Sleep hygiene refers to the habits you adopt in order to have a quality sleep, which allows you to rest properly and feel refreshed when you wake up. It includes everything from bedtime to eating a balanced diet (1). 

Undoubtedly, this is a very important aspect of daily life. Poor sleep quality negatively affects concentration and mental performance. It also increases the risk of chronic diseases (2). Good sleep hygiene, on the other hand, contributes to several functions of the body. While sleeping, the body repairs damaged tissues, strengthens memory and regulates the immune system and hormone secretion (3). 

Why is sleep hygiene important in menopause?

During menopause, many women experience sleep disorders. This is largely due to the hormonal changes of the stage (4). The decrease in oestrogen and progesterone affect rest, as both hormones play a key role in sleep regulation. Therefore, their imbalance can result in insomnia or frequent nocturnal awakenings (5). 

During menopause, symptoms capable of altering good rest also appear. For example (4): 

• Hot flushes. 

• Night sweats. 

• Muscle aches. 

• Episodes of anxiety. 

Establishing a correct sleep hygiene during this stage reduces the risk of developing some health problems. Especially those that are more associated with menopause, such as cardiovascular diseases, type 2 diabetes and obesity (5). 

Approaches to improve sleep hygiene 

Fortunately, there are some habits you can easily incorporate to improve your rest (1,6): 

• Establish a regular routine: try to go to bed and get up at the same time every day. Even on weekends. 

• Create an inviting bedroom: your bedroom should be dark and quiet at night. It is also important that you consider the temperature of the room, as it should not be too cold or too hot. 

• Limit exposure to screens before bedtime: try not to check your cell phone, use the computer, or watch TV at least one hour before bedtime. 

• Exercise during the day: physical activity is associated with a better night's rest. However, avoid intense movements from dusk onwards. 

• Balance your diet: limit caffeine and alcohol, which are stimulants and affect rest. Also, prioritise fruits and vegetables in your dinners, which are easier for your gastrointestinal system to digest. In the same vein, probiotics and prebiotics may help (7,8). 

In addition to the strategies for improving sleep hygiene discussed above, it is helpful to manage your menopausal symptoms. You should look for ways to cope with hot flashes, episodes of anxiety, muscle and joint pain, and loss of appetite. All these circumstances affect your rest indirectly (4). 

Relaxation techniques for better rest 

Besides the above strategies, there are other very useful tools. These are meditation and deep breathing techniques, which are effective in improving the quality of your night's rest (1). 

Meditation is a practice to seek a state of calm that helps reduce stress and limit intrusive thoughts. There are different types of meditation to apply at night. You can opt for mindfulness, body scanning, or variants of yoga (9). 

Another alternative is diaphragmatic deep breathing, which can be combined with meditation. It consists of breathing slowly and with amplitude, so that each inhalation and exhalation expands and expels as much air as possible (9). To perform it, try the following (9): 

• Lie down on the bed, close your eyes, place one hand on your chest and the other on your abdomen. 

• As you inhale through your nose, feel how your abdomen expands, but the thorax remains still. 

• Now, exhale slowly through your mouth and let all the air out. Try to keep the chest hand still and the pressure coming from the abdomen. 

• Repeat several times. 

Incorporating meditation and deep breathing, as well as sleep hygiene strategies, can make a big difference in the quality of your rest. However, what works for one person may not work for another. If your sleep disorders persist or worsen, it is critical that you seek professional guidance. 

Referencias bibliográficas 

1. Suni E, Rosen D. Mastering Sleep Hygiene: Your Path to Quality Sleep [Internet]. Sleep Foundation. 2024 [cited 2024 Jun 7]. Available from: https://www.sleepfoundation.org/sleep-hygiene

2. National Heart, Lung, and Blood Institute. What Are Sleep Deprivation and Deficiency? [Internet]. United States Government. 2022 [cited 2024 Jun 7]. Available from: https://www.nhlbi.nih.gov/health/sleep-deprivation

3. Patel AK, Reddy V, Shumway KR, Araujo JF. Physiology, Sleep Stages. StatPearls Publishing; 2024 [cited 2024 Jun 7]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526132/

4. National Health System. Menopause. Symptoms [Internet]. nhs.uk. 2022 [cited 2024 Jun 5]. Available from: https://www.nhs.uk/conditions/menopause/symptoms/

5. Tandon V, Sharma S, Mahajan A, Mahajan A, Tandon A. Menopause and sleep disorders. J Midlife Health [Internet]. 2022 [cited 2024 Jun 7];13(1):26. Available from: https://pubmed.ncbi.nlm.nih.gov/35707298/

6. Mayo Clinic Staff. Sleep tips: 6 steps to better sleep [Internet]. Mayo Clinic. 2022 [cited 2024 Jun 7]. Available from: https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379

7. Godos J, Grosso G, Castellano S, Galvano F, Caraci F, Ferri R. Association between diet and sleep quality: A systematic review. Sleep Med Rev [Internet]. 2021 [cited 2024 Jun 7].;57(101430):101430. Available from: http://dx.doi.org/10.1016/j.smrv.2021.101430

8. Haarhuis JE, Kardinaal A, Kortman GAM. Probiotics, prebiotics and postbiotics for better sleep quality: a narrative review. Benef Microbes [Internet]. 2022 [cited 2024 Jun 7];13(3):169–82. Available from: https://pubmed.ncbi.nlm.nih.gov/35815493/

9. Newsom R, Rehman A. Relaxation Exercises To Help Fall Asleep [Internet]. Sleep Foundation. 2024 [cited 2024 Jun 7]. Available from: https://www.sleepfoundation.org/sleep-hygiene/relaxation-exercises-to-help-fall-asleep