The Impact of Sleep on Performance for Menopausal Triathletes

Sleep disturbances are prevalent during the stages of perimenopause and even into menopause, and their impact extends beyond nighttime restlessness. Poor sleep quality and insufficient sleep can contribute to multitudes of health conditions in women, including cardiovascular disease, cognitive impairments and mental health issues.

Not getting enough sleep can affect all areas of your life. Lack of sleep can make you feel even more irritable or depressed, might cause you to be more forgetful, and can even lead to falls. Research now suggests that waking from sleep may trigger hot flashes, rather than a hot flash waking you from your sleep.

In addition to the above mentioned issues, the physiological issues that arise from lack of sleep during menopause can be:

• Insufficient sleep can contribute to cardiovascular disease, cognitive impairments, and mental health issues.

• Sleep loss can increase appetite and can lead to weight gain. 

• Sleep loss can affect metabolic health, including energy expenditure, body adiposity, and eating behaviors.

• Sleep loss is prevalent in postmenopausal women and is 2 to 3 times more likely than in younger women.

• Menstrual cycle disruption. Sleep loss affects the hormone leptin, which is produced in lower quantities when women don't get enough sleep and in turn it affects ovulation.

All of those will significantly affect your ability to train, and maintain your fitness in whatever sport you are trying to participate in. Instead of suffering, there are things you can do. The following is a list of easy to control things that may help you sleep better and thus be able to maintain your fitness.

• Create a sleep schedule: Try to go to bed and wake up at the same time each day. 

• Avoid napping: Napping in the late afternoon or evening can make it harder to sleep at night. 

• Avoid heavy meals and caffeine: like coffee, tea, and chocolate, close to bedtime. 

• Avoid alcohol: Even small amounts of alcohol can make it harder to fall asleep and stay asleep. 

• Create a bedtime routine: Try reading, listening to music, or taking a warm bath before bed. 

• Keep your bedroom comfortable: Make sure your bedroom is a comfortable temperature and as quiet as possible. You can also try using 100% cotton or bamboo sheets to feel cooler. 

• Avoid screen time: The light from devices like TVs, computers, and phones can make it harder to fall asleep. 

• Exercise regularly: Regular exercise can help improve sleep, but avoid exercising right before bed. For some this causes a rise in metabolic rate for hours 

• Try relaxation techniques: Relaxation techniques can help stimulate the body's parasympathetic nervous system, which helps you slow down and prepare for sleep. 

• Consider hormone replacement therapy: Hormone Therapy (HT) can help with hot flashes and other menopause symptoms, which can lead to more restful sleep. 

For me I’ve changed a few of the above suggestions with much benefit, such as avoiding big meals, caffeine and alcohol close to bedtime. I’ve stopped all screens about an hour before bed, and just recently started hormones, and so far my hot flashes have nearly gone away (I was having a couple dozen a day, plus a couple changes of clothes throughout the day), and I can sleep again!

If you are still having trouble sleeping it may be time to talk to your doctor. If your doctor isn't listening or just saying to take melatonin or get a white noise machine, it’s time for a new doctor. That new doctor can be found through NAMS, North American Menopause Society, or reach out to Midi Health. Both of these places are where you will find doctors who have been trained in everything menopause, and that’s their wheelhouse. They care about treating you and listening to your very individual issues and needs. One thing most people don’t realize is that doctors, including ObGyn's, don't get much, if any, menopause training. So stop seeing someone who isn’t trained in your needs.

There are plenty of communities out there to join and share your stories, and hear others. My favorite is the Feisty Media Menopause group on Instagram and Facebook, which I am a part of. I enjoy reading about others journeys and sharing mine. It's a group of women 40+ who are experiencing the plethora of peri and postmenopausal symptoms. Who knows, you may resonate with one that leads you to getting the health care direction you need. Just know you are not alone, so stop suffering alone. In fact stop suffering. Get the help you deserve.

Further reading here

Sleep and Sleep Disorders in the Menopause Transition: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092036/

Why your sleep can really suck during menopause: https://www.feistymenopause.com/blog/why-your-sleep-can-really-suck-during-menopause#:~:text=Common%20Causes%20of%20Fragmented%20Sleep%20in%20Menopause&text=Avoid%20eating%20a%20big%20meal,earplugs%20and%20an%20eye%20mask.Hot Flashes: https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do#:~:text=Hot%20flashes%2C%20especially%20night%20sweats,sleep%20aids%20such%20as%20melatonin

Mobility IS for Endurance Athletes, AND those in Peri & Post Menopause

 

Many of you know that participation in endurance sports requires many hours of training per week both in your sport, in strength sessions, and maybe even visits to the massage therapist, physical therapist or chiropractor. Wouldn’t it be nice to not need to see the physical therapist or massage therapist or chiropractor? But instead to go see one of them because you want to, not need to?

