Menopause And Sleep Disorders: Causes And Treatments

Menopause, a natural phase in a woman’s life, often brings significant changes, one of which includes sleep disturbances. As hormones fluctuate, many women find themselves grappling with sleep problems.

Understanding the intricate connection between menopause and sleep problems is crucial for managing health during this stage. This article aims to explore the causes behind sleep disorders linked to menopause and provide insights into potential treatments, offering relief and improved well-being.

An Overview of Menopause and Its Stages

Menopause marks a significant transition in a woman’s life, characterized by the cessation of menstrual periods. The link between hormonal fluctuations across various stages of menopause and disruptions in sleep underscores the importance of developing efficient menopause treatment and methods for management.

Premenopause and Early Signs

Premenopause starts in the late thirties to early forties. Hormones change slowly, showing mild signs at first. This time can bring sleep problems, signaling the start of menopause.

Changes in period regularity, mood swings, and hot flashes can mess with sleep, leading to tiredness and sleepiness during the day.

Perimenopause – The Transitional Phase

Perimenopause is the phase before menopause with bigger hormone changes and stronger symptoms. Sleep issues get worse, with insomnia or hypersomnia being a major problem.

Night sweats, hot flashes, and anxiety can also disturb sleep, making you more tired during the day and affecting overall health.

Menopause and Postmenopause

Menopause is when a woman hasn’t had a period for 12 months. After menopause, called postmenopause, hormone changes keep happening, and some menopause symptoms stay.

Sleep problems might continue or change, with insomnia, restless legs syndrome, and sleep apnea being common.

Menopausal Symptoms Affecting Sleep

Menopause brings many symptoms that can badly affect sleep, causing tiredness, irritability, and a drop in overall happiness. Knowing how these symptoms mess up sleep is important to manage them better.

Hot Flashes and Night Sweats

Hot flashes are common in menopause, causing sudden intense heat throughout the body, mainly at night. This can wake you up and make it hard to sleep again, leading to broken sleep. Night sweats, or sweating a lot while sleeping, can also disturb sleep by making you wet and uncomfortable.

Bladder and Vaginal Symptoms

Issues like needing to pee often and vaginal dryness can disrupt sleep. Waking up to go to the bathroom breaks your sleep cycle, making you tired. Vaginal dryness can make sex painful and add to discomfort, making it hard to relax and sleep.

Mood Changes and Mental Health

Mood swings, feeling down, and anxiety are also common in menopause. These feelings can stop you from relaxing and falling asleep. Anxiety can make sleep even harder, with too many thoughts and restlessness.

Joint and Muscle Pain

Pain in joints and muscles, often felt during menopause, can also ruin sleep. The pain can stop you from finding a comfortable position to sleep, leading to waking up often and having interrupted sleep. Long-lasting pain can make you more tired and less active during the day.

Sleep Problems Associated With Menopause

Sleep issues are quite frequent and bothersome for women going through menopause, affecting 40-60% of them. Insomnia is the most common sleep disturbance they face.

Insomnia During Menopause

Menopausal women often struggle with insomnia, which disrupts their ability to fall or stay asleep, affecting their sleep quality and health. Hormonal shifts, especially decreases in estrogen and progesterone, disrupt sleep. These changes interfere with the brain’s sleep-wake cycle, causing trouble in falling asleep and frequent night awakenings.

Sleep-disordered Breathing and Apnea

Irregular breathing patterns while sleeping, known as sleep-disordered breathing, are more frequent in menopausal women. A specific type, obstructive sleep apnea (OSA), where the airway gets blocked during sleep, is common in postmenopausal women. OSA’s risk is higher with age and weight gain, both typical in menopause.

Restless Legs Syndrome

Restless legs syndrome (RLS), which causes an unstoppable need to move the legs, especially at night, also interrupts sleep in menopause. While its exact cause is unclear, it’s likely linked to hormonal changes. RLS symptoms often intensify during menopause, leading to sleep issues and tiredness during the day.

Can Menopause Treatments Improve Sleep?

To ease menopause symptoms and better sleep, several options are available.

Hormone Replacement Therapy (HRT)

HRT treats sleep issues in menopause by providing estrogen and progesterone. It lessens hot flashes, night sweats, and mood changes, which all affect sleep. Yet, HRT isn’t right for everyone, and discussing its pros and cons with a doctor is crucial.

Antidepressants and Other Medications

Some antidepressants, specifically low-dose SSRIs, enhance sleep in menopausal women. They stabilize mood and lessen anxiety, indirectly aiding sleep.

Medicines like gabapentin and pregabalin also help, especially for restless leg syndrome (RLS), further boosting sleep quality.

Cognitive-Behavioral Therapy for Insomnia (CBT-I)

CBT-I, a non-medication method, effectively treats insomnia in both menopausal and non-menopausal women. It involves changing thoughts and behaviors that disrupt sleep.

Techniques like relaxation training and stimulus control therapy in CBT-I promote healthy sleep habits and enhance sleep quality.

Strategies for Sleeping Better During Menopause

Menopause brings hormonal changes and sleep issues, but there are effective ways to enhance sleep and overall health.

Establishing a Regular Sleep Schedule

Set a regular sleep pattern, even on weekends. Going to bed and waking up at the same time daily, regardless of tiredness, will train your body to expect sleep, making it easier to doze off and wake up rejuvenated.

Creating a Relaxing Bedtime Routine

Spend an hour or two before bed relaxing. Avoid screens like phones, computers, and TVs since their blue light disrupts sleep. Instead, read, take a warm bath, or listen to calming music to signal to your body it’s time to sleep.

