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The Impact of Perimenopause on Sleep: Tips for Better Rest

Black woman awake at night, seeming restless

Perimenopause is a transitional phase leading up to menopause, marked by significant hormonal changes that can impact various aspects of a woman's health, including sleep. Many women experience disruptions in their sleep patterns during perimenopause, which can affect overall well-being. Understanding these changes and adopting strategies to improve sleep quality can help you navigate this phase more comfortably.

How Perimenopause Affects Sleep

  1. Hormonal Fluctuations:

  • Estrogen and Progesterone: During perimenopause, levels of estrogen and progesterone fluctuate and eventually decline. Estrogen helps regulate sleep, so its reduction can lead to difficulty falling and staying asleep. Progesterone has a calming effect, and its decrease can contribute to sleep disturbances and insomnia.

  • Cortisol: Increased stress and anxiety during perimenopause can elevate cortisol levels, which disrupts the sleep-wake cycle and makes it harder to relax and fall asleep.

  1. Hot Flashes and Night Sweats:

  • These common symptoms of perimenopause can cause significant discomfort, leading to frequent awakenings and poor sleep quality.

  1. Mood Changes:

  • Mood swings, anxiety, and depression, often associated with perimenopause, can interfere with the ability to fall asleep and stay asleep.

  1. Sleep Apnea:

  • The risk of developing sleep apnea increases during perimenopause due to changes in body weight distribution and hormonal shifts that affect muscle tone in the throat.

Tips for Better Rest During Perimenopause

  1. Establish a Sleep Routine:

  • Go to bed and wake up at the same time every day, even on weekends. This helps regulate your body's internal clock and improves the consistency of your sleep.

  1. Create a Relaxing Bedtime Environment:

  • Make your bedroom conducive to sleep by keeping it cool, dark, and quiet. Consider using blackout curtains, earplugs, or a white noise machine.

  1. Practice Good Sleep Hygiene:

  • Avoid caffeine and heavy meals close to bedtime. Limit alcohol consumption, as it can interfere with your sleep cycle. Establish a calming pre-sleep routine, such as reading a book, taking a warm bath, or practicing relaxation exercises.

  1. Manage Hot Flashes and Night Sweats:

  • Keep your bedroom cool and use breathable, moisture-wicking bedding. Wear lightweight, breathable pajamas. Consider using a fan or air conditioning. If hot flashes and night sweats are severe, talk to your healthcare provider about possible treatments.

  1. Mindfulness and Relaxation Techniques:

  • Incorporate mindfulness practices, such as meditation or deep-breathing exercises, to reduce stress and anxiety. Progressive muscle relaxation and guided imagery can also help you unwind before bed.

  1. Exercise Regularly:

  • Engage in regular physical activity, but avoid vigorous exercise close to bedtime. Exercise can help regulate hormones and improve mood, both of which contribute to better sleep.

  1. Consider Herbal Remedies:

  • Some women find relief from sleep disturbances with herbal supplements such as valerian root, chamomile, or lavender. Always consult with a healthcare provider before starting any new supplement.

  1. Seek Professional Help:

  • If sleep problems persist, consider consulting a healthcare provider or a sleep specialist. Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for chronic sleep issues.

Remember, each woman's experience with perimenopause is unique, so it may take some time to find the strategies that work best for you. Prioritize your sleep health, and don't hesitate to seek professional guidance if needed.


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About Michelle

Michelle is a Doctor of Physical Therapy at Webb Physical Therapy, located in Lawrence, Kansas.  She's worked in PT for close to 10 years, and believes each patient should be treated with a holistic, whole person approach to healing.

She is devoted to helping her patients develop individualized treatment plans to help them achieve their specific goals.

Call (785) 813-1338 for a free 15 minute phone consultation, or email

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