How often do you focus on mobility? Do you know what mobility is, and how it can help you stay out of the PT and massage therapists office? 

Adding a great mobility plan to your endurance sport training is good for…

Injury prevention: Triathletes subject their bodies to significant repetitive, high impact movements, increasing their risk for overuse injuries. Many have several overuse injuries. Mobility workouts address muscle imbalances, reduce stiffness, and enhance joint stability, and nervous system regulation, ultimately lowering their potential for injuries.

Enhanced Performance: Imagine a swim long, powerful stroke that moves through the water effortlessly propelling you further than you are going right now. Or how about a pedal stroke on the bike in your deepest aero position that feels powerful and efficient as it does when you are upright. What about your run gait that is long, balanced and little vertical oscillation? Incorporating mobility exercises into your routine can improve not just your joint range of motion, but your strength in that new range, increasing power output along with better biomechanics and efficiency across all your disciplines.

Smoother Recovery: Endurance sports are demanding, physically, mentally and emotionally. When you have a solid mobility routine, this can aid in faster recovery through reducing muscle and joint stiffness, and continuing to maintain full ranges of motion that don’t limit your movement. With more fluid movement you'll be more willing to hit that hard workout once your planned recovery period is over, and not have to wait long for your next hard set.

The 40+ Woman

Perimenopause is where your hormones are on a crazy unpredictable roller coaster ride. Some days they are up, some down, and some days you’ll get extremes of both. This is what causes the symptoms, such as hot flashes or night sweats. They are also responsible for brain fog, irritability and decreased sleep. Wait, there's more. Don't forget about tight joints, and decreased muscle and bone mass to name a few. These things can sometimes go away after menopause, but some may still linger. Regardless of which of these periods of your life you are in, wouldn't it be nice to have control over even just one of those issues? Tight joints perhaps? You’ll benefit from doing focussed mobility training along with your triathlon training which will make your journey to the finish line more enjoyable.

You may have noticed that it takes you longer to warm up. There may also be joint aches and pains sometimes for no apparent reason. Before your traditional warm up, an additional mobility specific warm up may be helpful. This mobility work focuses on slowly moving your joints to warm them and the nervous system up. While doing them you will also increase your heart rate. The nice thing about mobility work is that it is a GREAT post-exercise cool down too. Doing them post workout will help bring your heart rate down while calming your central nervous system.

Functional Range Conditioning Mobility

When I talk about mobility, many people think of typical stretching and dynamic warm ups. But that is not it. I’m talking about specific, joint movement patterns that focus on your available range of motion. These movements will also help you improve your range of motion and strength, in a controlled systematic way. This practice is called Functional Range Conditioning, FRC for short. In short it is to “increase one's active, usable ranges of motion by simultaneously improving articular mobility, strength/resilience, and neurological control”. All things that start to deteriorate when we hit perimenopause. See how they define mobility work here.

When I first start with my athletes or clients, they always get a mobility screen. With this I learn where their limiters are, and it gives us a place to start building them up to be more durable. These limiters are worked on by starting each session, be it their swim/bike/run or strength sessions with the specific mobility exercises to address their needs. Then this allows us to shorten their warm up and get right into the heart of the workout.

 

Here is a quick video (sped up x10) on how I prep my ankles and hips before I run. It has helped me tremendously with getting rid of ankle, hip and back stiffness at the beginning of my runs. I feel better, so I run better, longer, and recover quicker as a result.

Above is a video for those swimmers looking to improve their shoulder mobility and strength to have a more powerful swim stroke. This mobility exercise focuses on shoulder external rotation both in increasing your range of motion, but improving nervous system function/control of that range of motion, AND building strength in the new range of motion…turn the volume up, I was having microphone issues.

The Long Haul

Are you looking to stay in your sport as long as YOU want to? If yes, then you’ve got to focus on more than swim, bike and run fitness. I’ve seen some amazing older athletes. At Nationals, this year, the oldest female competitor (and oldest competitor) was 84. This doesn't just happen. Go beyond SBR and work on your strength and especially your mobility.