Sleep and Menopause

An estimated 13 million people in the UK1 are experiencing perimenopause or menopause. The hormonal changes can affect many aspects of health, including sleep. Knowing what to expect and understanding the symptoms and causes of different sleep problems can help you get the rest you need during this life transition. 

Sleep is an essential part of life. During sleep, your body and mind can rest and repair after a busy day or week. You typically cycle through different stages of sleep2 throughout the night REM (rapid eye movement) sleep, non-REM sleep (also called slow wave sleep3), and various other steps in between. REM sleep helps you store memories and process information, while non-REM sleep helps the body rest and repair. When you don’t get enough of either one, you can feel sleepy during the day and have difficulty concentrating. 

Sleep Problems During Perimenopause and Menopause

Perimenopause and menopause can cause a wide range of sleep disturbances4. These may include:

  • Difficulty falling asleep 
  • Waking up during the night 
  • Waking up too early in the morning 
  • Trouble staying asleep once asleep 
  • Feeling unrested during the day 
  • Difficulty concentrating during the day

If you’re experiencing these sleep problems, you’re not alone. Nearly 40 to 50% of women5 in perimenopause and 35 to 60% of those in menopause list sleep issues as the most significant symptom. Over 25% of women6 report severe symptoms that affect their daily lives. 

Seeking help from your doctor can help you identify and manage any sleep problems you may be experiencing. With the proper treatment, you can get a better night’s rest and take back control of your sleep. 

Common Causes of Sleep Problems During Peri- and Menopause

A variety of factors can cause sleep disturbances during perimenopause and menopause. Movement disorders, sleep apnoea, and hormone imbalances are all potential causes of sleep disruption in this stage of life. Understanding the underlying causes can help you create an effective treatment plan that works for you. 

Movement disorders like restless leg syndrome are common during perimenopause and menopause7. These conditions cause you to move your legs or arms involuntarily throughout the night, disrupting your ability to sleep soundly. Treatment may involve lifestyle changes, medications, or physiotherapy. 

Sleep Apnoea is a severe sleep disorder8 that can occur during perimenopause and menopause. It causes you to stop breathing while you sleep because your airway is blocked or constricted, leading to interrupted sleep and daytime fatigue. Women don’t often recognise sleep apnoea as a potential symptom of perimenopause and menopause, but it is essential to be aware of it. Also, women experience Sleep Apnoea differently than men—they may have more subtle symptoms that can be harder to recognise. Treatment can involve lifestyle changes, medications, or a CPAP machine. 

Fluctuating hormone levels can also lead to sleep disruption9 during perimenopause and menopause. Night sweats or hot flashes prevent you from falling asleep or cause you to wake up during the night. Treatment can include lifestyle changes, hormone therapy, medications, or herbal supplements. 

These related sleep disturbances can make perimenopause and menopause a difficult time for many women. But understanding the causes of your sleep problems can help you find the proper treatment to get the restful sleep your body needs. With help and support, you can manage these symptoms and enjoy life again. 

What treatments are available for sleep problems?

The good news is that there are treatment options to help you manage your sleep problems. Treatments may include lifestyle changes, medications, hormone therapy, herbal supplements, or a combination of these approaches. Your doctor or healthcare provider can work with you to determine the best treatment to meet your needs. 

The most common lifestyle changes to improve sleep include: 

  • Establishing a regular bedtime routine
  • Creating an environment conducive to sleep (e.g., a dark, cool room) 
  • Reducing stress and anxiety 
  • Exercising regularly 
  • Avoiding caffeine, nicotine, and alcohol 
  • Limiting napping during the day 

Hormone replacement therapy is a treatment used to replace hormones that your body no longer produces. It uses synthetic or natural hormones to help balance out hormone levels. Hormone replacement therapy can treat the symptoms of perimenopause and menopause, including sleep problems and help to reduce night sweats and hot flushes, 10 allowing you to sleep better. It can also help improve your mood and energy levels throughout the day. These benefits can lead to a better quality of life and improved overall health. 

Hormone replacement therapy (HRT) offers many benefits besides helping with sleep. In addition to reducing the risk of chronic diseases, it can also treat osteoporosis, improve sexual libido and even help relieve depression and anxiety.