Sleep Health

The Hormonal Roller Coaster: Understanding Menopause-Related Insomnia

July 14, 2023
Cecelia Beringer

What Is Insomnia?

Getting a good night's rest can seem more like a far-off dream than a reality when it comes to insomnia. With constant tossing and turning, it can be hard to escape the grips of those stubborn sleepless nights.

The struggle is real, and it’s not just the difficulty in falling asleep; sometimes, the task of staying asleep can be a cause of frustration.

As many as 61% of postmenopausal women report experiencing insomnia symptoms, which can negatively affect their overall health and well-being. For women, the risk of insomnia is nearly double that of men, with one in four women experiencing symptoms at some point in their lives.

Unfortunately, the hormonal changes that occur during menopause can exacerbate sleep issues, leading to even more disruptions in sleep patterns. Understanding the impact of insomnia during menopause is crucial for women to take proactive steps toward managing their signs and improving their quality of life.

Can Menopause Cause Insomnia?

Insomnia during perimenopause and menopause is a common and frustrating experience for many women. While mild or occasional sleep disturbances may only plague some, others suffer from severe bouts of insomnia that affect their daily lives. Baker et al.(2018) reported that a significant 26% of women going through perimenopause and menopause experience insomnia that can disrupt their daily activities.  During this time of change, shifts and changes in hormones can greatly affect sleep habits, making it hard to fall asleep, stay asleep, and wake up feeling relaxed. Coping with insomnia during perimenopause can be challenging, but managing, but managing stress, engaging in physical activity, and seeking medical activity are proven strategies for alleviating symptoms.

As time passes, the troubling realities of insomnia become increasingly familiar to women. Data from the  Study of Women's Health Across the Nation (SWAN) (Lee et al., 2019) reveals that insomnia rates spike as per follows:

·       16–42% premenopause

·       39–47% perimenopause

·       35–60% postmenopause (Postmenopause: Impact on Weight, Hot Flashes, and More, 2021)

What Is The Link Between Menopause And Insomnia?

As women enter the stage of life known as menopause, they may be blindsided by a variety of uncomfortable symptoms. Hot flashes, mood swings, and weight gain are all common complaints- but what about sleep issues? Unfortunately, insomnia during menopause is all too real, with up to 60 percent of postmenopausal women experiencing frequent bouts of sleeplessness(Jehan et al., 2015).

This is due to several factors, such as:

Hormonal Changes:

As women approach menopause, their hormone levels decrease, and this can have a noticeable impact on various aspects of their life, including sleep habits. Female hormones, specifically estrogen and progesterone, play a critical role in regulating sleep patterns.

Progesterone is known for its sleep-promoting effects. As these hormone levels decline, many women find themselves struggling to fall asleep or stay asleep throughout the night. This can lead to perimenopause insomnia anxiety, a common  symptom afflicting many women going through this stage of life.  Faced with the added frustration of a disrupted sleep schedule, women may also experience increased stress, making it even harder to get a good night’s rest.

Hot Flashes

Perimenopause can be a particularly challenging time for women as they navigate the rollercoaster ride of fluctuating hormone levels. One of the most prevalent symptoms they experience is hot flashes and night sweats.

At first , the sudden rush of heat can be alarming, as you feel like your temperature is rising uncontrollably.  The reason for this is due o the rapid decrease in hormones causing your adrenaline level to increase. This is the same chemical that makes you react to stress or a fight-or-flight scenario. As a result, sleep can become elusive, making perimenopause a particularly anxious time. The difficulty in falling asleep can lead to insomnia, making you feel perpetually fatigued and irritable.

Melatonin Deficiency

As we age, sleep disturbances and insomnia become more common. One key player in the sleep-wake cycle is melatonin, a hormone that helps us stay asleep. However, research suggests that melatonin levels decrease with age, potentially contributing to sleep difficulties (Lee et al., 2019).

In women, there may be a link between menopause and a decline in melatonin. During perimenopause, the transition to menopause, levels of this crucial hormone may decline. This could help explain why sleep disturbances and insomnia are more common during this time. However, more research is needed to fully understand how menopause affects melatonin levels.

Cognitive Well-Being

Studies have shown a bidirectional relationship between sleep and mood, and insomnia can increase the risk of depression and anxiety(Lee et al., 2019). Moreover, hormonal changes during perimenopause can exacerbate sleep issues and have a negative impact on mood.

