Medically reviewed by Dr. Tamara Neuhaus MD

Sleep Problems and Perimenopause - How To Treat My Insomnia

I’m desperate to get a full night of restful sleep. Some nights it takes hours to fall asleep. Others, I zonk out immediately but wake up over and over again. I don’t want to get addicted to sleeping pills, but I have to do something. - Mei, 50

What is it?

Peri/menopause can leave you struggling to fall asleep, stay asleep, or wake up in the morning. It can leave you feeling lethargic throughout the day, impact your work and relationships—it can even affect your health by compromising your immune system, mental focus, mood, weight and more. If you’re not consistently getting at least 7 hours of sleep per night, you probably have insomnia. And you’re in good company. Many women in perimenopause and menopause share your struggle. 

Why does it happen?

Some things can cause insomnia at any age, like travel, eating or drinking too much (or the wrong things) too close to bedtime, or poor sleep habits like screen time or vigorous exercise just before bed. But here in peri/menopause you also get bonus causes, thanks to dwindling estrogen: night sweats can be so disruptive that you have to get up to change your pajamas or sheets, or just annoying enough to make you kick your covers off and pull them back on multiple times per night. The urge to pee in the middle of the night can get you up once, twice, or more. Plus, there’s just more to stress about in midlife: aging parents, growing kids, complicated relationships, more responsibilities at work, etc. Whatever the cause, the headline here is that you’re not getting the sleep you need. Luckily, there are many ways to fix that.  

What can you do about it?

If night sweats or the urge to pee are disrupting your sleep, the first thing you want to do is nip them in the bud. Click on those two links to learn about the treatment options available for these symptoms.

There are also non-addictive natural remedies that may help you get a full night’s sleep. But before you spend money on them, try these simple(ish) lifestyle changes that could solve your sleep issues.

  1. Get more exercise, preferably early in the day. It doesn’t have to be a big, sweaty workout. Take a brisk walk for 15-30 minutes/day, either to or from your office or as a walking meeting. Drop for a plank at lunchtime. Take the stairs. The more you move during the day, the better you’ll sleep at night.

  2. Avoid naps. ‘Nuff said.

  3. Eat dinner earlier—about 3-4 hours before bedtime—so your body has time to digest it fully and can focus on the task at hand: sleep. And take a pass on sweets, spicy food or alcohol, as they can disrupt your sleep.

  4. Set an alarm 90 minutes before you want to go to sleep. When the alarm goes off, so should all screens. Research has shown that the light from screens reduces melatonin (the sleep hormone) levels by 50% and this reduction can last for 90 minutes. We need melatonin to help us fall asleep!

  5. Once all the screens are off, change into comfy clothes and begin an evening ritual of your choosing to calm the nervous system and reflect on your day. Yoga, stretching, prayer, meditation, and journal writing are all great options.

  6. When you’re ready to tuck it in for the night, keep your bedroom dark and cool. And try to go to bed at the same time every night and wake up at the same time every morning, so your body automatically knows what to do when.

If you’re still struggling to catch some Zs after a few weeks of that routine, consider trying one of these non-addictive sleep aids:

  • Magnesium Glycinate improves sleep quality. It also helps stabilize mood, relax muscles, soothe joint and muscle pain, and contributes to heart and bone health.

  • Melatonin is the hormone that should naturally increase in your body when it gets dark outside. Taking a melatonin supplement at night can reduce the amount of time it takes you to fall asleep.

  • L-theanine, found in tea, is a unique amino acid that increases brain alpha wave activity which relaxes the mind, producing a sense of calm and mental clarity.

  • L-tryptophan is an essential amino acid that readily converts to serotonin and may be helpful in promoting better sleep.

  • Valerian and Hops are herbal remedies that may be helpful by boosting GABA levels. GABA is the calming neurotransmitter that boosts relaxation and therefore sleep.

  • Passion Flower and Lemon Balm are herbs frequently found in herbal sleep formulas. They work as gentle agents to promote sleep.

Always consult with your doctor before adding a supplement to your regimen, as some can have adverse interactions with medications. Also, let your doctor know if you’re experiencing any side effects (e.g.: change in bowel movements, headaches, daytime sleepiness, etc.) with any supplement you take.

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At The Cusp, we provide expert menopause care. We are a comprehensive, convenient virtual healthcare service dedicated to help you feel better.