Sleep Challenges During Midlife: The Critical Role of Rest
Anna Harrelson • June 2, 2024

Restoring Rest: Navigating Sleep Challenges in Menopause with Research-Based Insights and Practical Tips

Described as the Swiss Army knife of health, sleep is crucial for everyone, but its importance is magnified during menopause. If we're not getting enough rest, our bodies miss out on essential recovery processes such as brain detoxification, nervous system balance, and efficient metabolism. Let’s delve deeper into the sleep challenges of menopause, including insights from leading experts and relevant studies.


Hormonal Changes and Their Impact on Sleep

The menopause transition brings significant fluctuations in hormones such as estrogen and progesterone, which profoundly impact sleep. Estrogen helps regulate neurotransmitter systems that influence our sleep cycles. As estrogen levels decline, so does our ability to fall and stay asleep. Progesterone, known for its calming effects, also diminishes, leading to lighter and more disrupted sleep.


Lisa Mosconi, PhD, in her book The Menopause Brain, discusses specific brain changes during menopause linked to sleep disruption. She references studies that show reduced glucose metabolism in the brain during menopause, which not only affects cognitive functions but also sleep quality. Dr. Mosconi advocates for a holistic approach to managing these changes, emphasizing proper nutrition and hydration as keys to supporting brain health and sleep.


Matthew Walker, PhD, a renowned sleep researcher, highlights in his book Why We Sleep the importance of deep sleep in clearing beta-amyloid, a toxic protein linked to Alzheimer’s Disease. His research demonstrates that poor sleep quality can lead to an accumulation of these proteins, particularly troubling for menopausal women who are already at a higher risk due to hormonal changes.


Practical Tips for Better Sleep Hygiene

To combat these challenges, adopting effective sleep hygiene practices is essential. Here are strategies supported by research:

  1. Consistent Sleep-Wake Schedule: Studies show that a regular sleep schedule helps to stabilize your circadian rhythms, improving overall sleep quality.
  2. Optimal Sleep Environment: Research supports maintaining a bedroom environment conducive to sleep—cool, quiet, and dark. Consider using adaptive bedding materials suitable for temperature fluctuations common in menopause.
  3. Mindful Eating and Drinking: Avoid caffeine and alcohol close to bedtime, as they can alter sleep architecture, reducing the proportion of deep sleep.  I suggest stopping all calorie intake at least 2 hours prior to bedtime.
  4. Wind-Down Routine: Engaging in relaxing activities before bed can enhance sleep quality. Activities like reading or meditation support brain health and prepare the mind for rest.
  5. Screen Time Reduction: Research points out that the blue light from screens inhibits melatonin production, disrupting sleep. Using devices with night modes or avoiding screens an hour before bed can be beneficial.
  6. Consideration of Natural Sleep Aids: Some studies suggest that supplements like melatonin and valerian root can help improve sleep during menopause, though it’s crucial to consult with a healthcare provider before starting any new supplement.


Exploring Hormonal Treatments

For those experiencing severe disruptions and other bothersome symptoms of the menopause transition, Menopause Hormone Therapy (MHT) may be an option. MHT can help stabilize mood and improve sleep patterns by replenishing estrogen and progesterone levels.

Understanding and addressing sleep issues during menopause is crucial for maintaining overall health. By integrating insights from experts and applying practical sleep hygiene tips, we can navigate this transition more smoothly and ensure that our bodies and brains receive the rest they need.


I encourage you to explore these strategies and share your experiences. Together, we can support each other and improve our sleep and overall well-being during menopause.


