Insomnia from menopause: Causes, symptoms and treatment

At any point in life, the inability to fall asleep can make it difficult to function throughout the day. During menopause, insomnia can have an even bigger impact on your energy levels, mood, and overall health. Some women may refer to insomnia that occurs during menopause as menopause insomnia. Understanding why insomnia occurs during menopause and recognizing the symptoms are the first steps toward getting a better night’s sleep.

Healthcare providers are often unable to isolate a single cause of insomnia during menopause. Sleep problems may arise due to the following:

• Hot flashes and night sweats: Common menopause symptoms such as hot flashes and night sweats can make it difficult to get comfortable in bed or to stay asleep throughout the night.
• Depression: Many people experience mood swings and symptoms of depression during perimenopause. Depression can cause both severe fatigue and chronic insomnia.
• Stress: Some people experience emotional stress during menopause due to fears or worries about getting older. Combined with stress from relationships, work and other sources, these thoughts may keep you tossing and turning at night.
• Worsening of other sleep disorders: Sleep apnea, restless leg syndrome and other sleep disorders can develop or worsen during the menopausal years. Insomnia from hot flashes, night sweats and depression can further exacerbate those sleep disorders and lead to lower sleep quality.

Insomnia refers to the inability to fall or stay asleep during the night. Some symptoms include: 

• Inability to fall asleep, long after turning in for the night 
• Waking up frequently during the night 
• Waking up earlier than necessary or desired 
• Not feeling refreshed, even after sleeping 
• Daytime drowsiness, fatigue or irritability 
• Difficulty concentrating

Self-care and good sleep hygiene may allow you to get a better night’s rest. To address insomnia in menopause, follow these tips.

Stick to a regular bedtime schedule

Go to sleep and wake up at the same time every day regardless of your daily schedule. Sleeping in on the weekends or staying up one night to binge-watch a favorite show could disrupt your body’s natural circadian rhythms and interfere with your sleep cycle.

Limit screen time close to bed

Blue light emitted from television, computer and mobile device screens can excite the nervous system, putting you in a state that isn’t conducive to sleep. Stop screen time at least an hour before you turn in. Keep your phone stored in a drawer or out of reach so you’re not tempted to scroll in bed.

Control the environment

Keep your bedroom at a comfortable temperature. Use breathable bedding made from 100% cotton to better regulate your body temperature. If your room is too bright, wear an eye mask or purchase blackout curtains. Drown out disruptive sounds with a white noise machine or slip in a pair of earplugs.

Get more exercise

In addition to aiding in weight management and supporting cardiovascular health, regular exercise can help promote better sleep. Walk, swim, ride a bike or engage in other moderate-intensity exercise for at least 150 minutes every week but avoid exercising within a couple of hours of bedtime.

Limit alcohol and caffeine

Caffeine is a stimulant that can keep you up at night, and it’s found in coffee, tea, energy drinks, soda, and chocolate. Avoiding caffeine in the late afternoon and evening may potentially improve sleep.

Alcohol can also undermine your ability to get a good night’s rest. Although a glass of wine or a cocktail may make you feel drowsy initially, alcohol can disrupt your body’s sleep cycle.

Find stress relief methods that work for you

Addressing stress in a constructive way could lead to better sleep. Start a worry journal to record troublesome thoughts. Talk to someone you trust about your feelings or see a mental health provider. Relaxation techniques like deep breathing and mindfulness meditation may also benefit you. Set aside some time every day for an activity you enjoy like soaking in a bubble bath, reading a good book, gardening or baking something delicious in the kitchen.

If your symptoms persist or interfere with your daily life, talk to your healthcare provider. They can discuss your symptoms with you and determine if prescription medications and other treatments may help you sleep better. In addition, your provider may recommend hormone replacement therapy (HRT), self-care and other interventions to ease symptoms of menopause that may be contributing to insomnia.

Published March 2023.