The New York Times just ran an article on the benefits of estrogen and the controversial issues surrounding better control of menopause symptoms vs. future cancer risks. I wrote a lengthy reply to comment on the Well Bog, but evidently, I’ve been blacklisted! None of my comments are showing up on any the the Well Blogs. I decided to place it here instead:
I frequently see young men with hot flashes, night sweats, moods swings, insomnia, and irritability. No, they’re not going through menopause—but they’re slowly gaining weight, experiencing a relative change in their involuntary nervous system. The involuntary nervous system is what controls, temperature, sweating, blood pressure, heart rate, digestion, etc.
Women with smaller jaws and dental crowding are more likely to suffer the effects of menopause due to smaller upper airways.
Progesterone is a powerful upper airway muscle dilator—it actually tenses your tongue muscle. As progesterone slowly drops in a woman’s early 40s, the tongue can fall back easier in deep sleep due to muscle relaxation. This leads to more frequent obstructions and arousals. Studies have shown that women wake up from breathing pauses, and not from night sweats (the same reason as waking up to go the the bathroom). As you slowly gain weight, the fat cells in your throat begin to narrow your already narrow airway even further, preventing you from getting deep sleep.
Here are 10 tips for menopausal women to improve your sleep:
1. Most women with these issues naturally prefer to sleep on their sides or stomach. However, if you do sleep on your back, switch to your side.
2. Don’t eat or snack within 3-4 hours of bedtime. Excess stomach juices can be suctioned up into your throat, waking you up more frequently.
3. Avoid alcohol within 3-4 hours of bedtime. Alcohol relaxes your muscles.
4. Over-optimize your nasal breathing. Try nasal saline irrigation before bedtime, and try nasal dilator strips (Breathe Rite), especially if you have flimsy nostrils. Nasal congestion aggravates tongue collapse downstream.
5. Practice yoga, tai chi, meditation, or any other discipline that promotes relaxation.
6. Sing. Exhalation is activated by your parasympathetic nervous system. The more time you spend breathing out, the longer you’re stimulating the relaxing half of your involuntary nervous system. You can also play a wind instrument, hum, or whistle.
7. If you snore, or if one of your parents snore, get checked for sleep apnea. Even if you don’t snore or are thin, you can still stop breathing often. Gaining even a few pounds can uncover sleep apnea.
8. Oral appliances that advance the lower jaw forward can help some women. There are a variety of inexpensive over-the-counter devices (usually for snoring), as well as more formal appliances made by dentists.
9. Working with your doctor, consider over-the-counter bio-identical progesterone creams.
10. If you must sleep on your back (due to pain, discomfort or other reasons), use a contour pillow or a roll-type husk-filled pillow. These pillows tilt your head back slightly, which can open up the space behind the tongue.
If you have some time, perhaps you could relay this valuable information to Tara Parker-Pope in the New York Times Well Blogs in response to her post on estrogen. Thanks.