Hot, flashy science
This research from the NIH is hard science and without some kind of medical degree might be tough to wade through, but it has some really interesting points to make about wtf is going haywire, exactly, in our bodies during our evening hot flashes. I am going to try to translate it into plain English without removing the science. If you are interested in getting a little nerdy about why we are getting so hot, stay with me. I think it such a power move to understand the physiology of this, and of course understanding what causes an issue leads to possible solutions.
Most (oversimplified) articles will tell you that hot flashes and night sweats are caused by reduced estrogen levels, but there are plenty of people around - children, men - who have low estrogen levels and are blithely going about their sleeping business without sweaty sternums. This article poses a compelling theory: that it is estrogen WITHDRAWAL, partnered with elevated norepinephrine in the brain, that is causing us to go slightly outside our “thermoneutral zone”.
Let’s unpack that. The body has a pretty small window of temperatures it is able to fully function at - you know 98.6 as the ideal norm - and even a few degrees too warm takes us into a sweating response, while a few degrees too cool triggers a shivering response - the upper and lower ends of our thermoneutral zone. The thermoneutral zone is where the body is happy and can safely and fully function, without sweating or shivering.
Norepinephrine is a hormone secreted by the adrenal glands in times of stress. Like adrenaline, it switches the body from its normal happy “rest and digest” (parasympathetic) state into its emergency - “fight or flight” (sympathetic) response. It sends blood and energy away from our internal organs and to our muscles so we can run or fight or defend ourselves. This is super helpful during a bear attack. It is less helpful in the middle of the night. Here are a few of the symptoms of increased norepinephrine in the brain oh gosh let’s see if any feel familiar: anxiety, rapid heart beat, agitation, and sweating. Over time, sleeplessness and loss of libido.
Norepinephrine is thought to narrow what our body considers to be a safe and reasonable thermoneutral zone, causing us to trigger into sweating more readily. We have all experienced this - someone snaps at you, you get nervous and start sweating. It looks like this.
HILARIOUSLY, estrogen serves to mellow the action of norepinephrine in the brain. If we have any. When estrogen drops in the middle of the night, and norepinephrine rises, we overheat, get anxious, wake up, and sweat.
Why is norepinephrine elevated all of a sudden in the middle of the night? It isn’t! We are living in stress response too much of the time in our day. This causes increased norepinephrine all the time. Which is decreasing our thermoneutral range, triggering us to overheat more easily day and night, and now with ever less estrogen to balance us out.
Is this not so interesting?! I am an endocrine nerd, so I like knowing this. But aside from sheer glandular fun, this info suggests a strategy: lower your norepinephrine load! How do we do that? Spend more time in rest and digest (parasympathetic) mode and less time in fight or flight (sympathetic) stress mode.
And how do we do that?
It is all the annoying shit you already know, just now with science! We can do a few things to lower the number of times we get stressed during the day:
1. Put your phone on silent and turn off as many notifications as you can. Those beeps and pings and little red circles give us virtual pellets of excitement, which stimulate fight or flight response, switching us to sympathetic mode. Turn them off.
2. Don’t watch a lot of zombie shows and murder things. Like duh but also seriously. You have no idea how much murder podcast related insomnia I treat.
3. Don’t play video games. (except tetris!) They are adrenaline machines. I’m so sorry. I know some people like to unwind playing games but it might be counterproductive. I am always bad news Jane on this stuff. Get a load of number 4.
4. Don’t drink coffee. Or just the less the better. It is made to rattle your teeth in your skull. Our tolerance for that sort of shit really plummets around age 45. And have you noticed your teeth rattle in your skull now more anyway? #boneloss Also, sugar. And cocaine. Again, very sorry and also you know this.
But we can absolutely not avoid getting triggered into sympathetic nervous system mode a jillion times a day because 2023 am I right?? So, let’s look at how to get back to parasympathetic nervous system once you’ve gotten startled.
1. Laugh in the face of peril. We need to let our bodies know that the danger has passed. It isn’t enough to think to ourselves, “okay that meeting is over, and it hasn’t killed me”. We actually need to make physical sounds of relief like laughing and great big sighs to signal to our adrenals that the emergency has ended, and it hasn’t killed us.
2. Shake it like a polaroid picture. Once your body has, in a panic, sent all your blood and energy to your muscles to escape the bear attack, the best way to burn through that literal nervous energy is by moving it. Brisk walking, running, tree climbing, shimmying, and dance parties all work. Ideally, you would sprint three blocks, climb a tree, and loudly proclaim “hahaha I have outrun the bear!” So, something like that. Shake it off. Shake it up. You will know it worked when suddenly you have a sense of relief and pleasure coursing through your veins instead of panic and overwhelm. Yoga helps enormously.
3. Meditate. Okay I know I know. But here is the trick: don’t try to meditate when you are freaking out. Meditate every day for 15-60 minutes as part of a regular practice. It is too late once you’re freaking out. You can’t think your way out of a norepinephrine-induced panic attack. But you can lower your threshold for tipping INTO a norepinephrine-induced panic attack by meditating regularly at a quiet point in your day. The old joke goes if you don’t have 20 quiet minutes to meditate in your day, meditate for 40 minutes. If your life really genuinely doesn’t have 20 quiet minutes in it, and you can’t see any place to carve 20 minutes from, it isn’t hard to imagine why you are feeling so jangled.
4. Carve out some quiet times throughout the day. If your eyes pop open in the morning and you grab your phone and immediately go into 17 hours of panicked overstimulation, don’t think there is anything in this world that will allow you a peaceful and restorative night’s sleep. You will never find the time. You must insist upon the time. Carve it with a knife. This leads naturally into a whole rant about late stage capitalism and the oppressive, racist, colonialist, misogynistic, misogynoir norms that keep us running when we should be resting and I am frankly out of steam from writing this post. Just literally too tired of typing to rant. But I have one ready to go at some later date, believe that. Let’s just say I am going to go rest and you should too. I spend an amount of time lying on the couch under a pile of cats every day that has to be seen to be believed.
5. Get freaky. Any physical thing in you life - sex with yourself or others, swimming, a walk, yoga, qi gong - that is some intense burst of physicality followed by some feelings of relief and relaxation will help the cause.
6. Breathe. Deep belly breaths, making your exhales last a little longer than your inhales, making noises and sighing as you exhale all release tension from the body. Equal breathing is an ancient yogic practice that will absolutely restore you to parasympathetic rest.
What does a hot flash feel like for you? How long does it last? How does it come on and how does it end? Are you cold after? Is there emotional or body sensation? Describe it! Tell me everything!