The Perimenopause Sleep Struggle: Why You’re Tired and How to Fix It

Let’s talk about the #1 struggle for women in perimenopause: SLEEP.

If you’re nodding along because you’re tired (again), you’re not alone, and you’re definitely not imagining it. Statistics show that more than half of women aged 40 to 59 in perimenopause sleep less than 7 hours a night. That is simply not enough to feel vital, energetic, and sharp.

In fact, perimenopausal women often score lower on sleep quality than both pre-menopausal and post-menopausal women. It is a frustrating "award" to win, but there are biological reasons why your rest has gone off the rails. Once we understand the why then we can learn to work with our body instead of against it.

Why is our sleep so terrible?

It is a perfect storm. Hormone fluctuations (estrogen and progesterone), hot flashes, mood swings, and changes in melatonin production all gang up to mess with your rest. Add in the stress of caregiving, career demands, and life’s curveballs, and it is no wonder we feel like we will only sleep when we are dead.

Common disturbances include:

• Insomnia: Struggling to fall or stay asleep.

• Night Sweats: Waking up drenched and overheated.

• Circadian Rhythm Shifts: Those lovely 3am wake-ups with no hope of getting back to sleep.

• Sleep Apnea: Very common post-menopause and often goes undiagnosed.
  

  

Why you can't just "push through"

Ignoring bad sleep is a recipe for feeling like crap on the daily. Poor sleep leads to more cravings, less willpower, and a body that clings to extra weight (especially around the belly). Beyond just feeling groggy, chronic sleep issues in midlife are linked to higher risks of cognitive decline. Sleep is when your body does its best "total body clean up." Without enough of it, you’re left with a lot of mental cobwebs.

The Science of the 3am Wake-Up

If you can get to sleep but can’t stay asleep, you're dealing with "sleep maintenance insomnia." At the center of it all is a tiny part of your brain called the suprachiasmatic nucleus (try saying that 10 times!). This little cluster of cells sits just above where your optic nerves cross. Your internal clock (the circadian rhythm) is regulated by light. When you sense daylight, your brain signals you to wake up. As it gets dark, you produce melatonin. Modern lifestyle practices like late-night scrolling confuse this clock. But it isn't just light; your sleep/wake cycle is also impacted by:

• Meal Timing: Eating late (especially carbs and sugar) can spike blood sugar and snap you awake.

• Alcohol: It might help you fall asleep fast, but it fragments your sleep and triggers middle-of-the-night wake-ups.

• Cortisol and Stress: If your brain stays "on guard," deep sleep remains elusive.

• Inflammation: Low-grade inflammation can make your brain more alert at night.

• Gut Issues: Think your gut only impacts your poo? Gut dysbiosis can mess with GABA production (your calming neurotransmitter) and promote wakefulness.

• Hormone Dysregulation: Low testosterone can disrupt sleep cycles and cause more wake-ups. While common in men, some women experience this as well.
  

How to Reclaim Your Rest

The best approach is individualized.

What worked for your friend probably won't work for you, and what you got away with in your 20s likely won't cut it now.

Read that again: What you used to be able to get away with probably no longer works, my friend. Before jumping to over the counter sleep aids which often just mask the issue without improving sleep quality start with these quick wins:

1. Cool Down: Lower the thermostat, use a fan, or invest in a cooling mattress topper. We personally use this and it honestly was the best money I've spent for my

2. Watch the Caffeine and Alcohol: Keep both to the early part of the day (or even better-don't drink!) to avoid sabotaging your deep sleep cycles.

3. Morning Light: Get sunlight in your eyes first thing in the morning to set your internal clock.

4. Ditch the Phone: Scrolling isn't "me time," it is a melatonin blocker. Charge your phone outside the bedroom or at least across the room. Try swapping that time for some real relaxation: talk to your partner, pray, journal, listen to music, a meditation, or read.

You Are Not Broken

You’re not just "bad at sleep," your biology is shifting.

The good news is that there is 100% hope for your rest in this stage of life. Hormone therapy can be a game changer, but it won't do the heavy lifting if your lifestyle practices are still working against you.

If you are regularly waking up multiple times a night and dragging through your days, you owe it to yourself to find the root cause. My favorite thing to troubleshoot with women is sleep, because when it gets better, your life improves in every single area.

Ready to find your unique sleep recipe? Book a free discovery call with me here to get to the bottom of your struggles and reclaim your energy.