How Menopause Affects Sleep (and Ways to Sleep Better)

Menopause is a natural stage in women's lives when the ovaries stop producing estrogen and progesterone, typically occurring between ages 45-55. This hormonal shift marks the end of menstruation and brings significant changes to how women sleep.

Hot flashes affect up to 85% of women going through menopause – that's about 143 million women in the U.S. Of those experiencing hot flashes, up to 64% report significant sleep disturbances and higher insomnia rates [1]. Sleep difficulties affect up to 46% of women in the years leading up to menopause, with about half experiencing sleep disorders after menopause.

The symptoms of menopause usually begin about four to seven years before a woman's last period and can continue for years afterward. While menopause sleep issues are incredibly common, there are effective ways to manage them and get better rest during this phase of life.

What happens to sleep during menopause?

Menopause doesn't just flip a switch overnight – it's actually a gradual process that happens in three stages, and sleep problems can start years before your periods actually stop.

• Perimenopause is when your hormones start fluctuating, usually in your 40s. This is often when sleep problems first show up, and they can be pretty unpredictable. One night you might sleep fine, the next you're awake for hours [2].

• Menopause officially happens when you haven't had a period for 12 months. Sleep problems often peak during this time as hormone levels drop significantly [3].

• Postmenopause is everything after menopause. Some women find their sleep improves during this stage, while others continue to deal with sleep issues for several more years [4].

The sleep changes during menopause are different from regular aging sleep changes. While it's normal for sleep to get lighter and more fragmented as you get older, menopause adds its own unique challenges, like hot flashes, night sweats, and hormone-related mood changes that can make sleep problems much worse.

Common menopause sleep problems

Menopause affects sleep in several ways, and you might experience more than one of these issues:

Hot flashes and night sweats

Hot flashes are probably the most well-known menopause symptom, and they're a major sleep disruptor. They tend to be worse at night and can significantly interfere with your ability to get quality rest.

A hot flash typically lasts two to four minutes and can wake you up from deep sleep with intense heat, sweating, and sometimes a racing heart or feelings of anxiety. Even after the hot flash passes, it can take 30 minutes or more to cool down and fall back asleep. Some women have multiple hot flashes per night, turning sleep into a series of interrupted periods rather than restful hours.

Hot flashes only last a few minutes but can happen several times throughout the day and night. While many women see improvement after menopause, some continue to experience hot flashes for up to 20 years [1].

Night sweats are basically hot flashes that happen while you're sleeping, and they can leave you so drenched that you need to change your pajamas or even your sheets. They tend to become more frequent as you near menopause and may continue at high intensity for years after your last period.

Insomnia and sleep disruption

During and after the menopausal transition, women have an increased risk of developing insomnia – a sleep disorder characterized by difficulty falling asleep, staying asleep, or both. You might find yourself lying awake for hours or waking up multiple times throughout the night, unable to get back to sleep.

Research suggests that increased wakefulness during menopause causes women to notice and feel bothered by hot flashes that they might otherwise sleep through [5]. In other words, it's not always the hot flashes causing the sleep problems – sometimes the sleep problems make you more aware of the hot flashes.

The prevalence of insomnia during menopause is often linked to anxiety and depression. Hormonal changes and life circumstances–such as caring for aging parents, divorce, or career stress–can contribute to declining mental health during this time. Most people with depression or anxiety experience chronic insomnia, creating a cycle that can be hard to break.

Early morning awakening

Waking up at 2 or 3 AM and not being able to get back to sleep is another common menopause sleep issue. Your body might feel ready to start the day, but your mind knows you need more rest.

This can be especially frustrating because you end up feeling tired all day, but then have trouble falling asleep the next night.

Sleep apnea risk increases after menopause

After menopause, women have a significantly higher risk of developing sleep apnea, a condition where breathing stops and starts during sleep. Research shows that sleep apnea affects about 25% of women in the years leading up to menopause and more than one-third in the years that follow [6]] [7].