Warm regards,

Dr. Anna


WonderCreek Health Blog

By Anna Harrelson July 12, 2025
You know how people say, "Just drink some water and take a magnesium supplement" like it’s the answer to everything? Well… they’re not totally wrong. But like most good advice, the devil is in the details. Magnesium is one of the most essential minerals in the body, involved in over 300 enzymatic reactions , yet it remains one of the most commonly overlooked deficiencies in midlife women. And no, your annual bloodwork probably didn’t catch it. So What Does Magnesium Actually Do? Think of magnesium as a multitasking background assistant—it keeps the lights on and the gears turning across nearly every body system: Brain & Mood: Regulates GABA and NMDA receptors, supporting calm, focus, and resilience against anxiety and overstimulation. Muscles: Prevents cramping and twitching, supports strength and recovery, and reduces restless legs. Sleep: Plays a role in melatonin production and nervous system regulation. Bowel Function: Helps pull water into the colon to prevent constipation. Cardiovascular Health: Regulates blood pressure and helps with vasodilation. Hormone Balance: Assists in estrogen metabolism and combats insulin resistance. In short: if you’re exhausted, bloated, moody, foggy, tense, or irregular in your gut or cycle—magnesium deserves a spot on your radar. Why Is Magnesium So Important in Midlife? Estrogen and progesterone both influence magnesium levels. As hormone levels decline or fluctuate during perimenopause and menopause, so does your ability to retain and utilize magnesium. Add to that: Chronic stress (which depletes magnesium) Modern diets (often low in magnesium-rich whole foods) Medications like PPIs, diuretics, or certain antibiotics High caffeine, sugar, or alcohol intake (all increase magnesium excretion) And suddenly, a " borderline magnesium issue " becomes a perfect storm. Why Your Blood Test Might Not Show It Serum magnesium tests only reflect ~1% of total body magnesium. Most magnesium is stored in bone and tissue. So it’s very possible to have "normal labs" and still be clinically deficient. In practice, we go by symptoms, risk factors, and therapeutic response. Common Signs of Suboptimal Magnesium Trouble falling or staying asleep Anxiety or nervous system overactivation Fatigue or burnout that doesn’t resolve with rest Muscle cramps, spasms, or eye twitches Constipation Menstrual migraines or tension headaches Joint stiffness or tightness Sugar cravings or blood sugar crashes Best Food Sources of Magnesium Magnesium-rich foods include: Dark leafy greens (spinach, chard) Nuts and seeds (especially pumpkin seeds and almonds) Avocados Legumes Dark chocolate (yes, really!) Whole grains like quinoa and oats That said, many of us still fall short even with a healthy diet, especially during high-stress seasons or if absorption is impaired. Supplements: Which Type of Magnesium Is Best? Not all magnesium is created equal. Here are the forms we most often recommend: Magnesium Glycinate: Best for sleep, anxiety, and muscle relaxation. Gentle on the stomach.** Magnesium Citrate: Useful for constipation, but can cause loose stools at higher doses. Magnesium Threonate: May support cognitive function and brain health. Magnesium Malate: Good for energy and muscle pain, often used in fibromyalgia. We generally avoid magnesium oxide unless constipation is the only concern, as it’s poorly absorbed. **Mag Glycinate is generally my go to recommendation and what we take at our house Also, BLENDS can be good- but generally more expensive Dosing & Timing Most women benefit from 200–400 mg daily, depending on needs. Take it in the evening if you're targeting sleep or relaxation. Divide doses if taking more than 300 mg (e.g. AM + PM). Always start low and go slow, especially with citrate forms to avoid urgent bathroom visits. Final Thoughts If magnesium had better marketing, it would be a top-tier wellness darling. But because it’s quiet, essential, and boring on paper, we tend to overlook it. Yet for so many midlife women, magnesium is the missing link that helps all the other systems and strategies finally click. So if you're doing "everything right" and still feel off? It might be time to start taking magnesium!
By Anna Harrelson July 12, 2025
