Complete Symptom Guide to Menopause and Sleep - Stella

Menopause sleep

Sleep is cherished by many and it can be life-limiting when it is disrupted by menopause sleep difficulties. We understand the fear and anxiety of lying in bed, waiting and wishing for sleep to come, or waking repeatedly during the night. You are not alone.


Insomnia is a sleep disorder where you have trouble sleeping at least three times a week for at least three months and you cannot function during the day. 

While you may not have clinically diagnosed insomnia, menopause sleep difficulties can severely affect your functioning during the day and at work. Difficulties getting to sleep and staying asleep are common during menopause.

Sleep quality is important and deep sleep helps you feel rested and positively impacts your mental health and performance. Everyone needs different amounts of sleep, but an average adult needs approximately 6-8 hours.

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  • Nearly half of women have menopause sleep issues
  • Women aged 60+ are at a greater risk of sleep disruption
  • Perimenopause sleep problems begin when your hormone levels start to fluctuate

Feeling tired can lead to other menopause symptoms such as anxiety, depression, brain fog and weight gain. Read more about the stages of menopause.


Can’t fall asleep within 30 minutes of going to bed

Get fewer than six hours of sleep

Wake several times a night or lie awake for hours

Wake early

Feel exhausted when waking and find it hard to concentrate


Did you know that changing your lifestyle and avoiding certain things can really help keep your symptoms under control?

1. Sleep hygiene. Go to bed and wake at regular times and avoid sleeping in.

2. Avoid stimulants. Take care about what you eat and drink as they can interrupt your sleep. Reduce caffeine and nicotine and avoid alcohol, which will make you dehydrated and need to pee during the night.

3. Don’t eat late. Your body will find it hard to rest if it is dealing with a big meal close to bedtime.

4. Don’t exercise before bed. Try a relaxed wind-down routine in the few hours before bedtime

5. Reduce screen time. Keep off your mobile and laptops in the hour before bedtime and keep your mobile out of your room if you are tempted to scroll during the night if you wake.


Yes. HRT is known to improve sleep, mood and hot flushes during menopause. However, HRT comes with risks and is not suitable for everyone. Read more about the HRT debate.

Speak to your doctor about your personal treatment options.


Natural remedies

Great care needs to be taken when considering natural remedies for menopause sleep problems. Firstly, research studies on herbal supplements are small with limited reliable evidence. This makes it hard for clinicians to determine whether a remedy is safe and effective. Also, the quality and purity of the preparation you want to buy may be unknown. Read more on what are the best supplements for menopause.

Lifestyle changes

If you are finding sleep difficult during menopause, it’s worth evaluating your lifestyle and seeing if improvements result in better sleep. Take a look at your nutrition, stress management and exercise levels, as these can really help improve your sleep and health, both now and in later life.


As we go through menopause and perimenopause, our oestrogen and progesterone levels fluctuate. 

A decline in oestrogen causes vasomotor symptoms, such as hot flushes and night sweats which can cause sleep issues. Reduced levels of sleep-inducing hormone progesterone may cause sleep apnoea and snoring.

Also, as we age, we naturally produce less melatonin, a sleep-inducing hormone, which means sleep can become lighter and more disrupted.

Melatonin helps regulate our body clock. We have low melatonin during the day when it is light and high melatonin at night, when it is dark.


Menopause not sleeping

Fluctuating hormone levels can cause the following symptoms, which can disrupt sleep:

  • Hot flushes and night sweats
  • Mood changes, such as anxiety and depression
  • Going to the toilet during the night
  • Joint and muscle pains
  • Restless legs syndrome – a tingling, crawling sensation
  • Sleep apnoea – reduced progesterone may contribute to airway obstruction. It is more common after surgical menopause and weight gain may be a factor


Sleep issues can also be caused by changes in medication and supplements, an unhealthy diet, eating late, alcohol, caffeine, nicotine and stress.

Poor sleep can increase your risks of:

  • Mood disorders
  • Cognitive function, such as loss of focus and forgetfulness, and dementia
  • Headaches
  • Cardiovascular disease

You can be at greater risk of the following if you cannot sleep well:

  • High blood pressure and heart disease
  • Gastrointestinal issues
  • Osteoporosis
  • If changing your sleeping habits doesn’t work
  • Your symptoms are getting worse, or not improving
  • You are unable to function during the day or at work
Nothing can describe the panic of knowing you have to be up in a couple of hours and you’ve lain awake all night”



I can’t sleep anymore – is menopause the reason? Read more

How HRT and ambition helped get my energy and libido back. Read more

10 steps for a good night’s sleep during menopause. Read more

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