Getting a good night’s sleep in perimenopause and menopause can be tricky, to say the least.

From hot flushes and anxious thoughts to acid reflux, joint pains, and simply staring at the ceiling at 3am, there’s no end of reasons why sleep can disappear.

But before we get into the sleep tips, let’s look at why sleep can be so hard to find during our midlife shift.

How do we get to sleep?

A whole series of co-ordinated events have to happen before we can fall asleep.

We experience a drop in core body temperature, the brain receives signals that tell it to produce melatonin (the sleep hormone), and there’s a tipping point in the amount of adenosine in the brain.  Adenosine builds up gradually over the day, creating “sleep pressure” until it reaches a certain point when we can no longer resist falling asleep. 

These events rely on cues from our environment that influence the central body clock in the brain. Anything that interrupts these cues, disrupts sleep.

Sleep and hormone fluctuations

If we look at what’s happening in our bodies during peri/menopause, we can see there’s quite a lot that can disturb these sleep events.

 – Oestrogen levels are fluctuating and falling. The central body clock in the brain and all the little peripheral body clocks have oestrogen receptors.  They’re sensitive to the ups and downs of oestrogen which means we can have trouble falling asleep and often wake up too early.

 – Progesterone is falling. Progesterone has a calming effect in the nervous system. When levels fall we can experience more anxiety and insomnia.

 – Hot flushes mess with that drop in core body temperature.

 – Stress can lead to cortisol dysregulation, which in turn can disrupt melatonin production. 

I think you’ll agree there’s a lot going on!

How to get a good night’s sleep in perimenopause

Now we know what’s happening in our bodies, what can we do about it? 

There’s no magic bullet for improving sleep, I’m afraid. But trying a combination of food + lifestyle changes can make a significant difference.

Here are 5 of the most effective techniques I know, and if you want to delve deeper into this topic come and join The Midlife Shift Club. You’ll get access to monthly live sessions and Q&A on different peri/menopause topics, and plenty of helpful resources like the Sleep Checklist and Midlife Supplement Guide. 

On with the tips…

• Enjoy a 10-20 minute morning walk. This helps your brain to register natural morning light so it can better detect the drop in light levels at dusk and be ready to release melatonin.
• Swap caffeinated drinks for herbal alternatives. Caffeine has a half-life of around 6 hours, so that lunchtime latte can be keeping you awake at bedtime.
• Give yourself a screen-free bedtime routine to encourage relaxation and more melatonin.
• Try Montmorency cherry juice with warm milk. This type of tart cherry juice is naturally rich in melatonin.
• Opt for bed linen and nightwear (if you’re wearing any) made from natural, breathable fibres like bamboo and cotton that will help you keep cool.

Bibliography

Alvord, V., Kantra, E., & Pendergast, J. S. 2021. Estrogens and the Circadian System. Seminars in Cell & Developmental Biology, 126, 56. https://doi.org/10.1016/j.semcdb.2021.04.010

Troìa, L., Garassino, M., Volpicelli, A. I., Fornara, A., Libretti, A., Surico, D., & Remorgida, V. 2025. Sleep Disturbance and Perimenopause: A Narrative Review. Journal of Clinical Medicine, 14(5), 1479. https://doi.org/10.3390/jcm14051479