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Healthy Aging
Is Menopause Playing Havoc With Your Sleep?

Is Menopause Playing Havoc With Your Sleep?

By Sheryl Kraft

Created: 04/02/2013
Last Updated: 03/04/2020

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My husband loves to recount this story: When we were first married, he came down with the flu. One night, he was having a particularly tough time sleeping.

"Honey, wake up. I don't feel well."

I barely moved.

"Honey, please. Wake up. I can't sleep."


The pleading got a bit more insistent until I managed to register that someone was talking to me, and I wasn't dreaming.

Barely awake, I finally spoke.

"Go to sleep. You'll feel better."

And with that, I turned over and fell back into a deep, delicious slumber.

Call me a bad wife, but in those days, nothing got between my pillow and me.
(And in case you're wondering, yes, we're still married.)

But that was the last time I can remember sleep being so simple (for me, at least). First it was pregnancy and all the hormonal shifts that play havoc with your sleep.
Then, there were real, live, needy children in the house, who uncannily took turns waking up on alternate nights right around 3 or 4 a.m. Those children turned into teenagers who kept late hours and whose mother couldn't sleep until she heard the crunch of the gravel in the driveway.

RELATED: Sleep Disorders

The kids eventually moved out. Finally I could get a full night's sleep.


Was it my husband finally getting his sweet revenge?


Enter perimenopause and then menopause.

The years from peri- to post-menopause are when women report the most sleeping problems, says the National Sleep Foundation. In fact, as many as 61 percent report symptoms of—you guessed it—insomnia.

So many things come together at once to cause these sleeping issues. Hot flashes—also known as night sweats when they occur during sleep—start with a rise in your body temperature and end with you throwing off the covers and all your clothes (well, that's what I did). They not only can interrupt your sleep, but may keep you from getting back to sleep. Did you know the average hot flash could last up to three minutes? A few of these each night sure put a cramp in your sleeping style.

Mood disorders that come along with hormonal shifts (remember PMS?) can keep your mind racing at inopportune times. And just the anxiety of knowing that you haven't slept well since who-knows-when can set you into a cascade of more anxiety and worry that you won't sleep again tonight. Also, it's inevitable that you will have other things crowding your mind with worry, among them aging parents, chronic pain, your career, your children or your relationship.

Don't discount those late-night trips to the bathroom, either. As the bladder muscle ages along with the rest of you, its capacity to store urine diminishes.

RELATED: The Truth About Sleep as We Age

Sleep for Menopausal Times

While there's no one-size-fits-all solution to this widespread issue, just knowing what the alternatives are can help you rest better (or at least anticipate a good night's sleep):

1.    Hormone replacement therapy (HRT)
2.    Phytoestrogens in over-the-counter nutritional products such as black cohosh, extract of red clover and ginseng
3.    Sleep-promoting medication

Not for you? There's a lot more to try:

1.    Temperature: The ideal sleeping temperature is about 65 degrees Fahrenheit.
2.    Caffeine: Avoid caffeine after 2 p.m. Fact: Caffeine has a half-life of six hours, meaning that six hours after your last cup, half the caffeine is still in your body.
3.    Alcohol: Avoid alcohol within three hours of bedtime; rather than it being a sedative, it is a central nervous system suppressant and becomes a stimulant in quantities.
4.    Block out light: Keep your bedroom as dark as possible; wear an eye mask if you must. Even those LED lights from your alarm clock are strong enough to seep through your thin eyelids and disrupt your sleep.
5.    Dress for success: Wear loose-fitting, breathable garments, like cotton. Or nothing at all.
6.    Nix the electronics: Computers, TV, iPads, etc., are all sleep-stealers. Aside from stimulating your brain, the blue light they emit can interfere with a solid night's sleep.
7.    Eat right: A bedtime snack high in carbohydrates but low in protein (like whole grain crackers with some peanut or almond butter) speeds the amino acid tryptophan to the brain, which in turn is converted to serotonin (a sleep-inducing neurotransmitter).
8.    Exercise (and if you do, exercise more): A brand-new study just published in the journal Menopause says that higher levels of routine daily physical activity may be a key to a better night's sleep for menopausal women with hot flashes or night sweats. Most experts, however, recommend completing vigorous exercise at least three hours before bedtime because it can stimulate your heart, brain and muscles, as well as raise your body temperature.

