Why Does Sleep Change During Perimenopause?

If you fall asleep at night but wake up at three or four in the morning and can't get back to sleep properly, you're not alone. Sleep disturbances are very common during perimenopause.

For some women, this means having a harder time falling asleep; for others, it means fitful sleep or the feeling that even eight hours in bed no longer leaves them feeling as refreshed as they used to.

Why Might Sleep Change?

During menopause, several factors can affect sleep at the same time.

Hot flashes and night sweats can disrupt sleep, but mood swings, stress, and changes in daily life that occur alongside hormonal changes can also play a role.

The National Institute on Aging notes that hot flashes—especially night sweats—and mood swings can contribute to poor sleep during the menopausal transition.

Do hot flashes wake you up?

It is often believed that hot flashes cause waking up. The connection may be more complex.

The NIA notes that, based on research, in some cases waking up may actually precede a hot flash. This suggests that the relationship between sleep and menopausal symptoms is not always a simple cause-and-effect one.

Alcohol may seem helpful, but it can actually make your sleep worse

A glass of wine may help you fall asleep faster, but that doesn't necessarily mean you'll sleep better.

The NIA points out that even a small amount of alcohol can make it harder to sleep through the night. It also recommends avoiding caffeine late in the day, especially if sleep has already become fitful.

What can you do to support your sleep?

A sleep routine doesn't have to be perfect. However, some simple habits are quite well-founded.

Try to go to bed and wake up at roughly the same time each day, keep your bedroom cool, and avoid eating large meals late at night.

Regular exercise can support sleep, but it’s best not to engage in intense exercise right before bedtime. Reducing screen time before bed can also help. The NIA recommends these steps to support sleep during menopause.

When does it stop being just a bad night?

If a sleep problem has persisted for a long time or is significantly affecting your ability to function during the day, it’s a good idea to talk to your doctor about it.

Cognitive-behavioral therapy may be one option for treating insomnia. The NIA highlights it as a method that can help improve sleep in women with menopausal symptoms

Good sleep deserves attention

Changes in sleep are not something we should simply accept as a natural part of aging.

Once you understand what affects your sleep, you can begin to distinguish between the things you can change on your own and those for which it’s worth seeking help from a specialist.