Sleepless Nights? 7 Ways Menopause Affects Sleep and How to Improve It

Who wouldn’t want to sleep like a baby? Sound and restful sleep is what we all crave. Isn’t it? For many women, sound sleep seems like a faded dream when they hit perimenopause. In fact, the incidence of sleep disorders ranges from 16% to 47% during perimenopause and 35% to 60% after menopause, making sleepless nights a common struggle in this phase of life. 

When a woman hasn’t had her menstrual period for 12 consecutive months, she is considered menopausal. However, menopause symptoms like sleeplessness often begin early, during the transitional period called ‘perimenopause’. Many women may experience this transitional phase in their mid-30s, and menopause usually occurs in the late 40s to early 50s. 

While hormonal shifts during menopause are the major contributors, various other factors can also be blamed for your tossing and turning through the night. Fortunately, there are ways to improve sleep quality during this phase. Understanding the changes happening to you and how menopause affects sleep will help you get a good night’s sleep during this phase of your life.  

During perimenopause, 16% to 47% of women experience sleep disorders; this increases to 35%–60% postmenopause.  

How Does Menopause Affect Sleep? 

Sleep disturbances related to menopause usually involve difficulty falling asleep, frequent night awakenings, and getting up early in the morning, which can also contribute to daytime fatigue.. All of this affects health, relationships, and productivity as well. There’s no denying that sleep disorders during menopause stem from hormonal changes, but this is just a piece of the puzzle.  

Listed ahead are the 7 reasons explaining how menopause is affecting your sleep: 

1. Hot Flashes & Night Sweats 

Most women experience hot flashes and night sweats during menopause. Sleeplessness is often associated with hot flashes. These sudden and intense sensations of extreme heat can disrupt sleep by causing unexpected sleep awakenings. Hot flashes often affect the face, neck, and chest and can appear during the day or night. These episodes of intense heat typically last for 2-4 minutes and are, at times, accompanied by night sweats and anxiety. The discomfort caused by this makes it harder to fall asleep again. 

The frequency of night sweats tends to increase as menopause progresses and can persist for years after the last period. Research suggests that hormonal changes like dips in the estrogen levels may trigger both hot flashes and awakenings. While not every hot flash directly causes sleep disruption, studies show a strong link between their severity and poor sleep quality. 

What Causes Hot Flashes During Menopause?

2. Hormones & Circadian Rhythm 

Hormones that follow the body’s natural rhythm (circadian rhythm) control the sleep cycle. The rhythm also controls many other aspects of physiology, such as bowel movements, body temperature, and blood pressure. The sleep hormone melatonin helps regulate sleep by making us drowsy at night and alert in the morning.   

Estrogen and progesterone influence the production of melatonin. As hormones change, circadian rhythm regulation may be affected, leading to early awakenings and reduced deep sleep. Your body struggles to maintain a consistent sleep cycle. 

3. Restless Legs Syndrome 

Restless legs syndrome (RLS) is common during menopause. This condition causes uncomfortable sensations in the legs when lying down and an irresistible urge to move them.  The movement provides only temporary relief and makes it difficult to sleep, leading to insomnia.   

Estrogen influences dopamine, a neurotransmitter that controls movement. Hormonal changes may disrupt dopamine signaling, leading to tingling, discomfort, and an urge to move the legs at night. The decline in iron levels during menopause also has a role to play in this.  

4. Snoring and Sleep Apnea 

Snoring and sleep apnea become more common after menopause due to hormonal changes. Sleep apnea is a condition where a person briefly stops breathing while sleeping, which happens because the airway gets blocked or the brain doesn’t send the right signals to breathe. 

Estrogen and progesterone support muscle tone in the airway. The decline in these hormones can make the throat muscles weaker, which can cause the airway to collapse easily during sleep. Weight gain, which is also common in menopause, can add to this problem. Sleep apnea increases the risk of obstructive sleep apnea (OSA) and loud snoring, leading to poor sleep quality.  

5. Mental Health & Mood Shifts