This happens because declining reproductive hormones can cause the soft tissues in the throat to become more collapsible. Weight gain that commonly occurs during menopause can also cause airway obstructions. Sleep apnea can cause loud snoring, gasping during sleep, morning headaches, and feeling exhausted during the day, even after spending adequate time in bed.

Restless legs syndrome

More than half of postmenopausal women experience restless legs syndrome (RLS), a sleep disorder that causes uncomfortable sensations in the legs when lying down [8]. You might feel crawling, tingling, or aching sensations that make you want to move your legs constantly.

The discomfort is typically relieved by movement, but only temporarily, which makes it difficult to fall asleep and stay asleep. Experts believe that fluctuating hormones and iron deficiency may trigger RLS following menopause.

Mood changes affecting sleep

Menopause can bring anxiety, depression, or mood swings that make it harder to wind down at bedtime. You might find your mind racing with worries or feel too keyed up to relax.

Also Read: Why Sleep Deprivation Can Lead to Serious Health Issues

Why menopause disrupts your sleep

Several changes happen in your body during menopause that directly affect your ability to sleep well:

Hormone changes

The main culprits are dropping levels of estrogen and progesterone. Estrogen helps regulate your body temperature and affects your brain's "thermostat." When estrogen levels drop, your brain becomes more reactive to temperature changes, triggering cooling processes like sweating at lower body temperatures. This is what causes hot flashes and makes it harder for your body to cool down for sleep.

Progesterone has a calming, sleep-promoting effect. When progesterone levels fall, you lose this natural sleep aid, making it harder to fall asleep and stay asleep.

Body temperature regulation issues

During menopause, the thermoregulatory zone in your brain gets altered by lower estrogen levels. Women experiencing night sweats have a narrower range of comfortable temperatures, making it much harder to maintain the cool body temperature needed for quality sleep.

Changes to your internal clock

Following menopause, many women experience a weakening of their circadian rhythms – the biological processes that operate on a 24-hour cycle. This includes your natural sleep-wake cycle, which can become less reliable.

Metabolism and weight changes

Menopause affects how your body converts food into energy. Low estrogen levels can contribute to weight gain, particularly around the midsection, which increases the risk of developing snoring or sleep apnea.

Mood and brain chemistry changes

Changing estrogen levels interferes with neurotransmitters involved in mood regulation. This explains why mood swings, depression, and anxiety are more common during the menopausal transition – along with the sleep difficulties that come with these conditions.

Increased stress and life changes

Menopause often happens during a time when life is already stressful, dealing with aging parents, teenagers, career pressures, or relationship changes. Add hormone fluctuations to existing stress, and sleep often suffers.

Physical discomfort

Joint aches and pains can become more noticeable during menopause. Bladder issues might mean more trips to the bathroom at night. These physical discomforts can make it harder to get comfortable and stay asleep.

Anxiety about sleep itself

Once you've had several bad nights, you might start worrying about sleep during the day. This anxiety about whether you'll be able to sleep can actually make sleep problems worse.

Also Read: Harvard Researchers Find that a Good Night’s Sleep Can Add Years to Your Life

How long do menopause sleep problems last?

The timeline for menopause sleep issues varies quite a bit from woman to woman, but here's what you can generally expect:

Perimenopause sleep problems can start in your 40s and continue until menopause. This stage can last anywhere from a few months to several years, and sleep issues often come and go unpredictably.

Menopause is when sleep problems often peak. Hot flashes tend to be most frequent and intense during the first year or two after your periods stop.

Postmenopause brings improvement for many women. Hot flashes typically become less frequent and less intense over time. Most women see significant improvement in their sleep within 2-5 years after menopause.

However, some women continue to have sleep issues for longer. About 20% of women still experience hot flashes 5+ years after menopause, and other sleep problems related to aging can continue. Up to 97 million women suffer from sleep trouble, specifically due to hot flashes and the night sweats that follow [1].

For most women, the worst sleep disruption during menopause is temporary.

Proven ways to sleep better during menopause

While you can't stop the hormone changes happening in your body, there are many practical ways to improve your sleep during menopause.

