Take Back Your Sleep!

Sixty-one percent of FOFs have trouble sleeping . . . but you can beat the odds.


Have you had trouble sleeping? You’re not alone. In a recent survey sponsored by Red Hot Mamas and Sunovion Pharmaceuticals, Inc., 79 percent of menopausal women reported having trouble staying asleep, and 63 percent struggle just trying to fall to sleep. We spoke to Karen Giblin, president of Red Hot Mamas, and with Dr. Jessica Vensel-Rundo, a neurologist with Cleveland Clinic’s renowned Sleep Center, to get the straight story on falling asleep after fifty.

  • FOF: Karen, tell us a little more about this survey.
    • KG: More than 900 women participated in our survey, and they shared their sleep problems in depth. Sleep is an important aspect of a woman’s life. Lack of sleep compromises our health, both physically and mentally. Our survey found that lack of sleep could seriously impact a woman’s quality of life, as well as her relationships with her spouse, significant other and business associates.
  • FOF: What causes the sleep problem primarily?
    • KG: Many sleep problems are not fully understood, including chronic insomnia. But certain stressful events, such as menopause, create anxiety that leads to short-term insomnia and then long-term sleep problems. Seventy-six percent of our respondents said sleep greatly or moderately affected their quality of life.
  • FOF: How exactly does menopause affect sleep?
    • ImageKG: Some women are bothered at night by hot flashes. Other issues are sleep apnea, use of prescribed medications, stress, and just the overall changes that occur in midlife. Menopause often provokes anxiety since women aren’t feeling completely up to par physiologically. Many of them feel like Mexican jumping beans in the middle of the night. The next day, they’re irritable, drowsy and can’t function. In our survey, forty-one percent of the respondents said they had difficulty concentrating. Unfortunately, only 38 percent of them consulted with their healthcare providers about their problem.
  • FOF: Why aren’t women talking about it with their doctors?
    • KG: Women tend to overlook their need for sleep. We oftentimes take care of others before taking care of ourselves. They also don’t think their doctors will take their sleep issues seriously. In my opinion, there needs to be more awareness about sleep issues as this is a major health concern for women. Insomnia not only causes poor concentration and memory loss, it can also lead to increased risk of accidents, heart disease and other chronic diseases, such as diabetes and depression. We need about seven hours a night for optimum health.
  • FOF: Why not take sleeping pills?
    • KG: There are several prescription options to improve sleep, but taking medication is a personal decision, The first thing to do is establish healthy sleep habits. It’s important to have a schedule for sleep every night, to learn how to wind down before going to sleep. Create a soothing bedtime ritual if you can. Read a good book in a comfortable pair of pajamas. Sleep on nice, clean linens in a cool environment. Maybe listen to a soothing CD. Don’t put on the TV set and watch the news before you go to bed. Make sleep a priority in your life.
  • FOF: What if you still get up in the middle of the night?
    • ImageKG: Don’t stare at the clock and let the day’s worries run through your mind. Get up out of bed and do something boring such as reading a boring book or listening to relaxing music. Many menopausal women tell me they’ve become proficient HSN and QVC buyers. They get themselves into trouble because all these boxes start arriving. Once you feel drowsy again, go back to your room and go to bed.
  • FOF: What’s the most important thing to take away from this study?
    • Communicate with your healthcare professional. Discuss the duration and frequency of the problem and how it’s impacting your life so she can advise you about what to change. You might need to eliminate caffeine or make environmental changes, such as making sure your bedroom is cozy, cool and dark. Discuss treatment options with your clinician. For resources on how to manage insomnia during menopause, visit  www.takebackyoursleep.com.


Dr. Vensel Rundo adds:

“If you’re over fifty and you suddenly start experiencing difficulty sleeping, it’s important to determine is this is insomnia or if there’s some other kind of sleep disorder–namely, sleep apnea. Sleep apnea is characterized by an obstructed upper airway, causing repetitive pauses in breathing during sleep. Sufferers wake up throughout the night and may not even realize what’s happening. Post-menopausal women are at increased risk, because with a loss of hormones there’s a loss of tone in your airway muscles. That makes your airway more collapsible and floppy and increases your chances of apnea. To be screened for this disorder, you have to go through an overnight sleep study at the clinic. But once we diagnose you, there are excellent treatments available.”

Karen Giblin
Red Hot Mamas North AmericaKaren L. Giblin is founder and CEO of Red Hot Mamas North America, Inc., a group that educates thousands of women about menopause health, and a world-renowned expert on menopause issues. To find out more and to join the menopause conversation, visit her website, redhotmamas.org.

{Health} 9 Sleep Aids for FOFs (You’ve Probably Never Tried)

Stop popping pills and counting sheep, FOFs. Here are 9 unconventional aids for catching zzz’s.

