It seems unfair – not only does perimenopause, the years leading up to menopause, cause hot flashes, mood swings and other uncomfortable side effects, but it also may disrupt sleep. The National Sleep Foundation found that 61% of women in perimenopause or menopause experience insomnia.

"The biggest way menopause impacts sleep is related to the hormones," says Paul Zolty, M.D., a sleep medicine specialist and pulmonologist at Piedmont Physicians Georgia Lung. "Estrogen declines and other hormones may affect the central nervous system."

Potential sleep-disrupting factors include:

• Hot flashes and night sweats. 40% of perimenopausal women have hot flashes.
• Mental symptoms, like anxiety, depression, low libido and memory issues associated with changing hormones.
• Medical conditions that present around menopausal age, such as sleep apnea, mood disorders, thyroid disorders, rheumatoid diseases and cardiac conditions.
• Medications used to treat these conditions, such as antidepressants. 

Lifestyle modifications to improve sleep

Menopause may be inevitable, but there are things women can do to improve the quality of their sleep:

• Exercise regularly.
• Quit smoking if you currently smoke. Nicotine can negatively impact sleep.
• Wear lightweight, breathable cotton clothes when you sleep.
• Take a cool shower before bed.
• Sleep with light covers, not heavy blankets.
• Use a fan or air conditioning to improve air circulation in your bedroom.
• Avoid nicotine, alcohol and/or caffeine before bed.
• Practice stress management techniques, such as meditation, massage or yoga.
• Eat healthy meals and avoid eating a large, heavy dinner. Be mindful of any foods that trigger hot flashes, such as spicy or acidic foods.

Medical intervention to improve sleep

If lifestyle modifications do not help, talk to your doctor about supplements or hormone replacement therapy.

• Hormone replacement therapy. "Hormonally, progesterone has the greatest direct impact on sleep and some patients find that nightly progesterone supplementation can improve sleep patterns," says Heide Moeling, M.D., an obstetrician and gynecologist at Piedmont.
• Supplements. "From a 'natural' standpoint, melatonin has been shown to help reduce minor sleep difficulties," Dr. Moeling says. Get your doctor's okay before taking any new supplements.

Talk to your physician if you have trouble sleeping, whether it's related to menopause or otherwise. Chronic insomnia can lead to high blood pressure, heart disease and other serious health conditions. 

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