Sleep Disturbances & Restful Nights

Most women need about 7–9 hours of sleep before age 65 and 7–8 hours after. Yet during menopause, it’s common to face restless nights, trouble falling asleep, waking up often, or feeling unrefreshed in the morning.

These challenges often begin in perimenopause and may continue into postmenopause, with up to 60% of women affected. Hormonal changes, life stress, and natural shifts with aging can all play a part.

The encouraging news is that sleep can improve. With the right habits, support, and sometimes medical care, you can restore your energy and find more peaceful nights again 

Sleep struggles can show up in different ways. Many women describe:

• Trouble falling asleep, even when tired
   
• Waking up often during the night
   
• Rising earlier than planned
   
• Feeling drained despite spending hours in bed
   

These patterns can leave you exhausted, foggy, and frustrated — but you’re not alone. Many women experience the same challenges during the menopausal transition.

Shifting hormones during menopause can disrupt sleep in several ways:

• Estrogen helps regulate body temperature and REM sleep; lower levels may cause night sweats and frequent waking.

• Progesterone has calming, sleep-promoting effects. When it drops, insomnia and anxiety can rise.

• FSH (follicle-stimulating hormone) increases as estrogen falls and is linked to poorer sleep efficiency.

• Melatonin the “sleep hormone,” naturally declines with age and even more during menopause, leading to lighter, less consistent sleep.

It’s not just low hormone levels - the ups and downs of perimenopause can also fragment sleep and leave you feeling less rested
 

Menopause-related sleep problems often have multiple layers:

• Hot flashes and night sweats can wake you or prevent deep rest. Some women even wake before a hot flash begins.

• Hormone changes may lower melatonin, making it harder to fall and stay asleep.

• Obstructive sleep apnea (OSA) becomes more common after menopause, partly due to changes in hormones and body fat distribution.

• Restless Legs Syndrome (RLS) may worsen after menopause, causing an urge to move your legs at night.

• Genitourinary symptoms (like dryness or bladder urgency) can add to nighttime disruptions.

Together, these factors explain why sleep challenges are so frequent in midlife and beyond.

If sleep troubles last longer than 3 months, or leave you too tired to function well, it’s time to talk with your doctor.

Also, some medications, such as antidepressants, corticosteroids, or thyroid drugs, may affect sleep. 

A review with your healthcare provider can help identify causes and options for relief.