I'm sure you've developed your own sleep strategy if you're among the menopausal population struggling with this issue. Feel free to add your own tips; curious minds would love to know!


I find my overhead fan to be the biggest hot flash remedy in my arsenal. I switch it on and off several times a night (because first I am terribly hot and then I am inevitably cold).

A fan serves double duty - good white noise AND good cooling!

That's a good tip, Nancy, both from a white noise perspective and what the fan is really meant for (to cool you off!)

I never ever thought I'd be a drug girl, but 15 mg of Remeron puts me out like a light all night - and also keeps my head on an even keel. The power of pharmaceuticals.

I've began eating much better and exercising again, along with doing acupuncture, which has really helped.

Those are great ways to help with sleep, LL. And to help with lots of other things, too!

Probably not for everyone, but 15 mg of Remeron puts me out like a light all night! (bonus points: keeps me on an even keel during the day.)

Jane, My doc prescribed Remoron when I was having a particularly tough time sleeping - I took it one night and it had a paradoxical effect, making sleeping even tougher! Glad it works so well for you.

I don't turn on the bathroom light in the middle of the night (during my several trips!) to try to allow myself to get back to sleep more easily

And I keep a very dim nightlight on in the bathroom for precisely the same reason~

There are two basic philosophies, I think. 1. If you can't sleep, stay in bed and do some sort of relaxation exercise. 2. If you can't sleep, get up, because you don't want to condition your brain/body to think you should be awake when you're in bed. I'm in the 2nd camp. Get up, make camomile tea, turn on a low light and read until I can't keep my eyes open any more.

And I'm of the second camp...afraid that if I do get out of bed, I'll never get back.

I also get up. I DO try to get back to sleep, but when I realize that I've been tossing & turning & gradually becoming more awake instead of sleepier, I do get up. I also go into the kitchen, use dim lighting, and put up the kettle. My go-to is Celestial Seasonings' Sleepytime Tea; a drop of honey & a wee bit of skim milk, and occasionally 1/4 - 1/2 cup of Cheerios. I read a little, or do a crossword puzzle (sudoku, ken-ken, whatever), or I make the to-do list (I often do that before bed, which helps) for the next day.
I go back to bed in half an hour, more or less, and usually I fall back asleep.
The up-side of being retired from working full time is that I can usually sleep a little later on the days when I've had one of those nights. When I had to get up for work at 6 a.m., I often got migraines from the lack of sleep. Now those have lessened.

One of my big waking problems was movement by the cats. Now they are banned from the bedroom.

Smart move, to ban the cats. Hope they're giving you your well-deserved rest, and not scratching on the door!

Thanks for the checklist with great reminders and some new ideas.

You're so welcome, Irene. Hope they're helpful.

I am periodically having issues since I'm going through the change about 10 years too soon. I do find a colder room helps tons, as does relaxation/stretching before bed.

Ten years too soon? Glad, at least, you're finding relief with those strategies!

When I really have trouble sleeping I have a poem that I go through in my mind--I've been trying to memorize it literally for years but when I get about halfway through I'm usually zonked. It doesn't always work but I've sort of trained my brain that when I'm going through it, it's bedtime.

When I started perimenopause sleep was so difficult. I would wake up every few hours covered in sweat and my heart pounding. I didn't immediately realize what was happening and I hated it. I didn't have a poem, but I did try going through names. I would start listing names of pets, names of childhood teachers, friends, books, I would just start thinking lists of names and that would usually knock me back out. Sadly it never stopped the wakeups from happening. I eventually watched this documentary called "Hot Flash Havoc" that opened my eyes to what was going on with me, and taught me a lot about the history of and current state of treatments. I'm now on HRT, and sleep MUCH better than I was.

