Menopause & Sleep

If you wake up at 2 a.m. drenched in sweat or toss and turn through the night, you’re not alone. For many women, menopausal sleep disturbances bring more than hot flashes and mood changes. It can also mean restless nights and foggy mornings.

According to the Sleep Foundation, up to 61 percent of women in perimenopause and postmenopause report frequent sleep problems. Hormonal changes, night sweats and changes in mood can all make it harder to fall — and stay — asleep. But there are ways to get restful nights and restore your energy.

Key Takeaways: Menopause & Sleep

• Hormonal changes during menopause, especially lower estrogen levels, can disrupt sleep quality.
• Common issues include insomnia, night sweats, hot flashes and even sleep apnea.
• Good sleep hygiene, lifestyle changes, cognitive behavioral therapy for insomnia (CBT-I) and hormone therapy can make a big difference in some cases.
• Quality sleep supports heart health, bone strength and emotional well-being in women after menopause.

Why Sleep Changes During Menopause

Sleep difficulties can start even before menopause, during perimenopause, when hormone levels begin to fluctuate. As estrogen and progesterone levels drop, the brain’s sleep-wake cycles and temperature regulation can shift. That’s why hot flashes and sleep so often go hand in hand.

Hot flashes and night sweats are some of the biggest culprits. These sudden surges of heat can wake you multiple times during the night and make it harder to reach the deep, restorative stages of sleep. Over time, sleep that lacks consistency can make you feel tired during the day, irritable and unable to concentrate.

Tapan Desai, MD, a board-certified pulmonologist and critical care and sleep medicine specialist with Franciscan Physician Network, explains that for many women, these changes are a direct result of hormonal shifts.

“There are certain populations that are prone to sleep disorders after menopause,” Dr. Desai said. “Many of women have issues after the age of 60 or 65. When estrogen levels drop, it can make it harder to fall asleep or stay asleep.”

Poor sleep isn’t just about being tired.

“Sleep affects our memory, mood, cognitive performance and immune system function. It also helps our heart health, lowers stress hormones like cortisol and supports a healthy metabolism.”

Common Sleep Disruptors After Menopause

During menopause, several changes in your body can make it harder to get a good night’s rest. These can lead to menopausal sleep disturbances that can impact overall health.

Hot flashes and night sweats

Hot flashes and night sweats are among the most common reasons women experience poor sleep during menopause. Sudden heat and sweating at night can wake you often, make it hard to stay asleep and leave you tired the next day.

Insomnia

Insomnia in menopause can mean it’s difficult to fall asleep or stay asleep, or you wake up too early. It often connects to stress, mood changes or feeling too warm.

Sleep apnea

After menopause, women are at increased risk for obstructive sleep apnea — a disorder where breathing repeatedly stops and starts during sleep. Unlike men, women may not always have one of the most common symptoms, loud snoring. Instead, they might experience tiredness, headaches or restless sleep.

Restless legs syndrome (RLS)

Some women experience a strong urge to move their legs at night. It’s a sense of tingling or crawling sensations in the legs. RLS can make it hard to fall asleep and is sometimes linked to hormonal changes or iron deficiency.

Mood and stress

Anxiety and depression, which can change during menopause, can make insomnia worse. Sleep and mood influence each other. When one suffers, the other usually does too.

Ways To Reclaim Restful Sleep

Dr. Desai said that many sleep challenges are manageable when you take a holistic, consistent approach. “Sleep is a global sort of problem that we need to improve in terms of habit,” he said. “Make sure you go to bed at the same time every night. Sleep, it’s like brushing your teeth — it only works if you do it right.”

Here are ways that can help manage perimenopause sleep changes and menopausal sleep disturbances:

1. Optimize your sleep environment

• Choose breathable bedding and moisture-wicking pajamas.
• Keep your bedroom cool (between 60–67°F) and dark.
• Use a fan or white noise machine to stay comfortable and block distractions.

2. Follow good sleep hygiene

• Avoid caffeine or alcohol in the late afternoon and evening.
• Power down screens 30–60 minutes before bed.
• Stick to a consistent bedtime and wake time, even on weekends.
• Try relaxation practices such as gentle yoga, deep breathing or journaling.

3. Keep moving and stay active during the day

Regular exercise supports healthy sleep and reduces stress. Try to get at least 30 minutes of moderate activity each day. But make sure you finish your workout several hours before bedtime.

4. Explore cognitive behavioral therapy for insomnia (CBT-I)

CBT-I is a structured, evidence-based program that helps retrain your thoughts and behaviors around sleep. It’s one of the most effective non-medication treatments for chronic insomnia — especially for women in menopause.

5. Consider medical treatment options

For some women, hormone therapy can help manage hot flashes and sleep interruptions caused by night sweats. However, it’s not right for everyone. Other treatment options include short-term sleep aids, dietary changes or light therapy.

Why Sleep Matters Even More After Menopause

Sleep affects nearly every system in the body. Poor sleep is linked to an increased risk of heart disease and high blood pressure, changes in metabolism and bone density, weight gain and insulin resistance.

But consistent sleep can boost your immune system, balance your mood and support healthy aging. “More people today recognize how important sleep is to their overall health,” Dr. Desai said. “All of us are trying to improve our wellness and our health. People recognize that sleep is a huge portion of that.”

Find Your Path To Better Rest

Poor sleep during menopause is common. But it doesn’t have to be permanent. When you understand the changes in your body during menopause, you can address them head-on.

Restful nights are possible. And they’re one of the best gifts you can give your health.

If you’re experiencing ongoing sleep problems or suspect you may have sleep apnea, talk with your Franciscan Health provider.