The impact of menopause on sleep

If you’re not sleeping well, you’re not alone — the major hormonal changes involved in menopause can indeed wreak havoc on sleep.  

Sleep issues are frequently reported both in the years before and after menopause.  Whereas around 12 percent of women have sleep complaints on average, this number jumps to 40 percent for women in their late 40s and early 50s. So let’s examine what’s to blame — and what you can do about it.   

Top sleep disturbances

Some of the most common problems reported by perimenopausal and postmenopausal women include:

  • Hot flashes. Lasting from 30 seconds to five minutes, hot flashes affect 75% to 85% of women for around seven years on average, both before and after menopause. Why is it a sleep issue? At night, the increase in body temperature and blood flow to the face wakes you up, and because it also boosts your adrenaline, it can be hard to fall back asleep. When hot flashes occur at night, they’re also known as night sweats. 
  • Insomnia. This is when you have difficulty falling or staying asleep more than three nights a week. As many as 61 percent of postmenopausal women report symptoms of insomnia. 
  • Sleep-disordered breathing. Snoring can get worse during this time. In addition, your risk of obstructive sleep apnea, which causes your breathing to stop temporarily, increases. 
  • Mood disorders. Poor sleep is often associated with depression and anxiety, which can in turn worsen sleep issues. 
  • Other disorders. Restless legs syndrome and periodic limb movements disorder may also develop. Both feature involuntary nighttime movements that can disrupt sleep. 

Root causes and factors

Your ovaries stop producing estrogen and progesterone after menopause. Sleep experts believe less progesterone may contribute to sleep apnea, whereas less estrogen may factor into higher body temperatures at night as well as poorer moods. In general, our sleep-wake cycle also becomes less consistent as we age, leading to earlier wakeups and less sleep overall. 

Prescription treatments

Estrogen replacement therapy (ERT) boosts your estrogen levels while hormone replacement therapy (HRT) increases both estrogen and progesterone. They can both effectively treat hot flashes, insomnia, and mood disorders in menopausal women, but talk to your doctor about the risks and benefits. Your doctor may also consider prescribing antidepressants to help relieve hot flashes and improve sleep. 

Other potential therapies

There is some research suggesting that a diet that includes soy products, which contain phytoestrogen, can lessen hot flashes and sleep issues. Phytoestrogens are also available as supplements, as is melatonin, a natural sleep hormone that promotes falling asleep. Talk to your doctor about these alternative treatments, as well as whether cognitive behavioral therapy could help with insomnia. 

Tips for better Zzz’s

There are also some general strategies that can enhance your sleep quality, even during menopause. 

  • Lower your stress levels through exercise, yoga, massage, and other techniques
  • Maintain a healthy weight, and avoid large meals and spicy foods before bed
  • Forgo nicotine, caffeine, and alcohol later in the day, as they can all disrupt sleep
  • Develop a bedtime routine to wind down and relax (e.g. reading, a bath, meditation)
  • Wear lightweight pajamas or moisture-wicking fabrics, or even sleep naked to stay cool
  • Still hot? Lower your bedroom thermostat and/or get a fan (either ceiling or standing)
  • Stick to a regular bedtime and wakeup time, and avoid napping during the day
  • Keep a change of clothes and glass of water by your bed in case you wake up with night sweats

Reviewed by the Ovia Health Clinical Team


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