According to doctor Ngo Thi Kim Oanh, head of the Acupuncture and duong sinh Department at University Medical Center Ho Chi Minh City - Campus 3, women entering middle age often face complex physiological changes. Among these, chronic insomnia is a common symptom that is easily overlooked.
In reality, this is not simply difficulty falling asleep or restless sleep. Prolonged sleep disorders in this age group can become an independent risk factor leading to high blood pressure, metabolic disorders, and cardiovascular disease.
Estrogen decline: the culprit behind sleep fragmentation
Estrogen plays a role in regulating many biological systems, including the hypothalamic-pituitary-ovarian axis and the central nervous system. During the premenopausal stage, fluctuations in this hormone directly affect the hypothalamus, the center for sleep regulation.
Estrogen helps regulate serotonin, melatonin, and thermoregulation mechanisms. When hormone levels decrease or fluctuate erratically, women are prone to night sweats, hot flashes; rapid heartbeat, and frequent awakenings.
This "sleep fragmentation" reduces deep sleep duration, preventing the body from recovering. As a result, the sympathetic nervous system becomes overactive, increasing nocturnal cortisol secretion. This is the underlying mechanism that promotes cardiovascular risks.
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Dual risk of hypertension and diabetes
Chronic insomnia disrupts the circadian rhythm, especially the cortisol-insulin axis. Studies show that when sleep duration is under 6 hours per night for an extended period, insulin sensitivity decreases, causing insulin resistance and promoting increased fasting blood sugar.
Concurrently, prolonged sympathetic activation increases peripheral vascular resistance, maintaining high blood pressure. Middle-aged women, already having lost the protective shield from estrogen, face an even more pronounced risk when combined with weight gain, physical inactivity, and psychological stress.
"Many cases only accidentally discover cardiovascular disease after complications have arisen, while the history spanning many years prior actually started with two words: insomnia," doctor Oanh emphasizes.
Distinguishing between stress-induced and endocrine-related insomnia
Correctly identifying the cause leads to more effective treatment:
Stress-induced: Often related to work and family pressures. Patients have difficulty falling asleep, overthink, experience anxiety, and muscle tension. Sleep may improve with environmental changes or reduced pressure.
Endocrine-related: Accompanied by characteristic symptoms such as hot flashes, menstrual irregularities, vaginal dryness, and palpitations. Patients may fall asleep but wake up easily in the middle of the night and find it very difficult to fall back asleep.
In clinical practice, these two groups of causes often overlap, forming a "vicious cycle of pathology" that is difficult to break without timely intervention.
Multidimensional solutions: integrating traditional eastern and western medicine
To improve quality of life, doctors recommend a comprehensive treatment approach:
Sleep hygiene and exercise
Maintain a fixed sleep schedule, limit electronic devices before bed.
Avoid coffee and alcohol in the evening.
Moderate-intensity exercise (brisk walking, yoga, breathing exercises) helps regulate the autonomic nervous system and manage weight.
Modern medical interventions
Consider hormone replacement therapy (when indicated and closely monitored).
Use short-term supportive medication to avoid dependency.
Early screening for blood pressure, blood lipids, and blood sugar.
Support from traditional eastern medicine
According to Traditional Eastern Medicine, middle-aged insomnia is often due to Heart and Kidney Disharmony, Liver Qi Stagnation, or Yin Deficiency with Fire Blazing. Methods such as acupuncture, acupressure massage, and dietary adjustments effectively nourish the heart, calm the spirit, soothe the liver, and resolve stagnation.
Combining traditional eastern and western medicine helps reduce symptoms quickly, limits reliance on sedatives, and helps middle-aged women navigate physiological changes more smoothly.
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