Manage hot flashes and night sweats effectively

Since hot flashes are often the biggest sleep disruptor, managing them effectively can make a huge difference in your sleep quality.

Temperature control:

• Set your thermostat to 65-68°F at night

• Use fans to keep air circulating throughout your bedroom

• Keep extra fans handy or consider a smart thermostat you can control from your phone

• Try cooling mattress pads, gel pillows, or cooling towels you can keep in the freezer

Bedding and sleepwear:

• Use lightweight, breathable sheets made from cotton, bamboo, or moisture-wicking fabrics

• Avoid heavy comforters; instead, use light layers you can easily remove

• Wear lightweight, loose-fitting pajamas made from breathable fabrics

• Consider moisture-wicking sleepwear designed for night sweats

• Keep extra pajamas and sheets nearby for quick changes after night sweats

Pre-bedtime and nighttime cooling:

• Take a cool shower before bed to lower your body temperature

• Put your feet in cool water for a few minutes before sleep

• If possible, keep a bottle of ice water on your nightstand for immediate cooling during hot flashes

• Keep a cold, damp washcloth by your bed for quick relief

Create the optimal sleep environment for menopause

Beyond temperature control, your overall bedroom setup becomes crucial during menopause:

• Choose a cooling mattress: If your current mattress sleeps hot, consider a cooling mattress or mattress topper. Memory foam can trap heat, while latex and innerspring mattresses tend to sleep cooler.

• Block out light and heat: Use blackout curtains to keep your room cool during hot days and ensure complete darkness for better sleep.

• Minimize noise disruptions: Consider earplugs or a white noise machine if you're more sensitive to sounds during menopause.

Time your daily habits for better sleep

Small changes to your daily routine can have a big effect on your sleep quality:

• Exercise timing: Regular exercise can help reduce menopause symptoms and improve sleep, but avoid intense workouts within 3-4 hours of bedtime. Morning or afternoon exercise is usually best.

• Watch your caffeine intake: You might find you're more sensitive to caffeine during menopause. Try cutting off caffeine by 2 PM, or switch to decaf versions of your favorite drinks.

• Alcohol considerations: While a glass of wine might help you relax, alcohol can worsen hot flashes and disrupt your sleep. If you drink, try to have your last drink at least 3 hours before bedtime.

• Meal timing: Avoid large, heavy, or spicy meals within 3 hours of bedtime. Spicy foods can trigger hot flashes in some women.

Develop a calming bedtime routine

A consistent bedtime routine becomes even more important when hormones are making sleep unpredictable:

• Start winding down early: Begin your bedtime routine 1-2 hours before you want to sleep. This gives your body time to cool down and your mind time to relax.

• Practice relaxation techniques: Deep breathing, progressive muscle relaxation, or mindfulness meditation can help calm anxiety and racing thoughts. Even 10 minutes can make a difference.

• Manage racing thoughts: You can keep a journal by your bed to write down worries or tomorrow's to-do list. This can help get them out of your head so you can sleep.

• Control light exposure: Dim lights in your home 2-3 hours before bedtime and avoid phone, tablet, and computer screens 1-2 hours before sleep. The blue light can interfere with your body's natural melatonin production.

Get strategic light exposure during the day

Light exposure can help regulate your sleep-wake cycle, which often gets disrupted during menopause:

• Get morning sunlight: Spend 15-30 minutes outside in the morning to help regulate your circadian rhythm and improve nighttime sleep.

• Stay bright during the day: Keep your environment well-lit during daytime hours to maintain healthy sleep-wake cycles.

• Use blue light blocking glasses: If you must use devices in the evening, these can help minimize sleep disruption.

Consider natural alternatives

Some women find natural alternatives helpful during the menopause transition, especially for nights when anxiety or frequent wake-ups are a problem.

Common natural options include chamomile tea, valerian root, and magnesium supplements. However, it's worth checking with your doctor before starting any new supplements, especially if you're taking other medications.