"Hot Flash Havoc" really helped open my eyes, and I would recommend it to anyone, if you're interested you can check it out here: hotflashhavoc.com

That's one original idea I hadn't heard of before! I guess you only get to memorize the first few lines, then :)

I'm here to report that hot flashes and poor sleep do not go away after menopause. Those lovely symptoms have stayed with me. Ugh.

When does it get better at least? I had some sleep issues after onset of peri..missed periods but got them, but the sleep issues were mild and didn't happen often. Bascially I got great sleep. Then I went 7 months with no bleed at all. Thought I was done but then a very thin bleed for 5 days. A month after that bleed, started having severe insomnia some nights no sleep at all. This has continued for this whole time now on 8 months of symptoms, 9th month of no bleeding. I am definately in menopause, but is this supposed to at least ease after the 12 months? The only other symptoms is of course I'm hot/cold alot, the sweating has decreased though. I am so scared I am stuck in this no sleep then a little sleep then no sleep again pattern every other day or two it's ruining my life right now and I cry everyday over it. Any hope out there, anyone??? Any recovered and when??

Hi,I am 45 years old and haven't had a period in 10 months,my sleep all of a sudden took a turn for the worst,I am in recovery from klonopin,I have an anxiety disorder on top of it,but now when I go to bed,I toss and turn till around 3 or 4 in the morning,I can't get to sleep,I don't fall asleep until 3 or 4am. Sometimes not at all,I am packing because I don't wanna die from exhaustion and lack of sleep,any suggestions? Does this happen to u? It's scaring me. Thanks kristine

I learned that high estrogen can block thyroid hormones as well as zinc--both which impact sleep. But, I'm not in the health field, just a patient trying to figure out the sleep angle during menopause.  Sunlight is good to reset the circadium clock and blocking light when the sun goes down is crucial. Staying off electronics 3 hours before bed--actually wearing blu light blockers for all screens this time as well.

I have been experiencing the hot flashes for 3 yrs now. I have tried everything from hot milk, bio-identical hormone treatment, over the counter remedies,black cohosh, St. John's Wort, Prozac, herbal teas, and more. I am now suffering from sleep deprivation secondarily to the hot flashes. I am just beside myself as I am a very active person, like hiking 220 mi in 25 in CA on the John Muir trail and I rock climb, mountain bike and do yoga. Since starting menopause I have experience visceral fat deposition. I have never had a problem with abdominal weight gain.I am an NP and have read everything western medicine has on menopause, googled many articles and I have read and re-read Christina Northrup's books on menopause. Nothing has worked for me. Today I will stop all the over the counter remedies and go back on the Prozac. I am not sure what to do about the sleep but now I have the depression second to insomnia. Any thoughts, or idea would be welcome.

I wish you the best, know that this too, shall pass. Try not to think about sleep too much, melatonin is especially helpful (for me) and definitely hypnosis. Just u-tube them for sleep difficulties, especially Prima Facie and they should help you. I am currently doing neuro feedback at first it was great, now not so much.

Hello dear, you're not alone. I'm going on my fourth year of night sweats. It does come and go but when it's on, I literally get no sleep. I'm in a no sleep bout as I write this. Going on 10 weeks now :-(
When I say no sleep, I mean it. I have a night sweet every 30 minutes hence I never fall into a deep sleep.
I've been really changing my diet. No alcohol, coffee. Vegetarian diet with lots of probiotic foods. I'm walking and doing light weights three times a week. I'm building muscle and loosing some fat. Not around my belly though. My cortisol levels are very high because of the lack of sleep.
I'm exhausted and drag myself around.
My husband took me to Hawaii and can you believe I was miserable?
All of this is causing me to be very depressed and also full of anxiety.
I've tried every herb under the sun. I tried HRT last year for about a month I had some scary side effects so I quit them.
I'm still having periods but very sparatic. I've had one so far this year.
All of this to say yes u are not alone.
I'm here because I feel crazy and need support.
I will be 52 in June and praying for this to end.
I would pay to sleep...give my life savings :-)
Take care.
I hope you get relief soon

I think I'm going crazy ... I'm so tired I get in to bed I fall sound asleep for maybe an hour then I wake up burning hot covers thrown off etc I sleep with my windows wide open ..I'm 53 still having regular periods ... What's going on .. I don't drink or smoke .. I don't have late nights ... Just want to sleep ... This happens all night long hot then cold because I threw the covers off HELP

I thought I just read my own comment here - same age, same symptoms - just the same. hopefully whoever wrote this may be able to reply, 2 years later and tell me (us) how long this lasted. That's what I really need to know.

