Why is it harder to sleep during perimenopause?

It often gets harder to sleep during perimenopause because the hormones that help regulate sleep start fluctuating a lot. Estrogen helps influence your brain’s sleep-wake cycle, including serotonin and melatonin, and progesterone has a naturally calming, sedating effect. When those hormones become more erratic and then decline, sleep can get lighter, more broken up, and harder to get back to once you wake.

Then there are the symptoms layered on top. Night sweats and hot flashes can wake you suddenly, sometimes over and over. Stress, anxiety, irritability, and higher cortisol can leave your body feeling more revved up at night. Some women also start dealing with more nighttime urination, restless legs, or sleep apnea during this stage, all of which can chip away at sleep.

Here at Alloy, we break this down in more detail in our articles on menopause and sleep and can menopause cause insomnia. If your sleep trouble seems tied to hormonal symptoms, treatment can help, and a menopause-trained clinician at Alloy can talk through options, including whether progesterone or other menopause treatment makes sense for you.

This answer was created using the following resources: