Why Women in Menopause Often Experience Insomnia

Before your menopause-induced insomnia, did you used to be a good sleeper? Then you began this hormonal transition and became the princess and the pea. There are several reasons why menopause causes sleeplessness, and thankfully several ways to manage your symptoms as well. 

A woman lying in bed and staring at the ceiling

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Why You Don’t Sleep Well During Menopause

A number of factors gang up in menopause to disturb your sleep. Hormone levels, health issues, lifestyle, and situational stressors all play a role in whether you get to sleep and stay asleep. After the age of 40 (and sometimes before), you may have trouble getting or staying asleep because declining hormone levels affect the sleep/wake cycle. Additionally, hot flashes, night sweats, thyroid problems, pain, and breathing difficulties can keep you up. In particular, sleep apnea, which is related to changing estrogen levels and weight gain, is common in menopause.

At any age, stress can keep one up. But during menopause, women may be dealing with aging parents, surly teenagers, divorce, job worries, and money problems. All of these difficulties can make it hard to sleep. And if you're depressed or anxious outside of these challenges, getting and staying asleep may feel impossible.

If you do have health problems, medications (both prescription and over the counter) may keep you awake. Diet and use of substances such as caffeine, nicotine, alcohol, or supplements can also be factors.

What Can You Do About Insomnia?

What to do about sleepless nights depends on what is causing them. But taking action helps. If you're taking stimulants, for example, stop or greatly reduce your intake of caffeine. Quit smoking, don’t drink alcohol, cut back on chocolate, and check any supplements you're taking to see if they're affecting your sleep. 

If anxiety or night sweats are waking you, treat your symptoms. Check with your medical provider and discuss which medications or supplements might alleviate your symptoms. There are several types of prescriptions that help, including antidepressants, anti-anxiety medications, and sedative/hypnotic drugs. A short course might get you back into a natural sleep pattern.

If your meals tend to be heavy on carbs, your body may not be able to maintain your blood sugar balance over night. This can result in hot flashes at night and night sweats.

Whether you use black cohosh, flaxseed oil, antidepressants, or a short course of hormone therapy, you can make choices that will ease your symptoms enough to re-establish a good sleep pattern.

Remember to take medications and supplements as directed and to talk to your medical provider about the medications you are already taking to see if side effects are keeping you awake. A doctor, counselor, personal trainer, acupuncturist, massage therapist, or naturopath, either alone or in combination, may help to restore your sleep cycle. You can use our Doctor Discussion Guide below to help you start that conversation with a healthcare professional.

Insomnia Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Change Your Environment and Routines

Keep your bedroom cool. You have a very sensitive hot flash threshold during menopause, so you want to keep your body as cool as you can without being uncomfortable. Anything that raises your body temperature can trip the switch, so keep your bedroom temperature a few degrees lower at night.

Moderate your body temperature to minimize night sweats. Wear light pajamas, and keep a cool rag or cold pack in a zip plastic bag next to the bed. Put the cool pack on your face and chest as soon as you notice a hot flash coming on, and do deep breathing until the flash passes. Try to stay relaxed while you do this. Practice slow, deep breathing during the day so that when you wake with anxiety or a hot flash, you can use the technique to calm and relax. Progressive relaxation, cognitive behavioral therapy, biofeedback, or self-hypnosis are all techniques that will serve you well during periods of insomnia and other distressing moments.

Practice good sleep hygiene. Go to bed at a regular time, and use your bed only for sleep and sex. Relax before bed. Remove the television from the bedroom, and don't eat for at least two hours before bed. Also, keep your bedroom dark. You want to send your brain the message that nighttime is for sleep, as light cues you to wake up and stay up.

Exercise outside during the day. The combination of natural light, vitamin D, and exercise is a recipe for better sleep. Be sure to work out early in the day to get more daylight and avoid being too energized before bedtime.

Stay Positive

Don’t blame yourself if you can’t get shuteye. It sometimes comes with the menopause territory, and the more you despair about it, the less you will sleep. Sleeplessness is frustrating and spills out into all of your daytime activities. You owe it to yourself to get the rest and recovery that can only happen with a good night’s sleep. Then, when life dishes up a new challenge, you can say, “Let me sleep on it.” And you will.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Boston’s Women’s Health Book Collective, Our Bodies, Ourselves: Menopause, Touchstone/Simon and Schuster, New York. 2006.
  • Morin, CM, Colecchi, C, Stone, J, Sood, R, Brink, D, “Behavioral and Pharmacological Therapies for Late-Life Insomnia:A Randomized Controlled Trial” JAMA, Vol. 281, No.11 991-999. 281: 991-999, Mar, 1999, 21 Jan, 2008
  • Murphy, P, “Altered Sex Hormone Levels, Higher Body Temp Affects Sleep Quality In Postmenopausal Women,” SLEEP, December, 2007. Associated Professional Sleep Societies, LLC, 21 Jan. 2008
  • North American Menopause Society, (NAMS), Menopause Guidebook: Helping Women Make Informed Healthcare Decisions Around Menopause and Beyond, 6th Edition , North American Menopause Society, 2006. 10 Oct. 2007.

By Kate Bracy, RN, NP
Kate Bracy, RN, MS, NP, is a registered nurse and certified nurse practitioner who specializes in women's health and family planning.