I started having hot flashes 2 years ago, but they subsided. Now I have hot flashes ALL THE TIME (I'm 52).

My auntie told me to, "just enjoy it, it won't last forever". I believe that part of getting through this God awful time is partly our mental outlook on it.

I know it's hard, I've been to two doctors, read until I have no more to read. It also helps that my children and fiance are going through this with me with a smile.

Be encouraged and pray we all get a good night's sleep soon. I'm sleepy all the time and have bags under my eyes. I have to order more concealer today!

We will get through this! Forever be encouraged!

I have found that my problem with hot flashes and sleep deprivation was resolved by the elimination of caffeine from my diet and more Vitamin E - sometimes 800 mg.

Here are some ideas from someone dealing with hot flashes for about 26 years - honestly!

Hormon treatments are not as bad as once thought about 10 years ago.
Hot flashes can be a sign of cancer.
Red night lights, LED clocks etc., are less likely to wake you up more.
Stretching (in the dark) helps relieve tight painful muscles and tension.
Getting out of bed and finding a favorite comfortable spot to cool off pays off in the long run.
Go to bed early enough to allow 2 or 3 hours of awake time and stop worrying about getting enough sleep.
Take charge of your life to avoid depression, diet & exercise, activities.

Well as it is 3:32 am I have found reading these posts. helpful. The last ten months have been challenging it started with a diagnosis of hypothyroidism. Followed by depression and currently sleeplessness and hot flashes. have just stared taking estroven. I know I need to exercise more and eat healthier but I am having trouble motivating myself which in turn is causing more depression.

anyone know a gyno in NYC that specializes in menopause??

I was diagnosed with early menopause last year and my gp said that i was either in the last stages or actually over it as i havent had a period in 4 years. Before this i was on the depo injection and didnt show any signs of premenopause. I still get nightnsweats and sleep for me is virtually non-existent (it is now 07:52 and i have been awake for 4 hours). I only sleep on average 4-5 hours a night and still do a full time rotating shift job. I lay in bed fidgeting and trying to fall back to sleep but thdn end up waking my partner, who is a very light sleeper. I wish i could sleep for a full eight hours sometimes as i get very lethargic and if i nap after work then i have trouble getting to sleep when i need to. I have tried several remedies and tricks to help but nothing seems to work

I don't have hot flushes - In fact I don't flush at all - Instead I feel as if I am internally combusting - I feel extremely hot on the inside but my skin remains cool. As soon as I lie down it starts and for someone who always feels the cold and relishes sleeping under tons of blankets this is too much. I throw all the covers/pyjamas off and within no time start shivering but still feeling hot. Have found no solution. Am wrecked. Glad to read (well not "glad" that others suffer) I am not alone. Just how long is this going to last? At 53 I still have regular periods and there's no end in site....

Reading these comments made me feel much better as I too have been awake most of the night. Tonight I woke up at 12.30 after only a couple of hours sleep feeling completely unrefreshed. For me, it's a good night's sleep if I make it to 4.30. I am 55 and have not had a period for 4 months. Lately, the insomnia symptoms have been worsening due to stress. Drinking 2 cups of warm home made soy milk have helped with hot flushes but the sleeping is no good! I am going through a period of intense work stress which aaI think is exacerbating it too! The sun has now come up so at least I can stop trying to sleep!

I recently had to go to the doc's office because I'd been sick for over a month with the latest thing going around my school. The nurse practitioner asked me if I had a fever or chills. I just laughed and laughed and said, 'How would I know?'

I am 58 and have been going through menopause for 8 years now and had hot flashes that kept me awake throughout the night and I could not sleep. I finally resorted to HRT and it definitely helped. Because I have been using HRT for 7 years my doctor said I need to take a break. I decided I should try and wean myself off and see what happens. Well for the last month I have not slept the entire night because of the hot flashes. I sleep in spurts and have not had an entire night's sleep for a month. I have tried all the remedies all women recommended in this blog. Nothing works for me. I plan on going back on HRT as soon as possible. I understand the risks but I cannot go on like this anymore.

