How Menopause Affects Sleep—and What You Can Do About It

Menopause is a natural transition in a woman’s life, typically occurring in the late 40s to early 50s. As hormone levels shift—particularly estrogen and progesterone—many women experience symptoms that affect both physical and emotional well-being, including one of the most common and frustrating: trouble sleeping.

If you're tossing and turning more than usual, you're not alone. Let’s explore how menopause can affect your sleep patterns—and what you can do to get more sleep.

Hormonal Changes and Sleep Disruption

During perimenopause (the years leading up to menopause), your ovaries gradually produce less estrogen and progesterone. These hormones play an important role in regulating your circadian rhythm and sleep quality.

Estrogen, for example, helps keep body temperature stable and may influence serotonin, a neurotransmitter involved in sleep. Progesterone, often called the “natural sleep-promoting hormone,” has a calming effect on the brain. As levels of both decline, it's no surprise that sleep difficulties become more common.

In fact, studies show that 40–60% of women experience sleep disturbances during the menopausal transition (1).

Other Factors That Interfere with Sleep During Menopause

Aside from hormonal shifts, several other menopause-related symptoms and lifestyle factors can contribute to poor sleep:

• Hot flashes & night sweats: Sudden heat and sweating can wake you up repeatedly during the night.
• Mood changes: Uneasiness and irritability can interfere with your ability to fall or stay asleep (2).
• Environmental factors: Noise, light exposure, uncomfortable bedding, or excessive screen time can disrupt your sleep routine (3).

How to Improve Sleep During Menopause

The good news? Many women find relief through simple lifestyle changes and other non-prescription support. Here are several ways to improve your sleep during menopause:

1. Stick to a sleep schedule: go to bed and wake up at the same time every day—even on weekends.
2. Limit caffeine, alcohol, and heavy meal: avoid coffee, tea, chocolate, spicy foods, and alcohol late in the day, all of which can impact sleep quality (4).
3. Create a calming nighttime routine: take a warm bath, try gentle stretching, or sip a non-caffeinated herbal tea like chamomile or lavender before bed (5).
4. Cool your sleeping environment: keep your bedroom dark, quiet, and cool to help minimize sleep interruptions from night sweats or hot flashes (6).
5. Exercise regularly—but not too close to bedtime: physical activity during the day promotes better sleep, but late-evening workouts might keep you wired.
6. Try relaxation techniques: deep breathing, progressive muscle relaxation, or meditation can help your body and mind wind down
7. Consider a dietary supplement, such as Equelle, with S-equol: Equelle offers menopausal sleep support. It is associated with more sleep and improved quality of sleep⁋,|| †

When to Talk to a Healthcare Professional

If sleep disruptions continue to affect your quality of life, it’s a good idea to speak to your healthcare provider. They may suggest approaches like:

• Cognitive behavioral therapy for insomnia (CBT-I)
• Menopause-specific treatments, such as hormone therapy or non-hormonal options

In some cases, addressing underlying issues like mood disorders, thyroid imbalances, or sleep apnea may also be important.

The Bottom Line

Sleep challenges during menopause are incredibly common—but they’re also manageable. Understanding the connection between hormones and sleep can empower you to take small, meaningful steps toward better rest. With consistency and support, restful nights are still within reach.

References

1. Baker, F. C., de Zambotti, M., Colrain, I. M., & Bei, B. (2018). Sleep problems during the menopausal transition: Prevalence, impact, and management challenges. Nature and Science of Sleep, 10, 73–95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810528/
2. Smith, R. L., Flaws, J. A., & Mahoney, M. M. (2018). Factors associated with poor sleep during menopause: Results from the Midlife Women’s Health Study. Sleep Medicine, 45, 98–105. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918428/
3. World Sleep Society. (n.d.). Environmental sleep factors. Retrieved January 18, 2023, from https://worldsleepday.org/environmental-sleep-factors
4. Mayo Clinic News Network. (2020, August 12). Mayo Clinic Minute: Managing sleep during menopause. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-managing-sleep-during-menopause/
5. Hopkins Medicine. (n.d.). Natural sleep aids: Home remedies to help you sleep. https://www.hopkinsmedicine.org/health/wellness-and-prevention/natural-sleep-aids-home-remedies-to-help-you-sleep
6. National Institute on Aging. (2021, September 30). Hot flashes: What can I do? https://www.nia.nih.gov/health/hot-flashes-what-can-i-do

⁋ Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).

|| Significant vs. baseline and not placebo.

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