1. Teas and Tinctures with Passion flower: Decaffeinated herbal tea has long been a fix for sleeplessness, but natural product companies have become savvier to the distinct needs of menopausal and post-menopausal women. Many have created blends of tea including Passion flower, a plant recently show to help women with menopausal symptoms such as aches and cramps, fall asleep.

Try: Jade and Pearl Sleepy Time Special

2. Peanut butter: The ubiquitous nutty spread is high in tryptophan, an amino acid with soporific effects. For best results, eat it on whole-wheat toast, another sleep-inducing food, an hour before bedtime (that’s how long it takes for the tryptophan to reach your brain).

Try: One of ten varieties such as “Mighty Maple” or “White Chocolate Wonderful,” from Peanut Butter and Co.

3. Chinese herbs: Herbal remedies for insomnia have been used in China for generations. They have become widely available, more recently in the United States in the form of herbal packs and tinctures. The blends differ vastly but can include sleep-inducing roots, seeds, oils and extracts from herbs commonly found in Asia such as Poria (Fu Ling), Spiny Jujube (Suan Zao Ren) and Biota Seed (Bai Zi Ren).

Try: iSleep Herb Pac

4. Cooling sleepwear: Many nightwear companies have caught heat for neglecting the needs of FOFs experiencing menopausal night sweats. But some are listening; they’ve swapped cotton for micro-fiber fabrics that wick away perspiration and are quick drying. So…cool!

Try: Cool-jams Sleepwear

5. Bedtime Bars:  A new line of NightFood Bars claims to help you fall asleep, and they just might be on to something. According to the National Sleep Foundation, eating a balance of protein and carbs before bed can actually help you sleep better. The Night Food bars  boast a combo of protein (soy) and carbs (oats, cookie crumbs, flour) as well as the sleep-inducing hormone, melatonin.

Try: NightFood Bars

6. Cherry juice: Just this year, a study conducted by three universities found that cherry juice could reduce insomnia in older adults. Researchers believe the high content of melatonin in cherries plays a role in inducing sleep at night and wakefulness during the day.

Try: R.W. Knudsen Organic Just Tart Cherry juice

7. An acupressure mat: Acupressure mats, with their rows of plastic or rubber “spikes,” may sound and look like torture devices, but they have actually been reported to have sleep-inducing effects. The thousands of small points on the mat stimulate specific reflex points and release blocked energy. This in turn can ease tense muscles and create deep mental and physical relaxation.

Try: Yantra Mats or Spoonk Space Mats

8. A sleep shot: We have energy drinks galore, but what about an anti-energy shooter? A few companies have developed relaxation shots; mini-beverages sans caffeine and sugar that promise to help you doze off. Different brands contain different ingredients, but many rely on natural substances such as chamomile, Ecklonia Cava, Valerian root extract or melatonin, a hormone known to induce sleep.

Try: iChill

9. A smartphone app: A cell phone and uninterrupted sleep don’t usually go hand in hand, but a new smartphone app works through Bluetooth sensor technology to track your sleeping habits. A wristband measures body movement during sleep to find your ideal wake time. The app will set your alarm to this time so you awake feeling naturally alert and refreshed. It also will analyze your sleep cycle to determine your quality of sleep each night and the number of nightly awakenings.

Try: Wakemate Smartphone App

Enter to win Sleepy Time Special tea from Jade and Pearl by commenting below and answering: Have you ever taken sleeping pills?

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Are Your Sleeping Pills Safe?

Sleeping pills are more popular than ever–especially for women over fifty. But are they a safe solution?

FOF Founder, Geri Brin, has been taking prescription sleeping pills for 5 years. “I don’t know what would happen if I tried to sleep without them,” she explains. “I’m afraid to try.”

According to The National Sleep Foundation, a full 61-percent of post-menopausal women suffer from insomnia, and prescriptions for the new class of sleep aids, which include Ambien, Lunesta and Sonata, have doubled in the last five years. These meds are clearly popular, but are they safe, and–more important–are they the solution?

We spoke to Dr. Jessica Vensel-Rundo, a doctor at the Cleveland Clinic’s renowned Sleep Disorders Center, to get the straight dope about doping up to fall asleep.

