Sleep
Menopause and sleep: why you’re waking in the night, and what helps
If your sleep has gone to pieces in your forties or fifties, you’re not imagining it, and you’re not alone. Here’s why it happens, and the small things that make the nights easier.
By Kim Palmer, Founder of Clementine
· 4 min read
In short
- Sleep often gets worse in perimenopause, the years before your periods stop. Night sweats, early waking and a busier mind all play a part. For most women it settles again after menopause.
- The NHS suggests a cool bedroom, light layers, cutting back on the things that set off hot flushes, and a steady getting-up time. If you’re awake for 20 minutes, get up and do something quiet.
- Waking at 3am isn’t only a menopause thing. In our own data, women in their early twenties were up after midnight as often as women in their fifties.
Yes, menopause can wreck your sleep, and it usually starts before you expect it. Sleep tends to get worse in perimenopause, the years leading up to your last period, and for most women it settles again afterwards. The SWAN study, which has followed thousands of women through midlife, found that sleep quality and quantity drop from perimenopause onwards, then stabilise or improve after menopause for the majority. Decades of research to tell us menopause is bad for sleep. No sh*t, Sherlock. But the second half is the bit worth holding on to: for most women, it gets better.
I’m speaking from the middle of it. I’m perimenopausal, I’m on HRT, I’m mum to two boys (12 and 8), and I’m a fully paid-up member of the 3am club. Mine started in my early 40s, and I didn’t make the link for ages. If that sounds familiar, this is for you.
Why menopause keeps you awake
It’s rarely one thing. It’s usually a few at once:
- Night sweats. The NHS describes hot flushes as your face, neck and chest suddenly feeling very hot, and when they happen at night, they’re night sweats. They wake you up, and then you’re too hot to drop off again.
- Waking early and not getting back. SWAN found that women with early-morning waking and frequent night sweats were more likely to have sleep problems that hung around. Waking up drenched at 4am is bad for your sleep? No sh*t, Sherlock.
- A busier mind. The NHS says poor sleep can leave you irritable, stressed and anxious. And a stressed mind is harder to switch off the next night.
You’re in good company, and it’s not a quick phase. The NHS says symptoms usually last seven to nine years, sometimes longer, and change along the way. So it’s worth finding what works for you, rather than waiting it out.
What helps tonight
These come from the NHS’s own list for hot flushes, night sweats and sleep. None of them is hard, and some will make you roll your eyes (keep cool when you’re too hot: no sh*t, Sherlock). They’re the basics for a reason.
- Keep the bedroom cool. Open a window, use a fan, and choose a lighter duvet.
- Wear light layers. Ones you can take off in the night without fully waking up.
- Keep a cold drink by the bed. The NHS suggests a cold drink, a fan or a cool shower when a flush hits.
- Notice your triggers. The NHS names spicy food, caffeine, hot drinks, smoking and alcohol. You don’t have to give them all up. Just notice which ones show up on your bad nights.
- Get up at the same time. Going to bed and getting up at similar times helps your body know when it’s time to sleep.
- Don’t lie there fighting it. If you’re still awake after around 20 minutes, the NHS says to get up, sit somewhere comfortable and do something relaxing until you feel sleepy.
If it’s wearing you down, talk to your GP. You don’t have to just put up with it. The NHS says cognitive behavioural therapy (CBT) can help with both hot flushes and sleep problems, and your GP can talk you through the treatments.
It isn’t only menopause
Finally, a finding that isn’t a no-sh*t-Sherlock. When we wrote The 3am Report, I expected the 3am wake-up to be a menopause story. It wasn’t. Women aged 18 to 24 did just as much of their listening after midnight (22%) as women in their fifties (18–20%). See finding seven.
That shows when women went looking for help, not how everyone sleeps. But it tells me something. Perimenopause makes night waking more common, and it can start in your late 30s or early 40s. It just isn’t the whole picture. A full head wakes you too, at any age. So if the cool room and the cold drink aren’t enough, look at what you’re carrying into bed as well. Our mind won’t switch off page has four things that help with that.
And if it’s the heat that wakes you, Becca McLeish’s Too Hot To Sleep is below, with the first five minutes free. Sleep During Menopause, a twenty-minute session made for exactly these years, is coming soon.
Questions
Can menopause cause insomnia?
Yes. Trouble getting to sleep and staying asleep is one of the symptoms the NHS lists, and the SWAN study found sleep gets worse from perimenopause onwards. For most women it improves again after menopause.
Why do I wake up at 3am during perimenopause?
Often because of a night sweat, or because your body wakes you early and your mind gets going. But in our own data, women in their early twenties were awake after midnight as often as women in their fifties, so hormones are rarely the whole story.
How long do menopause sleep problems last?
The NHS says menopause symptoms usually last seven to nine years, sometimes longer, and they change over that time. SWAN found sleep stabilises or improves after menopause for most women.
How can I stop night sweats waking me up?
Keep your bedroom cool, wear light layers and keep a cold drink by the bed. The NHS also suggests cutting back on spicy food, caffeine, hot drinks, smoking and alcohol, which can set off hot flushes.
When should I see a GP about menopause and sleep?
When it’s affecting your days, not just your nights. You don’t have to wait until it’s unbearable. Your GP can talk you through treatments, and the NHS says CBT can help with both hot flushes and sleep problems.