Managing Stress and Anxiety

Stress and anxiety, heightened during menopause, can worsen sleep. Use stress-reducing practices like yoga, meditation, or deep breathing to calm your mind and body, aiding in better sleep.

Here are a few more additional tips for improving your sleep:

  • Keep your bedroom dark, quiet, and cool for optimal sleep.
  • Steer clear of caffeine and alcohol before bed.
  • Regularly exercise, but not right before sleep.
  • Get daily sunlight exposure to maintain your natural sleep cycle.
  • If sleep troubles continue despite these changes, consider seeking professional advice.

Natural Remedies for Sleep During Menopause

Besides traditional treatments, natural methods can also enhance sleep during menopause. These include using herbal supplements, changing daily habits, and practicing relaxation techniques.

Herbal supplements like valerian root, essential oils, and melatonin can be effective. Valerian root, known for its calming properties, may lessen anxiety and aid relaxation. Melatonin helps in regulating sleep cycles.

Making lifestyle changes can also improve sleep. This involves:

  • Stick to a regular sleep schedule.
  • Avoid caffeine and alcohol before bedtime.
  • Exercise regularly.
  • Practice relaxation techniques like yoga, meditation, and deep breathing.

Vitamins that Help with Menopause Insomnia

Integrating vitamins into your diet can significantly help with sleep regulation, especially for menopausal women experiencing sleep disturbances.

Vitamin D

Low levels of vitamin D are linked to higher insomnia risks.

  • Role: Regulates sleep-wake cycles.
  • Benefits: Boosting vitamin D can enhance sleep quality.
  • Sources: Fatty fish, egg yolks, fortified dairy products.

Vitamin B12

  • Importance: Essential for melatonin production, which controls sleep-wake cycles.
  • Deficiency Effects: Disturbed sleep patterns and potential insomnia.
  • Sources: Meat, poultry, fish, eggs.


Research shows magnesium supplements improve sleep in people living with insomnia.

  • Function: Aids muscle relaxation and promotes calmness, both vital for restful sleep.
  • Benefits: Adequate magnesium levels can lead to better sleep quality.
  • Sources: Leafy green vegetables, nuts, seeds.

Remember, while these vitamins are helpful, it’s crucial to consult a healthcare provider before beginning any supplementation.

Does Post-Menopause Insomnia Go Away?

Many women face ongoing sleep issues after menopause. Changes in hormones during menopause can lead to problems with getting to sleep, staying asleep, or feeling rested after sleep. While some women may see their sleep improve eventually, others might deal with these issues for a long time.

If you’re dealing with lasting insomnia post-menopause, getting professional advice is key. A doctor can check for other reasons behind your sleep issues and suggest suitable treatments.

Watch out for these indicators that you might need expert help for your post-menopause insomnia:

  • Trouble falling or staying asleep most nights.
  • Waking up still feeling tired.
  • Insomnia affects your daily activities, causing concentration problems, irritability, or tiredness during the day.

Frequently Asked Questions

Does progesterone help with sleep?

Progesterone, a hormone that relaxes the body and mind, may improve sleep. It helps regulate your sleep pattern and is used to treat insomnia. This hormone is also available in supplement form.

How long does progesterone make you sleepy?

Progesterone might make you sleepy within 30 to 60 minutes after taking it, and this can last up to 8 hours. If used for sleep, take it at the same time nightly and avoid driving or using machines until you know its effects.

Can menopause cause sleep apnea?

Menopause can lead to a higher chance of getting sleep apnea, where breathing pauses and starts again while sleeping. While men usually have it more, women's risk goes up post-menopause due to changes in estrogen and progesterone affecting their airways.

Does estrogen help you sleep?

Estrogen, a hormone that helps control your sleep-wake cycle, can aid in better sleep. Research shows estrogen replacement therapy can enhance sleep quality in menopausal women.

Can hormones cause insomnia?

Absolutely! Hormones can induce insomnia. Imbalances in these sleep-regulating hormones can disturb sleep patterns. Cortisol (stress hormone) and melatonin (sleep hormone) also affect sleep.

Does menopause cause weird dreams?

Menopause might lead to unusual dreams due to hormonal changes. These changes disturb your sleep patterns, causing more REM sleep, the phase when dreaming happens. As a result, you might experience more vivid and strange dreams during this time.

Can HRT help with insomnia?

Hormone replacement therapy (HRT) can assist menopausal women experiencing insomnia by balancing estrogen and progesterone levels. This helps regulate their sleep patterns and lessen sleep disruptions from hot flashes and night sweats, ultimately improving sleep quality and duration.

Final Thoughts

During menopause, women often experience sleep disturbances due to hormonal changes. Understanding this link is crucial for managing these issues.

Seeking advice from healthcare professionals, they can explore personalized treatment plans, including lifestyle modifications, medications, and alternative therapies.

Additionally, support from groups and resources, alongside strategies like a sleep-friendly environment and relaxation techniques, can significantly improve sleep quality and overall well-being during this transitional phase.

Read nextThe Menopause Diet: Your Key To Healthy Aging


  1. National Library of Medicine, Journal of Menopausal Medicine, Jinju Lee et al., 2019, “Sleep Disorders and Menopause”
  2. National Library of Medicine, Menopause, Lisa Taylor-Swanson, et al., 2018, “The dynamics of stress and fatigue across menopause: attractors, coupling, and resilience.”
  3. National Library of Medicine, J Menopausal Med, Hyun-Kyung Kim, et al., 2015, “The Recent Review of the Genitourinary Syndrome of Menopause”
  4. National Library of Medicine, Journal of Sleep Medicine and Disorders, Shazia Jehan, et al., 2016, “Obstructive Sleep Apnea: Women’s Perspective”