  • FOF: Why is insomnia so common in women over fifty?
    • Dr. Vensel-Rundo: Several insomnia triggers are common in this population: depression and anxiety, often due to a life change such as a death in the family, loss of a job or a divorce. Pain is also a big issue, whether from arthritis, fibromyalgia or something else. And hormone fluctuations and hot flashes due to being post-menopausal. Those are the top ones. In about 15 percent of cases, the person has primary insomnia, which means there’s no underlying medical problem causing the insomnia.
  • When is medication a good treatment idea?
    • Dr. Vensel-Rundo: As a short-term solution, medication can be great. That’s really how these medications were initially tested–for six weeks of use. They were intended to help you through a rough patch such as a death in the family or recuperation from an operation. The problem with sleep medications is that they may be a quick fix, but they can lose effectiveness over time. You build up a tolerance or develop side effects, and when you take the medication away, the insomnia is still there.
  • So what is the long-term solution?
    • Dr. Vensel-Rundo: Cognitive behavioral therapy is the main non-drug treatment for insomnia. That includes relaxation techniques, biofeedback and sessions with a sleep psychologist. Some patients are just not interested in that type of commitment. They may say, “Look, I’ve tried some of these things before and they’re not going to work for me.’ Those are the patients who typically opt for medication alone.
  • Would you prefer that patients opt for other treatments beforethey go to a medication?
    • Dr. Vensel-Rundo: Yes. In general we–sleep medicine specialists–feel that the cognitive and behavioral treatment is the best treatment out there, because it actually retrains you to fall asleep on your own.  Studies have show that the effectiveness is probably about the same as a pill, initially, but in the longterm, it’s really the cognitive treatment that works.
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  • Are there times when people go on the medication alone for 6 weeks, get back on track and are just fine?
    • There are, but often patients will hit the six-week mark and be afraid to stop taking the medication. For those people, I try to ease them off of it.
  • Several women at the FOF offices–including our founder–have remarked that their doctors were very quick to prescribe sleep medications when they complained of trouble sleeping. Is this typical?
    • Dr. Vensel-Rundo: I think a lot of doctors in primary care are more likely to write a prescription because they are dealing with multiple medical problems. If a patient comes in complaining of a few things and mentions in passing, “oh, I’m also having some trouble sleeping…” the doctor may decide to prescribe a medication to address the issue immediately, hoping it will be a short-term problem. At the sleep center, our whole focus is sleep, so we do a very thorough history and really try to get a better feel for what is going on before we prescribe any treatment.
  • What are the biggest dangers of these medications?
    • Dr. Vensel-Rundo: There has been a lot of media coverage on dangers such as driving, eating or making phone calls in your sleep. The truth is, those are very rare. I’ve only had one or two patients complain to me about those types of symptoms. Most of the side effects are no more than a woozy feeling the next morning if you take it too late the night before.
  • Are these medications addictive?
    • ImageDr. Vensel-Rundo: The ones that we’re discussing–the non-benzodiazepine hypnotics such as Lunesta, Ambien and Sonata–are not addictive. You can build up a tolerance to them, and they can lose their effectiveness over time. If you come off of them abruptly, you can have “rebound insomnia” so I typically recommend that my patients come off of them gradually. The benzodiazepines which are sleep medications such as Ativan, have some addictive properties. We rarely prescribe those.
  • Is any one medication better than the others? How do you choose?
    • Dr. Vensel-Rundo: It really depends on what the patient is complaining of. If it’s a sleep initiation problem–a difficulty falling asleep–then Ambien would probably work well. But if it’s a sleep maintenance issue–meaning you’re getting up a lot in the night–then there’s Lunesta or Ambien CR which are designed to help you stay asleep. Honestly, it’s often an insurance issue–which medication is covered by insurance and which is least expensive. Ambien is a cheaper alternative because it’s available in a generic form called Zolpidem. Most of us prescribe it more for that reason.
  • What about dangers of people using them the wrong way…or abusing them.
    • Dr. Vensel-Rundo: I’ve had a couple of patients who were taking double the maximum dose of Ambien plus an antidepressant, an anti-anxiety and a pain medication, and they’re still not sleeping. Taking a high dose of Ambien or Sonata alone would probably not be a significant problem, but if you add them to pain medications and anxiety medications, that’s an issue because the combination can cause central nervous system depression and respiratory depression.
  • What about melatonin and other over-the-counter medications?
    • Dr. Vensel-Rundo: Melatonin works well for people who have a delayed sleep phase. That means they don’t feel sleepy until 3 in the morning and they don’t want to wake up before 12 o’clock in the afternoon. The key is to take it 5 or 6 hours before you go to sleep. Over-the-counter sleep aids such as Tylenol PM and Benadryl are fine for taking once in a great while, but they definitely lose their effectiveness over time.
  • What about people who use alcohol to wind down and fall asleep?
    • I would not recommend it. Even though it can help you fall asleep, when alcohol is coming out of your system there’s withdrawal effect which can actually wake you up. You wake up early with your heart pounding!
Jessica Vensel-Rundo, MDDr. Vensel-Rundo is a neurologist at the Cleveland Clinic who specializes in sleep disorders and treatment.