Still not sleeping well? Make melatonin part of your daily routine.

Woman stretching after a good night’s sleep

By Dr. Mary James, ND

Sleep is something we all took for granted when we were younger. It just seemed to happen naturally, right? But as we move into middle age, many women spend too many of those night hours feeling anxious, uncomfortable and wide awake.

If you suffer from insomnia and are worried about the side effects of “sleeping pills,” here’s how you can reset your sleep cycle naturally.

Why is insomnia so common in menopause?

One key reason for sleep disturbance after age 35 involves changes in an important hormone called melatonin. Melatonin prepares the body for sleep. As the sun goes down, melatonin is supposed to rise, triggering a shift in our circadian rhythms and the drowsiness that begins the sleep cycle.

Among all the other shifting hormones in perimenopause and menopause, melatonin production can drop, leaving women awake at night, tired in the morning and unable to concentrate during the day. This is made worse by our exposure to artificial light, especially the blue light of all the screens many of us watch at night. Stress hormones can also suppress melatonin production — one of the reasons that stress interferes with sleep.

There are many other reasons for insomnia during perimenopause and menopause. With the shifting of estrogen, progesterone, and testosterone, many women experience vasomotor symptoms like hot flashes, night sweats, and heart palpitations. These symptoms can suddenly wake women out of a deep sleep during the night and make it difficult to get back to sleep.

Are you throwing off your internal calendar?

Melatonin keeps your sleep on track by signaling the time of day and time of year to all of the cells in your body. The hormone is released by the pineal gland in the brain, which is regulated by the suprachiasmatic nucleus (SCN). This complex relay between brain and body is set off by darkness and light.

In other words, when your surroundings are dark, your SCN sends a message to your pineal gland to release melatonin and prepare your body for sleep. But with light — from your cell phone or computer or the streetlights in your neighborhood — this sequence is blocked.

Low melatonin levels are also connected to many other states of health and disease, such as cancer, fibromyalgia, depression and bone loss. So, rebalancing melatonin can benefit your body on many levels.

Woman falling asleep during the day

Boost your melatonin naturally

You can boost your own melatonin naturally by lowering lights and shutting down your electronic devices two hours prior to going to bed. This signals to the SCN that it is time to release melatonin and get the body ready for sleep. During daylight hours, try to get some exercise and expose yourself to natural sunlight by spending time outside or near a bright window. When it’s time for sleep, make sure your bedroom is cool, dark and free of electronics.

Unfortunately, for some women in menopause, these simple changes might not be enough.

Supplementing with melatonin: how much, and for how long?

Even if other sleep aids have failed, melatonin supplements can be a safe and effective way to reset your sleep cycle naturally during the menopause transition. In fact, studies show that menopausal women treated with melatonin reported improvements in mood, depression and sleep.

I recommend taking a low dose of melatonin one to two hours before going to bed. Very low doses (0.3-1.0 mg) are often the most effective. In 2004, MIT researchers found that the higher-dose commercial melatonin products weren’t as effective as lower doses for sleep disturbances. When receptors in the brain are exposed to too much of the hormone, they tend to be less responsive.

Try a low-dose supplement of melatonin for one to two months and then take a break to see how your sleep is. You might just need melatonin for a while to reset your body’s sleep-wake cycle. Deep restorative sleep — the kind that came naturally in your younger years — is still possible!

What are the top five causes of insomnia?

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Bellipanni G, Di Marzo F, Blasi F, Di Marzo A. Effects of melatonin in perimenopausal and menopausal women: our personal experience. Ann N Y Acad Sci. 2005;1057:393–402.

Amstrup AK, Sikjaer T, Mosekilde L, Rejnmark L. The effect of melatonin treatment on postural stability, muscle strength, and quality of life and sleep in postmenopausal women: a randomized controlled trial. Nutr J. 2015;14:102–102.