Menopause and sleep don’t always go together. Here are some of the reasons behind menopausal sleep problems, and some tips to help you get some rest.
This article was reviewed and fact-checked by Dr. Fionnuala Barton.
Dr. Fionnuala Barton is a GP, Women’s Health Doctor, and registered member of the British Menopause Society.
She is passionate about optimizing physical and emotional wellness for women at all stages of life and has a particular interest in early recognition and management of perimenopausal and menopausal symptoms, POI, PMS, and PMDD.
Dr. Barton is the founder of The Menopause Medic, an independent women’s hormone health clinic that aims to provide empathetic, holistic, personalized, proactive, evidence-based women’s hormone health consultations.
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You don’t need us to tell you that seven to eight hours of sleep per night is a healthy goal for adults to aim for.
But, if you’re one of the (at least) 39% of women struggling with menopause and insomnia, you’re probably ready to throw a pillow at the next person who points that out.
Menopause and sleep are connected, whether it’s perimenopause symptoms giving you a rude awakening, or hormonal imbalances making it hard to get a full night.
So here’s what might be going on, and some steps you can take to wake up feeling a little more refreshed.
In this article: 📝
- What is menopausal insomnia?
- Why does menopause affect sleep?
- Is your sleep loss definitely menopause-related?
- Does menopause insomnia go away?
- How can I sleep better during menopause?
What is menopausal insomnia?
It’s well established that menopause and lack of sleep go together for a lot of women.
But where’s the line between poor sleep and menopause, and actual insomnia?
According to the medical definition, you might be in an insomnia phase if you can tick a few of these boxes:
- It takes you longer than 30 minutes to fall asleep
- You get less than six hours of sleep on three or more nights a week
- You don’t feel rested when you get up
- You feel tired throughout the day
- You find it difficult to focus or remember things
- You’re clumsier or make more mistakes than usual
- You have other symptoms, like headaches or gastric problems
- You feel anxious, stressed, or irritable
Is this you? If so, what exactly is going on?
Why does menopause affect sleep?
There are two main reasons why sleep and menopause are not friends.
First, the menopause hormones themselves, and second, the symptoms those hormones can give you.
The hormone thing
No matter how tiring your day was, your body gets the best quality sleep when your hormones are balanced.
That’s why stress or anxiety can make it so tough to sleep – the extra cortisol and adrenaline are preparing your body to face the challenges it’s expecting, and understandably, these clash with the melatonin that tells your body that it’s okay to switch off.
Estrogen and progesterone hormones are also really important for sleep.
During perimenopause (the period of time before the official menopause, which is officially 12 months after your last period), your levels of these hormones are also erratic. They’re on a downward trend, but it’s not a smooth curve.
So there are going to be a lot of days when you have too much of one or not enough of the other, and a lot of nights when you find yourself staring at the ceiling thinking, “if I fall asleep now, I can have four hours, If I fall asleep now, I can have three…”
The symptoms thing
Does menopause make you wake up in the middle of the night? It might be because of some classic perimenopause symptoms.
These are often to blame for the link between menopause and sleep disturbance.
- Night sweats can have you waking up cold, clammy and tangled in your sheets.
- Hot flashes can wake you up and have you reaching for a fan.
- Restless legs or painful leg cramps can give you a very rude awakening.
- Waking to pee.
- And then there’s the fact that fluctuating hormone levels can be responsible for some really unpredictable dreams.
Is your sleep loss definitely menopause-related?
There might be other factors at play though too. If you are struggling more and more with insomnia, it could be worth getting a general health check before you blame it all on menopause.
Some medications make it harder to sleep, and anemia (iron deficiency) can cause sleep problems too.
Also, the older you get, the higher your risk of sleep apnea – a condition where you don’t breathe regularly while you’re asleep, which makes it almost impossible to get the deep, restorative sleep your body really needs.
Does menopause insomnia go away?
The good news is that menopause is a transition, so as long as your insomnia isn’t related to something else, there will be an end to this phase of your life, and the symptoms which are making it difficult to sleep will (eventually) subside.
But that’s not always the most reassuring news when you then read that, on average, women can experience various forms of menopause symptoms for about seven years.
Studies have shown that up to 60% of postmenopausal women have phases of insomnia – much more than men of the same age.
OK. So if that’s the bad news, your next question is probably, “what can I do about it?”
How can I sleep better during menopause?
First of all, the medical options: both hormone replacement therapy (HRT) and hormonal birth control are sometimes used to stabilize hormones at different stages of menopause.
For some women, antidepressants can also be helpful.
Not all these options are right for everyone, so your doctor will be able to give you advice.
Some women find that essential oils like clary sage and fennel help to ease a whole range of menopause symptoms, including issues with menopause and sleep problems.
Chamomile, lavender, and ylang-ylang are also classic sleep aids.
You can try a few drops in a bath or in massage oil, or spray them on your pillow.
As for supplements, passionflower and valerian are some of the most helpful natural sleep aids.
Or, for something more potent to bring some calm into your menopausal life, how about CBD oils?
Without a prescription, the next best things you can do to improve your sleep are:
Set up your bedroom so it’s just right
- A cool temperature (about 65F/18.5C)
- A blackout curtain or silk sleep mask
- Sheets with natural fibers like cotton or silk (these are great for combatting hot flushes too)
Get lots of natural light during the day
- If your schedule lets you, exercise in the sunlight
- If you’re stuck at your desk, consider using a daylight lamp for an hour or two each day
Keep screens out of the bedroom
- Charge your phone in another room
- Use an analog alarm clock
- Ideally, switch all your screens off an hour before you plan to go to sleep, and use a blue light filter if you need to look at them after dark.
Unwind before bedtime
- Have a warm bath or shower (try Epsom salts or something similar)
- Read or listen to chilled out music for a while before you turn in
- Write down anything you’re worried about or make a to-do list for the next day so your brain stops turning these things over when it should be going to sleep.
Finally, let yourself make a plan B
If it all goes wrong and you find yourself wide awake at 2am, you don’t have to lie there for the rest of the night.
It’s often more helpful to walk around a little, make a hot drink, pick up your bedside book or chill out in another room rather than lie awake worrying.
Chances are, any one of these could help you feel sleepy again.
So just because menopause is wreaking havoc with your hormones, there are at least some ways to try and work around it.
Good luck… and sweet dreams!
📚 More on menopause:
Introducing, Peanut Menopause
What Happens During Menopause?
How to Deal With Menopause
When Does Menopause Start?
Hot Flashes: Causes, Symptoms, and What to Do
What to Know About Menopause Joint Pain
Unusual Menopause Symptoms You Might Not Know
Menopause Fatigue: What to Know and What to Do
Essential Oils for Menopause: What Helps?
What You Need to Know About Menopause Mood Swings
Evening Primrose Oil & Menopause: What’s the Story?
What are the Signs Perimenopause is Ending?
What are the 34 Symptoms of Menopause?
Menopause Weight Loss: What to Know