Poor sleep is one of the most common and most disruptive symptoms of menopause, and it is also one of the least talked about. Many women assume it is simply something they have to endure. It is not.
What happens to sleep during menopause
The drop in oestrogen and progesterone that happens during perimenopause and menopause affects sleep in several ways. Night sweats and hot flashes wake you up repeatedly. Progesterone, which has a calming, sleep-promoting effect, decreases. Anxiety, which also tends to increase during this time, makes it harder to fall and stay asleep.
The result is often a pattern of waking multiple times in the night, lying awake for long periods and feeling exhausted during the day despite spending enough time in bed.
What helps
Keeping the bedroom cool is one of the most consistently helpful changes. A fan, breathable bedding and light nightwear all make a difference, particularly for night sweats.
Managing hot flashes during the day, through layering clothing and avoiding known triggers like caffeine, alcohol and spicy food, can reduce their frequency at night.
Establishing a consistent sleep routine matters. Going to bed and waking at the same time every day, even when you have slept badly, helps to stabilise your sleep cycle.
Cognitive Behavioural Therapy for Insomnia, known as CBT-I, is the most effective long-term treatment for sleep problems and works well for menopause-related insomnia. It is available online and in person.
If sleep problems are significantly affecting your quality of life, it is worth discussing options with your doctor. There are a range of approaches, including non-hormonal and hormonal treatments, that can help.