"Is Ozempic safe?" "Do I have to be diabetic to use it?" "Will I regain weight if I stop?" "I eat well, lift weights, sleep, take hormones—and I still can't lose weight. What's going on?" These are some of the most common questions I hear from women in midlife. And they’re incredibly valid. For decades, the conversation around weight and health has been riddled with shame, assumptions, and surface-level advice. But we’re finally shifting into a new era—one that recognizes obesity as a chronic, complex disease, not a personal failure. One that looks at metabolism through the lens of hormones, inflammation, genetics, stress, and brain chemistry, not just calories in and out. And at the center of this shift is an exciting class of medications known as GLP-1 receptor agonists. What Are GLP-1 Medications? GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally produces in the gut. It helps regulate blood sugar, insulin, and satiety (your sense of fullness). GLP-1s also slow gastric emptying and signal your brain to reduce appetite. Medications like semaglutide (Ozempic, Wegovy), liraglutide (Saxenda, Victoza), and tirzepatide (Mounjaro) mimic this hormone and have been revolutionary for treating type 2 diabetes—and more recently, for metabolic syndrome and obesity. These drugs are not stimulants or fad diet tools. They are hormone-based medications with powerful metabolic and anti-inflammatory effects. Why Are GLP-1s So Relevant for Midlife Women? Midlife is a time of massive hormonal transition. Estrogen, progesterone, and testosterone levels shift dramatically in perimenopause and menopause. This impacts insulin sensitivity, body composition, lipid metabolism, sleep, inflammation, and brain function. Even women who have optimized their lifestyle—dialing in nutrition, strength training, sleep, and hormone therapy—may find themselves stuck. GLP-1 medications can be the missing piece for women who: Have insulin resistance or prediabetes that isn’t budging with lifestyle alone Carry weight disproportionately in the visceral (abdominal) area Are at increased cardiovascular risk due to family history, labs, or existing conditions Are experiencing significant inflammation or joint pain related to metabolic dysfunction Have a history of PCOS or gestational diabetes Are postmenopausal and noticing rapid changes in weight or metabolism These medications work synergistically with hormone therapy and can reduce inflammation, improve insulin sensitivity, and help shift body composition. For some women, they are as life-changing as starting estrogen. It’s Not Just About Weight Loss GLP-1s are being studied for NAFLD (fatty liver), cardiovascular protection, neurodegenerative disease, PCOS, and even addiction and mood regulation. The benefits go far beyond the scale. That said, when stubborn weight is a major barrier to living fully—whether due to physical discomfort, comorbidities, or psychological toll—helping a woman reduce weight safely and effectively can open the door to movement, joy, and hope. So, Who Should Consider a GLP-1? I don’t believe in prescribing these meds as a first-line for someone who hasn’t addressed the basics. That’s not judgment—it’s strategy. If you haven’t worked on: Blood sugar balance through real food Resistance training and daily movement Addressing sleep and circadian rhythms Managing stress and nervous system regulation Optimizing hormones, micronutrients, and gut health … then you’re not giving yourself the best shot at lasting change. But if you have done the work and still feel like your body is working against you—or you have serious metabolic risk factors— then GLP-1 therapy might be a wise and evidence-based next step. Some women use it briefly to reset. Others may need it long-term, just like hormone therapy. It’s not a crutch. It’s a tool. And for the right woman, it can be life-changing. Common Questions I Hear "Will I gain the weight back if I stop?" Maybe—but not always. If the lifestyle foundations are in place, many women maintain progress even after discontinuing. But some women have chronic conditions that benefit from ongoing use. That’s not failure—that’s biology. "Are there side effects?" Yes. The most common are nausea, constipation, or bloating early on. Starting slow, staying hydrated, and eating smaller portions helps. Rare but serious risks exist, including pancreatitis. A good clinician will walk you through these carefully. "Will I lose muscle?" You can—unless you’re strength training and eating enough protein. We talk a lot about this at Wondercreek. Protecting lean muscle is critical. "Is this forever?" Not necessarily. Some women use these meds to reduce inflammation, restore insulin sensitivity, and break a cycle. Others stay on them longer due to underlying metabolic dysfunction. Every plan is individualized. Final Thoughts GLP-1 medications aren’t for everyone. But they are not cheating, shameful, or lazy. They’re a legitimate, science-based treatment for a serious, chronic condition. In my practice, we focus on healthspan—not just lifespans. That means preserving function, preventing disease, and helping you feel energized, sharp, and resilient for as long as possible. For some women, GLP-1 therapy is one of the most powerful tools we have to get there.