Issue 10.11.22 | Can’t Sleep? Here’s Why.


Sleep issues are common in the peri-to-post menopause stages of a woman’s life, triggered by the shifting estrogen and progesterone levels. Two studies provide insight into what might be the cause as well as what we can do to reduce the occurrence of those sleepless nights.

Sleep disorders affect 39 to 47 percent of perimenopausal women and 35 to 60 percent of postmenopausal women. The most common sleep problems reported by women going through menopause include hot flashes, insomnia, sleep-disordered breathing, and other mood and sleep disorders, according to research cited by Sleep

We turn to Sleep Foundation medical experts and Dr. Grace Pien, Associate Professor of Medicine at the Johns Hopkins Sleep Disorder Center for details about the impact and suggestions on how to improve sleep quality.

Some common reasons for sleep disruption during menopause include:

  • Hot Flash Disturbance

    Hormone swings during the menopause transition cause issues with body temperature regulation leading to hot flashes, which are reported to impact 75-80 percent of menopausal women. While common thought is that hot flashes cause women to awaken in the night, Dr. Pien says that many menopausal women actually wake just before a hot flash occurs not actually during a hot flash. “There are changes in the brain that lead to the hot flash itself, and those changes — not just the feeling of heat — may also be what triggers the awakening,” she says.

    It’s the brain, Jane!

  • Insomnia

    Insomnia is described as chronic difficulty falling or staying asleep more than three nights a week. According to the Sleep Foundation, women experience nearly double the average rate of insomnia, with one in four women7 experiencing some symptoms of insomnia. The risk of insomnia increases into menopause, with as many as 61 percent of postmenopausal women reporting insomnia symptoms.

  • Sleep Apnea

    “Postmenopausal women are two to three times more likely to have sleep apnea compared with premenopausal women,” Pien says. “Before we become menopausal, we’re fairly protected, but the protective effect of hormones seems to be lost with menopause. Furthermore, women often have more subtle symptoms of sleep apnea than men. Thus, they may be less likely to seek evaluation for sleep apnea. Their healthcare providers may also be less likely to recognize sleep apnea as a possibility, further delaying evaluation and diagnosis of sleep apnea.” According to the Sleep, obstructive sleep apnea (OSA) is a sleep disorder characterized by temporary pauses in breathing, which leads to gasping, snoring, and choking sounds, along with lowered sleep quality. OSA occurs in 2 percent of women. Once perimenopause begins, a woman’s risk increases by four percent each year.

It’s a wonder we sleep at all!

What Can You Do?

  1. Consistent Bedtime: Stick to the same bedtime every night. Human bodies function best when on a consistent schedule.
  2. Wind Down Early: Shutting down electronics or work at least one hour before bedtime allows brains to wind down and prepare to rest.
  3. Cool and Dark Room: Keeping the room cool and quiet can help your body prepare for sleep.
  4. Exercise: Getting exercise on a regular basis helps your body manage stress which can aid in better sleep quality.
  5. Supplements: Consider a supplement like valerian root or melatonin if the above practices don’t help with sleep quality.
  6. Hormone Replacement Therapy has also been shown to help reduce hot flashes, as well as insomnia, and mood disruptions and improve sleep quality.

Try not to get stressed about your lack of sleep. That will only make it worse. Keep yourself calm and just grab a cat nap when you need to help get you through.


How Does Menopause Affect my Sleep?

Menopause and Sleep

Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

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