Unlocking the Science of Sleep in Perimenopause


“Sleep is the first line of defence for our immune system, for our health and for our longevity.”

Dr. Stephanie Estima

In this episode, you will learn how to refine your sleep routine with proven methods and practices, delve into the relationship between hormonal shifts and their impact on sleep, harness the power of hormone replacement therapy for better sleep, navigate the unique sleep-related issues experienced by women in perimenopause and menopause and unravel the complex connection between depression and sleep quality – PLUS learn how to improve both.





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00:00:00 – Understanding Sleep Cycles,
Dr. Stephanie explains the two stages of sleep, non-REM and REM, and the four stages of non-REM sleep.

00:09:11 – Impact of Poor Sleep on Health,
Dr. Stephanie talks about how poor sleep leads to chronic stress and inflammation, which affects the balance in the autonomic nervous system.

00:14:22 – Hormonal Changes in Perimenopause and Menopause,
The hormonal changes in perimenopause and menopause, particularly the decline in estrogen and progesterone levels that affect sleep quality.

00:22:02 – Strategies for Better Sleep,
Practical tips for improving sleep, including establishing a regular sleep schedule, managing stress levels, avoiding caffeine and alcohol before bedtime, and creating a comfortable sleep environment.

00:30:15 – Importance of Napping,
Dr. Stephanie explains the benefits of napping for overall health and how it can help in making up for lost sleep.

00:15:00 – Understanding the Effects of Chronic Low-grade Inflammation on Energy Production,
Chronic low-grade inflammation can still produce energy, but it is less efficient, resulting in reduced ATP and glucose availability.

00:19:12 – Melatonin and Its Applications in Sleep,
Melatonin is crucial in sleep onset and reducing sleep efficiency.

00:25:21 – Melatonin Dosage and Quality Control,
Melatonin supplements vary in dosage and quality control, with some brands not accurately reflecting the dosage on the label.

00:29:36 – Herbitonin as Alternative Melatonin Supplement,
Herbitonin is a slow-release capsule that closely mimics the amount of melatonin humans produce. It is an alternative to traditional melatonin supplements that often contain supra-physiological levels of melatonin.

00:29:55 – Understanding Hormones and Sleep,
The importance of hormones in regulating sleep.

00:31:56 – Women’s Reproductive Hormones,
How women’s reproductive hormones are different from men’s and the importance of the circadian production of hormones.

00:33:29 – Progesterone and Sleep,
The role of progesterone in sleep, highlighting its hypnotic effect and respiratory stimulant properties.

00:36:49 – Estrogen and Anxiety,
The relationship between estrogen and anxiety, pointing out that declining estrogen levels during perimenopause and menopause can lead to an increase in fear and anxiety at night.

00:41:05 – Growth Hormone and Sleep,
The importance of growth hormone in regulating sleep and explains how growth hormone levels decline with age and various environmental stressors.

00:44:51 – Signs of Growth Hormone Deficiency,
Symptoms of growth hormone deficiency include decreased lean body mass, increased abdominal fat, insulin resistance, hypertension, high triglycerides, anxiety, depression, decreased bone density, and changes in physical appearance.

00:49:45 – Estrogen and Sleep,
Estrogen plays a role in the amount of time spent in rapid eye movement (REM) sleep and affects serotonin levels.

00:55:00 – Vasopressin and Urination,
Vasopressin is a hormone that helps regulate urine flow during sleep.

00:57:47 – Tips for Better Sleep,
To improve sleep quality, keep a journal of liquid and food intake and track transit time. Limit alcohol and caffeine intake, elevate legs before bed, and pee right before sleep. Stress management, temperature regulation, and hormone balance also play a role in better sleep.

00:48:09 – Women and Growth Hormone,
Women release growth hormone pulses differently than men and can achieve peak growth hormone secretion faster with resistance training or core temperature manipulation.

00:59:51 – Effects of Alcohol on Sleep,
Alcohol inhibits vasopressin, leading to increased urination and fragmented sleep. It also negatively impacts vitals.

01:02:59 – Sleep Hygiene Tips,
Regularity is key, especially waking up at the same time every day. Darkness is crucial, but the speaker does not recommend blackout blinds. Keep the room cold. Establish a wind-down routine and remove technology from the bedroom.

01:07:49 – Counterintuitive Approach to Insomnia,
Decrease time in bed to decrease association between bed and staying awake and increase sleep pressure.

01:14:08 – Women’s Health and Sleep,
Women experience changes in hormones during perimenopause and menopause that can lead to sleep disturbances like insomnia and hot flashes.

01:19:15 – Men’s Health and Sleep,
Men’s sleep can be affected by sleep apnea and testosterone levels. Treating sleep apnea and regulating testosterone can improve sleep quality.

01:14:13 – Napping and Supplementation,
Dr. Stephanie discusses the benefits of napping early afternoon and some supplements that promote progesterone balancing. She recommends evening primrose oil, chasteberry or vitex, ashwagandha, and rodiola Rosacea to increase progesterone naturally and improve sleep quality.

01:18:56 – Depression and Sleep,
The increased risk of depression during perimenopause due to fluctuating hormone levels and poor sleep quality.

01:22:41 – Hot at Night,
Dr. Stephanie shares strategies to reduce overheating at night, such as wearing moisture-wicking sheets, using a fan, and reducing room temperature. She also suggests taking a hot shower or bath before bedtime and warming up extremities with warm fuzzy socks.

01:25:13 – Improve Sleep Quality,
Tips to improve sleep quality during perimenopause, including setting a consistent sleep schedule, avoiding alcohol, and practicing good sleep hygiene. She also recommends seeking professional help for persistent sleep disturbances.


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Get yourself a copy of my best-selling book, The Betty Body

I’m Dr. Stephanie

Part geek, part magic, and all the way passionate about being a well-lived woman.

I want to throw my grandkids in the air in my 70’s. I want to be squatting even more weight than I am now, and putting my OWN luggage in the overhead bin. Sound like weird goals? For me these are just some of the little things that represent a life well-lived.

My health is MY job – I’ll be damned if I rely on luck, ‘good genes’ or a cocktail of drugs that over promise and under deliver.

The Betty Body is my first book-baby, and a collection of what I’ve learned after thousands of clinical hours, hundreds of conversations with the world’s top experts, and most importantly…

This book is an outline of what took ME from “rock-bottom health” at 38, to being my own version of a Betty in my perimenopausal mid 40’s. A woman who is physically strong, full of energy, enjoys mental clarity, great sex and a joyful family life. Is it all roses? Of course not. But I have the stamina and tools to deal with the push and pull of life so that it doesn’t turn into chronic stress.

I want this for you too. Let’s go Bettys!