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Does the menopause cause insomnia?

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I'm Sarah - Sleep Coach & Therapist. I help women to sleep better so that they feel like themselves again,

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Why Does Menopause Cause Insomnia? Discover What’s Going On & How to Sleep Better

Sleep problems, especially insomnia, are a common struggle for women going through perimenopause and menopause. In fact, up to 60% of menopausal and post-menopausal women report difficulty sleeping.

But why does this happen, and what can you do to improve your sleep? Let’s explore the connection between menopause and insomnia and get my practical tips to help you get the rest you deserve.

Understanding Menopause: A Natural Transition (aka Reverse Puberty!)

Menopause is a natural biological process that signals the end of a woman’s periods. It typically occurs between the ages of 45 and 55, with the average age in the UK being 51. You’ve officially reached menopause when you haven’t had a period for 12 consecutive months. After that date you are post menopause.

The ovaries gradually produce less oestrogen/estrogen and progesterone, the hormones that regulate monthly menstrual cycles. While this is a natural part of aging, menopause can also occur earlier due to surgical procedures (e.g. hysterectomy (removal of the womb) or oophorectomy (removal of ovaries)) or medical treatments (such as chemotherapy). 1 in 20 women experience a younger menopause due to a condition called premature ovarian insufficiency (POI).

Symptoms of Menopause

Every woman experiences menopause differently. Some breeze through it with minimal symptoms, while others face a range of challenges, such as:

  • Hot flashes and night sweats
  • Mood swings and irritability
  • Sleep disturbances, including insomnia
  • Brain fog and trouble concentrating
  • Fatigue and low energy
  • Changes in libido, hair, skin, and weight.

There are around 45 different symptoms of perimenopause (I was amazed when I first heard this). Among these, sleep problems like insomnia can significantly impact your daily life and well-being. So yes, the menopause can cause insomnia for a lot of women.

What is Perimenopause? The Lead-Up to Menopause

Perimenopause is the transition phase before menopause, during which hormone levels fluctuate. This phase can begin as early as your late 30s and may last for several years (or even a decade).

During perimenopause, you may still have periods, but they might become irregular—either lighter, heavier, or more spaced out. Alongside these changes, many women experience early symptoms of hormonal shifts, such as fatigue, mood swings, and trouble sleeping.

Why Perimenopause Can Be Confusing

One challenge of perimenopause is that symptoms often sneak up gradually. Many women don’t realize what’s happening (I didn’t) until they look back and connect the dots. For others, these hormonal shifts can begin suddenly, creating physical and emotional changes that feel overwhelming.

Sleep issues, including difficulty falling asleep and waking frequently, are often one of the first noticeable signs. (Click here to read my blog post Is There a Test For Perimenopause?)

Do I Have Insomnia?

Insomnia is a common sleep disorder that goes beyond a few bad nights’ sleep. It can look like:

  • Trouble falling asleep
  • Waking up frequently during the night
  • Waking too early and being unable to fall back asleep, or
  • Feeling tired or unrefreshed despite getting enough hours in bed.

For sleep problems to be officially labelled chronic insomnia, these symptoms occur at least three times a week for three months or more. But my experience of working with women with insomnia is that if you’ve had trouble sleeping for 6 weeks or more, you may already have an ongoing insomnia problem.

The Daytime Impact of Insomnia

Poor sleep doesn’t just affect your nights – it seeps into your days. Insomnia can lead to:

  • Persistent fatigue and low energy
  • Difficulty concentrating or “brain fog”
  • Mood changes, such as irritability or anxiety, and
  • Increased appetite, often leading to weight gain.

Poor sleep makes everything harder and for women in perimenopause, insomnia can feel like yet another hurdle in an already challenging phase of life.

Why Does Menopause Trigger Insomnia?

A few different things contribute to insomnia during perimenopause and post menopause:

  1. Hormonal Changes: As oestrogen/estrogen and progesterone levels drop, the body’s natural sleep-wake cycle can become disrupted. These hormones help regulate sleep, so lower levels can make restful nights harder.

  2. Night Sweats and Hot Flashes: These common symptoms can cause frequent awakenings, making it difficult to stay asleep or get back to sleep after you’ve woken up.

  3. Mood Changes: Hormonal shifts can lead to increased anxiety or feelings of restlessness or irritation, which can make winding down at night more difficult. Some women wake in the night feeling panicky too and struggle to get back to sleep.

  4. Physical Discomfort: Joint pain, headaches, and the need to pee frequently during the night can disrupt sleep.

  5. Age-Related Sleep Changes: As we age, our sleep patterns naturally change too, often leading to lighter-feeling, less restful sleep.

How to Improve Sleep During Menopause

The good news is that there are steps you can take to manage insomnia and improve your sleep quality. Here are some practical tips to help.

1. Set a Consistent Sleep Schedule

Wake up at the same time every day, even on weekends. This routine helps regulate your body’s internal clock, making it easier to fall asleep and wake up naturally.

2. Create a Relaxing Bedtime Routine

Spend at least 30 minutes winding down before bed. Avoid screens during this time, as the blue light emitted by phones and computers can interfere with melatonin production, the hormone that promotes sleep. Instead, try activities like reading or listening to calming music.

3. Check Your Sleep Environment

Your bedroom should be a haven for sleep. Keep it cool (16-18°C or 59-65°F), dark, and quiet. Consider blackout curtains and ear plugs if you are sensitive to your environment waking you up. Those loveable pets that we share our home with can also interrupt our sleep, so it might be time to make a change to their access too.

4. Watch Your Diet

Limit caffeine and alcohol, especially in the evening, as they can interfere with getting to sleep, staying asleep and sleep quality. Also, avoid large meals close to bedtime. (Click here to read my blog post Discover How Caffeine, Alcohol & Nicotine Affect Your Sleep.)

5. Move Your Body During the Day

Daily physical activity (walking is fine) can help you fall asleep faster and enjoy deeper sleep. Aim for moderate exercise earlier in the day, as vigorous workouts close to bedtime might have the opposite effect.

6. Seek Professional Help

If your insomnia persists please get help – don’t let it linger on and become more of a problem. Your doctor can look at medication options, such as hormone therapy or non-hormone based medications. A completely natural option, which has been widely proven to work for insomnia is cognitive behavioural therapy for insomnia (CBTI). CBTI targets the worry and unhelpful sleep routines that keep insomnia going night after night. It can help whether you are on MHT/HRT and your sleep isn’t better or if you don’t want to or can’t take hormone replacement therapy.

If the menopause does cause insomnia – what do I do next?

I have put together a FREE Mini Sleep Training if you’d like to learn more. It’s packed with practical advice to help you take control of your sleep and feel your best. Menopause can be challenging but it doesn’t have to rob you of restful sleep. By understanding the changes your body is experiencing and making small, intentional adjustments, you can manage insomnia and improve your overall quality of life.

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