 oils are very important for ensuring hormonal imbalance as I disscuss more in my "Naturopathic Favorite Things" blog.
If you are going nuts from insomnia, nuts just might be the answer as they are high in protein, fiber, and minerals. Eat RAW nuts and raw nut butters to avoid the rancid fats that develop in the roasting process. Roasting turns the biochemistry of nuts into nasty rancid fat that pack on pounds, trigger hormonal acne, and clog our arteries. Raw nuts such as peanuts and cashews in moderate quantities are a great treat to keep on hand.
The healthiest foods highest in tryptophan are: Cottage cheese, peanuts, salmon, cashews, halibut, shrimp, granola, oatmeal, avocado, turkey, cheese, milk, wheat germ, eggs, collard greens, raisins, chicken, yogurt, sweet potatoes, and spinach.
Try giving up dessert for a week or two, and see if that helps. Substitute one of the health bedtime snacks below. Most night-time waking in my patients I find is caused by low blood sugar, because Americans commonly eat a sugary evening dessert that jacks their sugar up super high right before bed. As we sleep the sugar then comes crashing back down. The body always wakes us up to alert us of these kinds of imbalances.
Keep in mind that excess fluids before bed also wakes us up, so ultimately it is best to not have any food or drink at least 90 minutes before bed. The older you are, the more you may need to restrict your evening fluids to ensure you don’t need a night-time trip to the restroom. Just be sure you drink up upon waking and stay hydrated throughout the rest of the day.
The ultimate recipe for success is pairing light proteins such as vegetable proteins, turkey, and white cheeses with a high fiber friend such as a fruit, vegetable, or a whole grain choice. These foods also are typically rich in calcium and magnesium, minerals that serve to relax the nervous system and alleviate muscle tension.
THE FORMULA FOR SUCCESS:
Protein + Fiber + Good Fat + Good Carbs + Minerals= Perfect Sleep!
Using these basic rules of biochemistry, I have craftily put together a list of snacks that should induce relaxation as well as ensure proper blood sugar. The last one is what I personally have for my bedtime snack every night. Enjoy!
The Best Bedtime Snacks for Female Insomnia:
Additional Sleep Tips for Women:
Thank you for the great Naturopathic Women's Health questions. Please continue to send them to me on a postcard to my address below. Remember if your Naturopathic question can't fit on a postcard then you need to BOOK A VISIT!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!