Why Insomnia Happens During Perimenopause (and What to Do About It)
You expect hot flashes. Maybe even mood swings.
But no one warns you about staring at the ceiling at 2 a.m., exhausted but unable to fall back asleep.
If this sounds familiar, you’re not alone. Trouble sleeping is one of the most common—and most frustrating—symptoms of perimenopause. Even women who’ve always slept well can suddenly find themselves wide awake for hours, night after night.
It’s not just stress or bad luck. There are real biological changes happening that make restful sleep harder to come by. Let’s look at why insomnia happens during perimenopause—and what you can do about it.
What’s Going On During Perimenopause
Perimenopause is the transition phase leading up to menopause, when your hormones—especially estrogen and progesterone—start to fluctuate. These shifts can throw off your body’s internal clock, temperature regulation, and stress response.
The result? You feel wired when you want to relax, wake up drenched in sweat, or struggle to fall back asleep once you’re awake.
Why Insomnia Happens
1. Hormonal Fluctuations
Estrogen and progesterone play key roles in sleep regulation.
When estrogen drops, it can cause hot flashes, night sweats, and mood changes that disrupt sleep. Meanwhile, progesterone, which naturally promotes relaxation, also declines—making it harder to wind down.
2. Night Sweats and Temperature Dysregulation
Fluctuating hormones confuse your body’s ability to manage temperature. Even a small rise in core temperature can trigger awakenings or make you toss and turn all night.
3. Cortisol and Stress
Perimenopause affects how your body manages cortisol, your stress hormone. If cortisol stays high at night, your brain stays alert when it should be resting—leading to racing thoughts and shallow sleep.
4. Mood and Anxiety
Hormone changes can also influence serotonin and GABA, brain chemicals tied to calmness and mood. Add in midlife stress—career pressure, caregiving, relationships—and it’s no wonder your mind won’t shut off.
5. Lifestyle Amplifiers
Caffeine, alcohol, and late-night screen time can all make insomnia worse. Many women also push through exhaustion, sacrificing rest for productivity, which only deepens fatigue and hormonal imbalance.
How to Improve Sleep
1. Regulate Your Routine
Go to bed and wake up at consistent times, even on weekends. Your body thrives on rhythm. Create a calming pre-bed ritual—stretch, dim the lights, or journal instead of scrolling your phone.
(Hey, I realize that this idea faces resistance. Believe me, when my alarm goes off at 5 am on a Saturday or Sunday I am NOT happy. But, this step has dramatically improved my sleep and it’s not just me, this step really does make a huge difference for most women.)
2. Cool the Room, Calm the Body
Keep your bedroom cool, dark, and quiet. Layer breathable sheets, use a fan, and skip heavy pajamas. Night sweats are less disruptive when your environment supports cooling.
(Consider setting the temp in your room to lower than what feels realistic or normal. The recommended temperature is between 60 and 67 degrees Farenheit. Try 65 and see how you sleep.)
3. Support Your Hormones Naturally
Exercise regularly, eat balanced meals, and avoid blood sugar crashes. Limiting caffeine and alcohol—especially after noon—helps reduce hot flashes and anxiety, both of which sabotage sleep.
(Consider keeping a journal and documenting what you consume in the afternoon and evening and how you sleep. After a week or two of tracking, look for patterns. You might be surprised.)
4. Manage Stress During the Day
Mindfulness, walking, or yoga help lower cortisol before bedtime. Calming your stress response during the day makes it easier for your body to transition into rest mode at night.
(I know that the last thing you want to hear is “reduce stress.” Women hear this too often and it’s often assumed that stress is causing whatever you’re dealing with. What I am saying/recommending, is that you take time to take care of yourself. Pay attention to what stresses you out and what relieves it. Indulge yourself, just a little bit, in calming activities that you enjoy. Read a trashy novel, color in a coloring book, do a word puzzle…whatever makes you happy and helps you disconnect for just a few minutes from the stress in your life.)
5. Supplements and Supports to Consider
Magnesium glycinate or threonate – helps muscles relax and promotes deep sleep.
L-theanine – supports calm focus and eases pre-bed anxiety.
Ashwagandha – an adaptogen that regulates cortisol and stress response.
GABA – helps calm the brain and make falling asleep easier.
Glycine – supports restorative sleep and temperature regulation.
Omega-3 fatty acids – stabilize mood and reduce inflammation.
Chamomile or valerian root tea – gentle, herbal options for relaxation before bed.
(Always check with your healthcare provider before starting new supplements. And try one supplement at a time so you can evaluate how effective it is for you. Supplements can be a huge waste of money if you do not assess their effectiveness. Some work, some don’t.)
6. Get Morning Light
A few minutes of morning sunlight helps reset your body’s natural clock, improving both sleep onset and mood.
(I realize this can be challenging, especially in the winter time. Ideas to make it a little easier…take your morning work breaks outside or in front of a window. Walk around the block. Invest in a sun lamp/light. If it is daylight when you wake up, stand in front of your east facing windows for a few minutes.)
7. Seek Professional Help When Needed
If insomnia persists, talk with your provider. Hormone therapy or targeted support can make a big difference. Personalized guidance—like a Sleep Audit—can help you understand what’s really behind your sleepless nights.
When to Seek Help
If you’re regularly getting fewer than six hours of sleep, or exhaustion is affecting your mood, focus, or relationships, it’s time to get extra support. Insomnia during perimenopause is common, but it’s not something you just have to “push through.”
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Ready to Finally Sleep Again?
You don’t have to guess why you’re awake at 3 a.m.—or keep trying random fixes that don’t work.
My Perimenopause Sleep Audit helps you uncover what’s really causing your insomnia and gives you personalized, practical steps to get back to restorative sleep.
For just $17, you’ll complete a short, targeted questionnaire about your sleep habits, symptoms, and goals. I’ll personally review your responses and send you a custom video explaining what’s happening—and how to fix it.
✨ Take the Sleep Audit today and start waking up rested, clear-headed, and ready to handle whatever midlife throws your way.