Women and Insomnia - How Can Menopause Cause Insomnia?

Women and Insomnia 

Women are more likely to experience insomnia than men, but why is it so?

According to 2005 National Sleep Foundation poll, around 57% of women and 51% of men reported they experienced insomnia several times a week, which means that women have more frequent bouts of sleeplessness than men. With ages, this gap between women and men only increases.

It is considered that fluctuations in the level of hormones which occur during the menstrual cycle, pregnancy and menopause can contribute to insomnia in women.

What Is Menopause and What Are Its Symptoms?

Menopause comes with ages and women officially reach it once 12 months have passed since their last menstrual period. But, before menopause occurs, women go through a period known as perimenopause which can last anywhere from 3 to 10 years. Perimenopausal symptoms usually start in the mid 40s and can continue through the early 50s.

During perimenopause, ovaries produce lower amounts of key hormones than they used to produce before, including estrogen and progesterone, and as the levels of these hormones fall, symptoms of menopause worsen. Women experience a wide range of symptoms and one of the most common symptoms is insomnia.

Other symptoms include:

  • Irregular periods
  • Frequent mood swings
  • Increased anxiety and depression
  • Hot flashes
  • Physical changes in the breasts, ovaries, uterus and cervix
  • Dry skin
  • Increased need to urinate
  • Reduced sex drive

How Does Menopause Affect Sleep and Cause Insomnia?

As women enter perimenopause, their periods don’t stop immediately or go away gradually, but their bodies rather start and stop functioning properly while figuring out a new way of being.

As this happen, hormones in their bodies go wild and these sudden fluctuations in the levels of hormones responsible for regulating their energy and the way how they function can also affect their sleep. But how exactly menopause affects sleep?

Hot Flashes

To stay asleep all night long, our bodies require cool temperature which is why our core body temperature naturally begins to drop at night  to facilitate the production of melatonin.

Hot flashes do the opposite. As hormone levels continue to fluctuate, women may find their bodies unable to maintain a consistent temperature and feel sudden surges and drops in their body temperature.

What they are experiencing is a surge of adrenaline caused by a rapid decrease of hormones. This is the same chemical responsible for our reaction to stress or dangerous situations and their bodies may have a hard time recovering from this sudden surge of energy, making it difficult for them to fall asleep again once they wake up and stay asleep all night. 

Many women also experience night sweats which usually result from these hot flashes and which  can also interfere with the quality of their sleep and the quality of their life. 

Sleep Apnea

As progesterone levels drop during perimenopause, the chances for developing obstructive sleep apnea increase. Women in perimenopause suffering from obstructive sleep apnea are also more susceptible to gaining too much weight and obesity, which can further lead to other health issues. 

Emotional Stability 

As we mentioned, perimenopause and hormonal changes can cause anxiety which can contribute to insomnia. Anxiety is activated by the stress hormone cortisol and as the levels of estrogen responsible for balancing one’s mood decrease in perimenopause, cortisol levels rise, which is why older women are at greater risk of stress, anxiety and, therefore, insomnia as well.

In addition, about 20% of women in perimenopause will experience depression which is also linked to estrogen loss and which can severely affect the quality of their sleep. 

Old Age

Along with perimenopause, aging process carries its own set of sleep problems. As we age, certain parts of our brain responsible for regulating sleep begin to atrophy which makes it difficult for seniors to fall asleep and stay asleep all night. Their sleep is often interrupted and they tend to wake up earlier than they should.


Just as natural hormonal changes can interfere with sleep, so can changes caused by certain medications or supplements prescribed to ease the symptoms of menopause. While eliminating some symptoms, these medications may cause certain side effects and sleep disturbance and insomnia are some of them. 

Are There Any Treatments That Can Help Women Whose Sleep Is Affected by Menopausal Symptoms?

There are some things that women can do to relieve or eliminate the symptoms of menopause which keep them up or wake them up every night. Some of these symptoms can be controlled simply by regulating sleep habits, while other symptoms can’t be controlled without taking proper medications. 

Here are some medical solutions:

Hormone Replacement Therapy

Hormone replacement therapy (HRT), some antidepressants and low-dose birth control pills have all been shown to alleviate the sleep problems associated with menopause. But, although HRT can relieve perimenopausal symptoms and improve sleep, it is used less today than in the past because of the consequences that its use causes. Namely, it increases the risks of blood clots, breast cancer, and gallbladder disease, so doctors only recommend using it as a short-term option if necessary. 

Melatonin Supplements

Scientists discovered that the natural levels of melatonin that our bodies produce tend to drop significantly in perimenopause. Taking melatonin supplements can help improve sleep. However, before taking anything, women should speak with their doctor first for advice on dosing and to ensure it won’t interfere with other medications they may be taking. 

There are also many natural and behavioral remedies that can improve sleep during menopause such as:

Establishing Good Sleep Hygiene

Women should stick to regular sleep schedule and try to sleep and wake up at the same time every day. In addition, they should try to create a cozy sleeping environment that will stimulate falling asleep faster and staying asleep all night long. They should keep their bedrooms clean, dark and cool and avoid watching TV, doing work or using them for anything other than sleep and sex. 

If they wake up during the night or don’t fall asleep within 15-20 minutes they should try leaving the room and spending some time doing something quiet like reading in another room. This way their brains will stop associating their bedroom with sleeplessness. 

Creating a Soothing Bedtime Routine 

A warm bath right before bedtime or drinking a cup of hot tea or a glass of milk can stimulate falling sleep faster. In addition, meditation or deep breathing exercises can also help eliminate stressful or worrisome thoughts that keep them up at night and help them fall asleep easier and stay asleep.

Investing in Cool and Comfortable Bedding

Certain mattress types like latex mattresses, innerspring and hybrid beds featuring layers of gel-infused foams are better at regulating heat than those mattresses made entirely of memory foam known for retaining body heat. Women in menopause should consider getting one such bed with special cooling features which will help them stay cool and sleep well throughout the whole night.

(Click here to see our top choice for the best bed for menopause.)

Besides mattresses, there are cooling pillows as well and special sheets made of breathable linen or cotton that can help women in menopause deal easier with hot flashes and sweating that follows them. 


Exercising regularly and outside if possible will give menopausal women an energy boost and help their brains maintain regular cicardian rhythms. Besides this, exercising regularly will also make them feel good, prevent them from gaining too much weight that often occurs with menopause and make them feel more tired by bedtime. 

Trying Therapies

Cognitive behavioral therapy for insomnia (CBT-I) proved to be effective in treating insomnia caused by menopause. It focuses on helping patients learn to recognize those negative thoughts and behaviors that usually interfere with their sleep, so they can replace them with healthier habits that will stimulate better night’s sleep.