Kathryn Pinkham- How Menopause Disrupts Sleep — and What You Can Do!
Is Menopause Ruining Your Sleep? You’re Not Alone
Do you find your sleep has taken a turn for the worse since entering menopause? You’re not imagining it — and you’re definitely not the only one.
Over 60% of women going through menopause report ongoing sleep difficulties. Hot flushes, night sweats, early waking, and a restless mind can make it feel like your body has forgotten how to sleep.
Why Does Menopause Disrupt Sleep?
As hormone levels shift — particularly oestrogen, progesterone, and testosterone— our body’s ability to regulate temperature, mood, and sleep rhythms also changes.Oestrogen plays a role in temperature regulation and REM sleep quality.
Progesterone has natural sedative properties, so when levels drop, it can be harder to fall and stay asleep and testosterone is linked to sleep depth and recovery — a drop can leave us feeling less refreshed.
On top of that, menopause often coincides with increased anxiety, irritability, and low mood — all of which can fuel insomnia. According to research, women in perimenopause and menopause are up to two to four times more likely to experience depression and anxiety compared to pre-menopausal years (Freeman et al., 2006).
The 3am Wake-Up Call
If you find yourself regularly waking in the early hours — especially around 3am — you’re not imagining a pattern. When we frequently wake at the same time (perhaps due to hot flushes), our body clock starts to adapt, almost expecting it.
At that hour, our brains are also less rational, making us more likely to ruminate and worry. Thoughts like "If I don’t sleep, I won’t cope tomorrow” or "I’ll feel depressed again" start to spiral. These thoughts add pressure to sleep, which only makes things worse.
3 Practical Tips to Improve Sleep
1. Don’t spend too long in bed.
It might sound counterintuitive, but spending excessive time in bed because you are exhausted actually weakens your natural sleep drive — the natural pressure that builds the longer we’re awake. If you’re regularly waking early, try going to bed a little later or getting up a bit earlier. This can help consolidate your sleep and improve quality over quantity.
2. If you wake with a hot flush and feel panicked, teach your body you are safe
Waking up hot and uncomfortable can trigger adrenaline making you feel a little panicky. But the more we try to fight the temperature change, the more our brain sees it as a threat, and keeps the cycle going.
So, next time you are in that situation:
- Don’t try to push the feeling away; instead, just sit with it.
- Scan your body: What exactly does it feel like? What is happening?
- Label each sensation (e.g., “tingling arms”, “pounding chest”).
- Let it peak. Then observe how it naturally fades.
This technique teaches your brain that while the sensation is unpleasant, it’s not harmful and you can cope— and in turn, it can reduce the frequency and severity of future episodes.
3. If you're anxious and wide awake, leave the room.
Lying in bed, anxious and tossing and turning, creates a negative association with your bed. If you're stuck in catastrophic thoughts, get up.
- Go downstairs or into another room.
- Watch something on TV, read, or do whatever you enjoy.
- Return to bed when you feel sleepy.
This helps you to keep the connection with your bed about sleep and not wakefulness.
The next day, get up at your usual time, even if you didn’t sleep well. Morning daylight and fresh air will help reset your sleep-wake cycle.
Sleep disruption is common during menopause, but with tips like these and more from a CBT for insomnia programme, you can improve the quality of the sleep you are able to get.
If you'd like step-by-step support, my menopause sleep course is designed specifically to help. And as a thank you for reading, you can use the code **DREAMI30** for £30 off.