Day 6 of HRT so thought I’d report in. Not a completely smooth transition to returning to normal sleep - disappointing but a work in progress. A couple of “my normal” fitful nights sleep but three much better (6/ 6.5 hours sleep).
Prior to being diagnosed as menopausal, the new GP also referred me to a sleep clinic, so I thought I would pass on the advice I received there. (Apologies if someone has already covered this upthread). I spoke to my sleep adviser over the phone on Thursday and euphorically advised her of my HRT prescription. She soon burst my bubble saying that she has patients on her books who are on HRT and still cannot sleep - great! She advised that, as I had experienced 5 years of fitful sleep, I could well have developed unhelpful sleep patterns that still need to be broken. Effectively, I need retraining!
Advice offered by the clinic follows that propounded by Colin Espie. His book is Overcoming Insomnia and Sleep Problems (and is so deathly dull it should have put me to sleep!). This operates on the basis that you should improve your overall sleep efficiency i.e. the amount of time you spend in bed actually asleep. You should only go to bed if you feel sleepy. Therefore you should get up if you are unable to sleep more than 20 minutes after going to bed if you have not fallen asleep. The same if you wake during the night and are having trouble going back to sleep. Instead, go downstairs and spend your time doing something quiet like reading for 30 minutes or until you feel sleepy again. I was advised not to listen to the radio in bed or watch TV/ have screen-time downstairs (as this risked over-stimulating my brain and waking me up further). I must confess that this advice was not something I relished following, not least because my house is blooming cold at night when the heating is off! It also means that, currently, DH and I spend very few waking hours in bed at the same time. No day-time naps are permitted (I wish!).
My bedtime was pushed back until 10.45pm (rather than 10/ 10.15pm) and the time I got out of bed brought forward to 6.15pm every day. The instruction is to get up at the same time every day (including weekends!) regardless of how well you have slept the night before, so as to reset your biological clock. Though a right royal pain in the butt, I must confess that I think that this is working. Whilst I am in bed less, when I do wake, I feel more rested as I think that I must have slept more deeply. The rationale is then to gradually increase the amount of time I am allowed to spend in bed as my sleep efficiency levels improve.
FYI these are some things that I did prior to getting professional sleep advice that I also think helped (whether psychosomatic or not!).
Try not to eat after 8pm.
Sleep with the window open, if you can, to reduce body temperature.
Get Vitamin D, ideally by getting outside during daylight hours for at least 15 minutes a day (without SPF and sunglasses on). This helps reset your biological clock.
Exercise (maybe outside, to kill two birds with one stone).
Take Magnesium.
No coffee/ chocolate / coke or anything else with caffeine in past midday (difficult when you are so tired but drink water/ camomile/ fruit tea instead as tiredness can be compounded by dehydration (admittedly boring)).
Lavender oil on the pillow.
Limit alcohol intake 5 hours before you want to sleep (ideally have none unless it’s a special occasion (annoying - I routinely break this one!)).
No PCs/ phones/ kindles/ TVs in the bedroom - your sleep sanctuary (!)
No PC/ phones/ kindles (anything with a blue light) after 8pm.
When I do wake during the night, I take a probiotic pill (which has lactobacillus acidophilus and bifidobacterium in it). I picked this up from Michael Mosley’s Clever Guts diet book, which said insomnia can be caused by poor gut health and discourages the consumption of processed food. I feel that this helps me go back to sleep quicker. (Mind you, I also went through a phase convinced that eating lentils helped me sleep!).
Good luck everyone!