Thanks for sharing the article . Really Helpful for Patients suffering from Sleep Issues.

IHaving read through every comment on this thread, nodding. recognising and empathising as I go. can I ask - please,  anyone who can bring us  some good  news, about how it all ends,  how much better life feels afterwards. Drop us a  post here.

We could do with some hope and reassurance from    women  who are actually through this time,  that this- will- genuinely- pass , .

My 70yrs  young aunt (20 yrs my senior and yet  her own worries and challenges who has more energy than I , would absolutely say get help now and know.

it gets better 



I'm 54 and have just started getting horrible acid reflux, but with no symptoms until I couldn't breathe at night for almost 10 days as my throat was so congested.  Antibiotics sorted it, but I now have to consider what I eat and drink and take tablets to treat it.  Also have had 2 weeks of imsomnia with an electrical type of buzzing in my head when I'm laying htere awake which is so annoying.  Bit by bit I'm trying to sort myself out and find out how to deal with all these symptoms.  Initially I was very stressed by it all, but I feel I am more in control now as knowledge is power!



I'm 46, have already had 'false' peri-menopause once, 5 years ago after chemotherapy and radiation for oesphagus cancer.  Hot sweats like you wouldn't believe, and NO sleeping.  I tried HRT back then & it was horrid, brought on a period after not having had one for 9 months, and that period lasted for 6 weeks, as well as causing other side effects like breast tenderness etc.  Fast forward 5 years & hot sweats have returned for last 3 months, along with turning into a psycho periodically re moods and the return of no sleep.  Problem for me is I've always had a level of insomnia.  Anyway, went to the doctors again the other day & she put me on the patch version of HRT - Estalis Sequi.  OMG - immediate life changer!!  After it being on for 2 days I am now nodding off at 9.30pm and only waking once or so during the night.  Finally feel like I'm waking refreshed.  I was hesitant to try due to past bad experience, but am so glad I gave it another go.  Don't suffer in silence, discuss with your physician and try different methods until you find something that works for you!!

Hi, ok sorry started going through this when I was 36 and I am now 51, with 4 years of no periods. Things have calmed however,night sweats are still with me as well. I have come up with a clever way now, to stop them in their tracks or end quickly...I use a salt water ice pack, that I get from the delivery places and wrap a pillowcase around it, and in it comes with me, sometimes two depending on weather. It’s -30 outside and I still use one every night. Hubby has noticed in the summer they are nice for him too, as they cool down the bed. No water leakage and you can control it by unwrapping layers of the pillowcase...I have a few of them, and I just exchange nightly. Give it a try...


I feel anxious. Can't sleep without sleeping pills. And to make things worse I think I’m getting addicted to them. How can I make myself feel better and sleep better?

It helps to know I'm not alone (misery loves company?)  My overnight hot flashes started in my late 40's with perimenapause.  Sleep problems impaired my thinking & job performance during the day, and I have continued to struggle with all of that since -- all very stressful.   Birth control pills helped some (I think stabilized my estrogen), but blood test December confirmed I am in menopause (age 53), so no more need for birth control.  Early on I tried melatonin until I had to keep upping the dose, now I only use occasionally to "break up" a bad cycle.    Meditation helps me quiet my monkey-mind and sleep a little deeper into the morning and/or get some rest after middle-of-night sweats.    But even following good sleep hygiene* the stress + sweat is just too disruptive (*two hygiene exceptions:  bedroom on 3rd floor hard to keep cool in warm months even with fan; dog sleeps on my bed and sometimes wakes me up needing cuddles - I think she's uncomfortable from tumors so I cant banish her as might be logical).   

Reading posts, I wonder if I should try HRT (assuming I can keep my job with the accompanying health insurance).   In the meantime, I just try for earlier bedtime to avoid catastrophizing when up 30-60 minutes a night.   Other suggestions welcome. 


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