Is insomnia in men a sign of the MANopause? DR MARTIN SCURR answers your health ...

My 66-year-old father has developed insomnia. He has no serious underlying medical problems, but takes ramipril. Could it be stress-related or linked to the ‘manopause’?

S. Smith, North London.

We all have a strong biological drive to sleep, peaking in childhood and young adulthood. The sleep pattern tends to go off the rails later in life, typically as a result of medical problems or social factors.

The conditions that contribute to insomnia range from lung and heart disorders to urinary ones, but you say your father has no serious underlying health problems.

Menopause is a well-known trigger for insomnia in women. Men also experience changing levels of hormones such as testosterone around the age of 50 (sometimes known as the male menopause or ‘manopause’) and research shows this can mark the start of sleep problems for them, too. However, this would normally kick in from middle age onwards.

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The sleep pattern tends to go off the rails later in life, typically as a result of medical problems or social factors [File photo]

Your father is taking ramipril for raised blood pressure. While this is not known to interfere with sleep, stress, which you mention, is a risk factor for chronic insomnia. I wonder if there might be life events which have resulted in his raised blood pressure as well as anxiety or stress.

Insomnia can be triggered by major life changes, such as retirement. Also, taking an afternoon nap may well destroy a previously healthy sleeping pattern as sleeping in the day is almost inevitably counterproductive.

Becoming worried about a lack of sleep may also contribute to the originating anxiety, thereby compounding the problem.

I wonder if there might be life events which have resulted in his raised blood pressure as well as anxiety or stress. Insomnia can be triggered by major life changes, such as retirement

I wonder if there might be life events which have resulted in his raised blood pressure as well as anxiety or stress. Insomnia can be triggered by major life changes, such as retirement

The main treatment for this is cognitive behavioural therapy (CBT), a talking therapy that aims to change behaviour patterns. The therapist will focus on the anxious thoughts, being realistic about what can be achieved, and offer some techniques for relaxation.

Typically, the patient will also be asked to keep a sleep diary to document bedtime and waking times over a few weeks. This will help the therapist point out factors that should be eliminated, such as drinking caffeine in the afternoon. It will also show the patient the progress they’re making, which helps them improve further.

Referral for CBT is something your father must discuss in consultation with his GP.

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