Symptoms Of Insomnia

When it comes to insomnia, there's more than meets the eye. From staying asleep all night to being unable to doze off, what seems like a simple inability to sleep may be rooted in many issues.

Insomniac may:

  • Take 30 minutes or more to fall asleep
  • Get less than 6 hours of sleep 3 days or more per week
  • Get up too early
  • Don’t feel rejuvenated or energized after napping
  • Feeling drowsy or drained continuously
  • Persistent worry about getting enough sleep

Insomnia can wreak havoc on your emotional and physical health. Persistent lack of sleep has the power to disrupt energy levels, affect concentration, weaken immune system function, and increase risks for other serious medical conditions.

Individuals might:  

  • Feel apprehensive
  • Feel agitated
  • Feel strained
  • Having trouble concentrating or staying focused
  • Find it challenging to maintain focus or recall things
  • Suffer more lapses or mishaps
  • Having migraine more frequently
  • Have digestive issues, such as a bloated belly

Medical Help For Insomnia During Menopause

Perimenopause can be an incredibly challenging time for many women. With fluctuating hormones comes a tidal wave of unpleasant symptoms. It’s tough enough navigating the day with a foggy brain and aching joints, but when the night rolls around, not being able to get a decent night’s sleep can be unbearable.

Luckily, there are remedies for perimenopause-related insomnia. Many women turn to hormone therapy, which aims to replace the hormones that they have lost. Not only can this treatment improve sleep, but it can also help with other menopause symptoms. For those who prefer a non-hormonal approach, a low-dose selective serotonin reuptake inhibitor(SSRI) may help (SSRI vs. SNRI: Differences, How They Work, and Side Effects, 2020).  While typically used to treat mental health conditions, these medications can also reduce the frequency and intensity of hot flashes, which can be a real advantage for sleep.

When it comes to perimenopause insomnia remedies, it’s comforting to know that there are options to help you get some much-needed rest. For those who are struggling with  mood changes, anxiety, or depression during this time, talk therapy may provide a valuable tool for understanding and coping with these feelings. By lessening the impact of mental health conditions, therapy may also help to improve sleep quality and overall well-being.

With the right support, women facing insomnia during menopause can find relief and enjoy a better quality of life.

What Are Perimenopause Sleep Problems Natural Remedies?

A 2019 review (Johnson et al., 2019) revealed that herbal remedies and dietary supplements don’t guarantee relief from menopausal symptoms, but there are still a variety of strategies to try.

Avoid Caffeine, Nicotine, And Alcohol

While there are many strategies out there, have you tried adjusting your daily habits? Smoking, caffeine consumption, and alcohol intake can all affect your potential to get a good night’s sleep. Even a small amount of alcohol can reduce overall sleep quality, contrary to popular belief.

Consider cutting back or quitting these substances, especially in the afternoon and evening, to improve your chances of catching some Z’s. It’s a simple adjustment that could make a big difference in your sleep routine.


One remedy that has been gaining popularity in the medical world is the power of aromatherapy. Specifically, the use of  lavender essential oil inhalation has shown the potential to lower hot flashes and induce relaxation (Nordqvist, 2019).

In clinical research comprising 100 women, experts learned that after 12 weeks of this treatment, participants experienced a 50% decrease in hot flashes (Johnson et al., 2019). Additionally, when combined with massage, aromatherapy has been shown to be more effective in bringing relief than either treatment alone.


A 2019 review suggests that hypnosis may be a natural and effective solution to alleviate these troublesome symptoms. According to the review, hypnosis can diminish hot flashes’ regularity and intensity by up to  50%, making it a valuable treatment for those struggling with insomnia due to hot flashes  (Johnson et al., 2019).  With such promising results, it’s worth considering hypnosis as a potential natural remedy for perimenopause-related symptoms.

Power Yoga

While there are numerous remedies available, one holistic method that has shown promise is yoga (Nichols, 2021). Recent studies have suggested that practicing yoga may decrease psychological symptoms associated with ​​ menopause, including anxiety and stress-related insomnia. However, the effectiveness of yoga as a treatment can vary depending on the style of yoga practiced and the individual’s needs, so it’s important to find the right approach for each person. Even though the results of studies on yoga have been mixed, there is enough information to suggest that it might help with perimenopausal symptoms.

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