Since the arrival of the menopause, the maid Maria Vanda Cavalvante Silva (51) did not know what a night was good asleep. With the intense heat waves characteristic of this phase, the paulistana woke up every half hour with discomfort and struggled to fall asleep again.

After months of martyrdom she went looking for a gynecologist who specialized in the sleep of women and began hormone replacement therapy, which significantly improved her symptoms. But the full restoration of sleep quality only occurred when the patient began practicing meditation, also on medical advice.

"I followed my ritual of meditation every day before going to bed, and I went to sleep seven hours a day, night," he says.

Like Maria Vanda, 32% of paulistana women have problems with insomnia, twice as many men. In the menopause phase, this percentage rises to 60% of women. It was reminiscent of this huge contingent of patients that researchers at the Sleep Institute of the Federal University of São Paulo (Unifesp), responsible for increasing these numbers, began to study the effectiveness of different therapies for the problem.

Hormone replacement and behavioral therapy are the most commonly used techniques, but in recent years the group has evaluated the effectiveness of so-called integrative methods, such as yoga, meditation and massage, and achieved good results.

Researcher at the institute, gynecologist Helena Hachul, presented some of these results during the 15th edition of the Brain Congress, an event on brain, behavior and emotions that was held in Gramado at the end of June. state.

According to the scientist, the results are especially important for women who do not want or can not do the replacement therapy. "If insomnia started after menopause, hormone replacement is the first treatment option, but there are patients with contraindications, such as those with breast cancer, so we have to think about options," he says.

One of the first studies conducted by Helena showing good results was the benefit of isoflavones, a soy-derived herbal remedy that functions as a "natural hormone therapy". In the study of 38 menopausal women, insomnia declined from 89.5% to 36.9% among the group that consumed the product, while in the patients who took the placebo the decrease was 94.7% for 63, 2%. .

Other institute studies have still shown the efficacy of acupuncture, meditation and massage. In the most recent research published in the journal menopausand this year a beneficial effect of mindfulness and relaxation on sleep quality, reduced insomnia, increased attention levels and reduced symptoms of menopause was observed. "The next study will be with aromatherapy," says the researcher.

Multiple causes. The good results of alternative therapies in the treatment of insomnia in women are related to the fact that the problem has multiple causes. "Menopause is a time of great unrest for the woman, it undergoes physical, psychological, hormonal changes, the cognitive / behavioral factor is very important, and practices such as meditation and relaxation are inserted, but this does not mean everyone is going" said Luciano Ribeiro. , a neurologist and coordinator of the Sleep Medicine unit in the German hospital Oswaldo Cruz.

In situations such as Maria Vanda, the best option was to combine different treatments, such as the use of drugs and hormones with the application of relaxation exercises. In the case of the seamstress Floraci Duarte de Oliveira, 61, alternative therapies made it unnecessary to use sleeping pills.

After the menopause, the patient also started having trouble sleeping, and even when she did, she woke up several times at night. Very anxious and worried, she did not have a good night's sleep or used insomnia medication. "I could even sleep with the medicine, but it was not a good night's sleep, I did not feel rested," she says.

About two years ago he started with acupuncture and meditation and dropped the pills. Also began the so-called sleep hygiene, a series of habits that people should practice before they go to bed, to enter. "I do not do heavy meals, I meditate, I avoid taking too much water before I go to bed, now I sleep without problems, I do not agree much less often and I feel more prepared the next day," she says.

See 8 tips for people with insomnia

– Leave the environment in low light and try to sleep at the same time whenever possible

– Avoid drinking coffee between late afternoon and in the evening

– Do not keep the clock in the room, because the fear of looking at it every minute makes sleep more difficult

– Do not have a TV in the room

"Just go to bed when sleep comes, do not do other activities (food or crafts) in the environment that should be limited to the rest period

– Look for ways to control stress and so-called "intrusive thoughts"; meditation and breathing exercises can help

– Train regularly and try to maintain a healthy diet.

– Avoid heavy meals at night and watch the evening meal (light meals) three hours before bedtime