Menopause and Insomnia: Why Sleep Gets Hard and What to Do
Menopause is a big change in a woman’s life. It marks the end of the menstrual cycle. But it also comes with many menopausal symptoms, like hot flushes, mood swings, and sleep problems. One of the biggest complaints? Insomnia during menopause.
Let’s talk about how menopause affects sleep quality, why it happens, and what you can do to feel better. We’ll keep it simple so you can understand and take action. If you need help now, check out our insomnia treatment page.
What Is Menopause?
Menopause is when a woman stops getting her menstrual period for 12 months in a row. It usually happens between ages 45 and 55. Before that, women go through perimenopause, where hormone levels like estrogen start to change.
What Is Insomnia?
Insomnia means having trouble falling asleep, staying asleep, or waking up too early. It makes people feel tired during the day. Chronic insomnia disorder lasts a long time, while acute sleep issues may only last a few nights.
Why Menopause Causes Sleep Problems
There are many reasons why menopausal women have sleep difficulties:
1. Hormone Changes
Low estrogen levels can affect your sleep-wake cycle and core body temperature. This leads to night-time awakenings and hot flushes.
2. Mood Changes
Many women feel depressed mood, anxiety symptoms, or have mental health conditions like depressive disorder during menopause. These affect quality of sleep.
3. Body Temperature
Sweats during menopause—also called night sweats—can wake you up often. Your body’s ability to control body temperature changes, making sleep harder.
4. Sleep Disorders
Women during this time can also develop sleep disorders like obstructive sleep apnea or central sleep apnea. These conditions disturb sleep all night long.
Who Has Menopause-Related Insomnia?
- Premenopausal women: Usually have regular sleep.
- Perimenopausal women: Start to have sleep disruption as hormone levels change.
- Postmenopausal women: Often report poor sleep quality, especially with frequent awakenings.
Common Sleep Complaints During Menopause
- Trouble falling asleep (sleep onset insomnia)
- Waking up too early (earlier sleep time)
- Waking up often (frequent night-time awakenings)
- Trouble staying asleep (sleep maintenance disorders)
- Daytime tiredness (daytime impairment, daytime sleepiness)
How Menopause Affects Mental Health
There is a bidirectional relationship between sleep and mental health. Poor sleep can make depressive symptoms worse, and feeling sad or anxious can make sleep harder.
Many midlife women feel stressed during this phase of life. Changes in family, work, and health can all play a role. That’s why sleep support is so important.
Treatments That Can Help
1. Cognitive-Behavioral Therapy (CBT)
CBT is a type of therapy for insomnia that helps change feelings around sleep and habits. It is a first-line treatment and part of Behavioral Sleep Medicine.
2. Hormone Replacement Therapy (HRT)
Hormone replacement therapy can help balance estrogen levels, which may improve quality of life and reduce sleep disturbances. This is also called menopausal hormone therapy.
Note: HRT isn’t for everyone. Talk to a doctor about medical history and risk factors before starting.
3. Dietary Supplements
Some women try Prolonged-Release Melatonin or exogenous melatonin to improve sleep. These help with the circadian rhythm and circadian clock.
4. Light Therapy
Helps reset your body’s circadian rhythm sleep patterns. Good for people who fall asleep too early or too late.
5. Exercise Therapy
Staying active can improve sleep and reduce depressed mood. Even walking or yoga helps!
6. Complementary Therapies
Some women use complementary therapies like breathing exercises, mindfulness, or herbal teas.
What About Therapy Beyond Age?
Cognitive therapy, behavioural therapy, and even talking with health practitioners can make a big difference—no matter your age or stage.
Need help getting started? Explore therapy for insomnia now.
Lifestyle Tips for Better Sleep
- Stick to a schedule
- Avoid screens before bed
- Keep your room cool
- Don’t nap too much
- Avoid caffeine late in the day
- Try relaxing before sleep
Medical Conditions to Watch
Some medical conditions can cause or worsen menopausal insomnia. These include:
- Diabetes (affects blood sugar levels, insulin levels)
- Thyroid problems
- Mood disorders like anxiety or depression
- Obstructive sleep apnoea or other primary sleep disorders
A sleep physician can help check for diseases with sleep disorders and offer the right help.
What Doctors Look For
Health experts take a careful history of your sleep habits and clinical history. They might suggest a systematic review or meta-analysis of your symptoms or do sleep studies.
If you’ve had surgical menopause (like a bilateral oophorectomy), this can affect hormone levels and sleep even more.
The Big Picture: Quality in Women’s Health
Sleep affects your quality of life, health outcomes, and mental health. That’s why treatment for sleep during menopause matters so much.
Whether you’re in the menopause transition, post-menopausal, or still in perimenopause, it’s never too early to take care of your sleep.
FAQs About Menopause and Insomnia
1. Why does menopause cause insomnia?
Hormone changes like lower estrogen levels mess with sleep patterns. This causes sleep disruption and night-time awakenings.
2. What’s the best treatment for insomnia during menopause?
Cognitive-behavioral therapy is a first-line treatment. Some also benefit from hormone replacement therapy.
3. Can melatonin help with menopause sleep issues?
Yes, exogenous melatonin or Prolonged-Release Melatonin may help regulate your circadian rhythm.
4. Is insomnia common in menopause?
Yes! Many menopausal women report poor sleep quality and other aspects of sleep problems during this time.
5. When should I see a doctor?
If you have chronic insomnia, frequent night-time awakenings, or other complex sleep issues, see a doctor or sleep physician.
If you’re struggling with sleep difficulties during menopause, remember—you are not alone. Many women face common symptoms during this life change. But with the right support, treatment, and care, you can get better sleep and feel like yourself again.
For personalized help, visit our insomnia treatment page or visit SAMHSA for more information.