If you're looking for a natural substitute to melatonin supplements, Sip2Sleep® offers a liquid sleep aid that's particularly helpful for the middle-of-the-night wake-ups that are so common during menopause. Made with Montmorency Tart Cherry and Venetron® (Rafuma Leaf extract), it's designed to help you settle back to sleep without morning grogginess. The convenient liquid form makes it easy to take 1-2 droppers if you wake up from a hot flash or just can't get back to sleep.

Additional lifestyle changes for better menopause sleep

A few other things can help support better sleep during menopause:

• Maintain a healthy weight: Extra weight can make hot flashes worse and increase sleep apnea risk. Even losing 5-10 pounds might help you sleep better. 

• Eat a sleep-supporting diet: Consider adding more plant-based foods that are high in antioxidants and rich in magnesium and vitamin D. These nutrients are known to support better sleep.

• Find ways to manage stress: Stress makes everything worse during menopause, including sleep problems. Whether it's yoga, taking walks, talking to friends, or seeing a counselor, having different ways to handle stress can make a big difference in how well you sleep.

The bottom line

Menopause sleep problems are incredibly common and can be really frustrating, but they're not something you just have to live with. While the hormone changes are out of your control, there are many effective ways to improve your sleep during this transition.

Remember that the worst sleep disruption during menopause is temporary. Don't hesitate to talk to your healthcare provider if sleep problems are significantly affecting your quality of life. There are many treatment options available, and you don't have to suffer through sleepless nights just because they're "part of menopause."

References:

1. Sleep Foundation. (2024, January 18). How Can Menopause Affect Sleep? https://www.sleepfoundation.org/women-sleep/menopause-and-sleep

2. Troìa L, Garassino M, Volpicelli AI, Fornara A, Libretti A, Surico D, Remorgida V. Sleep Disturbance and Perimenopause: A Narrative Review. J Clin Med. 2025 Feb 23;14(5):1479. doi: 10.3390/jcm14051479. PMID: 40094961; PMCID: PMC11901009.

3. Tandon VR, Sharma S, Mahajan A, Mahajan A, Tandon A. Menopause and Sleep Disorders. J Midlife Health. 2022 Jan-Mar;13(1):26-33. doi: 10.4103/jmh.jmh_18_22. Epub 2022 May 2. PMID: 35707298; PMCID: PMC9190958.

4. Hachul, H. C., Bittencourt, L. R. A., Soares Jr., J. M. C., Tufik, S. B., & Baracat, E. C. (2009). Sleep in post-menopausal women: Differences between early and late post-menopause. European Journal of Obstetrics & Gynecology and Reproductive Biology, 145(1), 81–84. https://doi.org/10.1016/j.ejogrb.2009.03.019

5. Bonanni, E., Schirru, A., Di Perri, M. C., Bonuccelli, U., & Maestri, M. (2019). Insomnia and hot flashes.Maturitas, 126, 51-54. https://doi.org/10.1016/j.maturitas.2019.05.001

6. Salari N, Hasheminezhad R, Hosseinian-Far A, Rasoulpoor S, Assefi M, Nankali S, Nankali A, Mohammadi M. Global prevalence of sleep disorders during menopause: a meta-analysis. Sleep Breath. 2023 Oct;27(5):1883-1897. doi: 10.1007/s11325-023-02793-5. Epub 2023 Mar 9. PMID: 36892796; PMCID: PMC9996569.

7. Krüger M, Obst A, Ittermann T, Bernhardt O, Ivanovska T, Zygmunt M, Ewert R, Fietze I, Penzel T, Biffar R, Daboul A. Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg-Western Pomerania, Germany. J Clin Med. 2023 Mar 7;12(6):2101. doi: 10.3390/jcm12062101. PMID: 36983104; PMCID: PMC10052671.

8. Wesstrom J, Nilsson S, Sundstrom-Poromaa I, Ulfberg J. Restless legs syndrome among women: prevalence, co-morbidity and possible relationship to menopause. Climacteric. 2008 Oct;11(5):422-8. doi: 10.1080/13697130802359683. PMID: 18781488.