‘I can’t remember when I last had a good night’s sleep, I just get comfortable and then suddenly I am throwing off the duvet to cool down. My hot flashes are unbearable & then I just struggle to get back to sleep. I dread going to bed and just feel so tired of feeling tired’
How often have you laid awake at night, trying to get comfortable and then a hot flash comes over you and the duvet just has to be thrown off ! Have you always been a good sleeper and taken pride in being able to fall asleep at a drop of a hat, and then the menopause happened and it changed overnight. A bad night’s sleep ravages our moods, making the next day feel like you are just trudging through life and barely surviving. Not only does it affect us but if we sleep with a partner, our interrupted sleep can often be cited as ruining their sleep, piling on the guilt. If this also drives you or your partner to sleeping in the spare room it just causes you to feel more wretched and so it continues.
Sleep is not only precious to us but vital and the menopause often robs us of getting healthy sleep. The NHS recommended 7-9 hours are often unachievable with our busy life styles, but the menopause just makes getting those hours so much harder. Sleep deficit affects our mental health and can lead to low mood & irritability. Notably around 39-47% of perimenopausal women & 35-60% of postmenopausal women will experience sleep issues. The most common including hot flashes, insomnia, disrupted sleep cycles and sleep disordered breathing (sometimes causes snoring). However it is often hot flashes that many of you mention that are causing interrupted sleep and indeed disturbing life at work or life in general. The rest of this article will focus on hot flashes and also explain how hypnosis could possibly be something to consider in managing these episodes.
Hot flashes can occur without warning and cause heat sensations to sweep across the body resulting in episodes of sweating. They can last as short as 30 seconds or as long as 5 minutes but it feels like a life time. In fact over 75% of us experience hot flashes which disturb our sleep. It is also incredibly hard to then to return to sleep due to the spike in adrenaline and the continued sweating. Notably 44% of women who suffer with severe hot flashes meet the clinical criteria for chronic insomnia which is totally debilitating & alarming. These hot flashes can plague us for around seven years and with some women in their 60s still experiencing them, and no one thought to tell us this !
In order to manage these episodes we need to understand that this response actually starts off in our brain, and the role of the hypothalamus is key to creating these episodes. The hypothalamus is the part of your brain that acts as your heating and cooling control centre and regulates your body temperature. It decides when you’re too cold and warms you up. It also decides when you’re too hot and cools you down. To do this efficiently it works by creating a ‘optimum zone’ that judges your body’s temperature is sitting within this zone therefore requiring no action to either heat or cool you down. Before the menopause the parameters of this optimum zone were set quite wide, and your body didn’t react to small fluctuations in temperature. But during menopause the falling levels of oestrogen affect your hypothalamus and the optimum zone’s parameters become narrower. As a result your body becomes more sensitive to small fluctuations in temperature and your hypothalamus may believe your body is overheating when it’s not. It then triggers your body’s cooling response by dilating the blood vessels near your skin giving you that flushed feeling. Your blood then moves faster around your body increasing your heart rate and creating heat which results in the sweating. While it may feel like hot flashes come out of nowhere, it’s actually your hypothalamus that is triggering them.
Hypnotherapy can make a difference to the hypothalamus being triggered and has proved invaluable in managing hot flashes. It has been clinically proven to reduce hot flashes up to 80% and can be used in conjunction with other treatments. There is also an overall positive impact from hypnotherapy which includes improving sleep quality, reducing stress, and increasing positive mood. Hypnosis creates a sense of calmness and this then slows down the stress response so that the hypothalamus is not so quickly triggered. When you are in this relaxed and focused state of attention your subconscious mind can reset and adjust to the brain’s reaction to sensitivity around temperature changes. This happens by listening to suggestions for hot flash management, and visualizing cooling situations and creating this feeling of calmness and coolness.
If you are nervous about hypnosis always remember that you are in control and you are not unconscious at any time but fully aware of where you are and who you are at all times. Think of it as being a ‘spa’ for the mind, time you have taken out of your schedule to focus on yourself to reset your thoughts. The key to hypnosis is to be in a relaxed state which then enables your conscious mind to go offline and enable the sub-conscious mind to be available to listen to the positive narrative to enable a change of thinking. The beauty of hypnosis is that it is equally effective online as in person as you only need to hear the voice of the therapist, and your job is to listen and to let go. At the start of the session you will be asked to get comfortable, choosing either to be seated or to lie down. In your own home it is great to get comfy and lie down and take this time to relax. Once you are comfortable you will be asked to close your eyes and then to bring your focus to your breathing. You will be guided to relax your body, one part at a time whilst keeping your attention on your breath. This body scan technique will help you to deeply relax and in this state of focused relaxation it becomes easier to ignore outside disturbances and intrusive thoughts. You will then be able to focus on the imagery and suggestions you will hear. You will be guided through some cooling imagery, this might be sipping an ice-cold drink on a hot day, or feeling the sensation of an ice-cube in your mouth. You may also be guided to imagine stepping into cool water or other cold environments. The purpose of this cool imagery is to encourage the brain to regain control of its temperature-control mechanisms and in your deeply relaxed state these images will feel very real. The images will be aligned to the information you have given prior to the session where you will be asked to identify places, things or substances that may make you think of coolness or being cooled down. Combined with imagery there will also be suggestions that you are able to manage your hot flashes in your day-to-day life. Such as, “Your hot flashes will bother you less and less, you will gain control over your hot flashes.” These suggestions are designed to give you a sense of control over your hot flashes, whilst also providing a sense of calm. The suggestions will then be anchored in your mind with you be asked to press your thumb and first finger together while the suggestions are repeated. Finally you will be counted back to the room which brings you back to your normal state of alertness. You will remember everything that happened and finish with a calmer, cooler body, brain, and mind. The hypnosis will be recorded for your own regular usage. This gives you access to the hypnosis narrative when you feel like you may need a refresher or just to use as reassurance where you may benefit from the relaxation to reset and feel back in control. A very enjoyable & relaxing experience with a great outcome.
Hypnotherapy is a great way to address sleep issues but it is important also to be mindful of your sleep routine as well. Keeping to a regular schedule helps if you can and ensure that you are sleeping in a darkened room that is well ventilated. Try to come off your devices a couple of hours before going to sleep, and make sure all notifications are on ‘sleep mode’ on your phone. Additionally avoiding alcohol and caffeine are also a good idea before sleep and that ‘night’ cigarette for those of you who smoke. There are also some great sleep wellness products on the market and here at Harley Street Menopause Midlife clinics we offer a great range of sleep enhancing products. For hot flashes our anti-wrinkle sleep pillow has an inbuilt cooling gel to alleviate them and also just give a sense of reassurance as you drift off to sleep. Lastly sleep is your super power and make sure you are harnessing yours, and that you seek the support to get back to loving your sleep time again.
M.Griffin, psychotherapist & clinical hypnotherapist