Menopause and Insomnia: Causes & Treatments

Last updated 01.16.2024 | by Dr. Karen Pike | 14 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


One in four women suffer from insomnia. But during menopause, the risk of developing this sleep condition increases, with more than 60% of postmenopausal women experiencing symptoms of insomnia.

A chronic lack of sleep can have a negative effect on almost every aspect of your life. It impacts your work, relationships with family and friends, and your ability to thrive. So, it’s essential to identify the cause of insomnia and treat the problem as soon as possible.

I’ve struggled with bouts of insomnia throughout my adult life, and when I reached perimenopause, the condition became worse. I would frequently have difficulty falling asleep and staying asleep, and I know from many of our readers that I’m not alone. Insomnia is one of the most prevalent side effects of menopause, and it can also be one of the hardest to manage. But there are ways to find relief from menopause-related insomnia, and in this post, I’ll show you how.

So, are you struggling to drift off at night? Are you battling through the work day on less than optimum sleep? You’re not alone, but thankfully, several treatments and interventions can help.

Below, I’ll explore the relationship between menopause and insomnia. I’ll also look at ways to tackle sleep disturbances so you can wake up feeling well-rested and ready to embrace the day.

How Common is Insomnia During Menopause?

Women are already more likely than men to suffer from chronic insomnia. But the chances of developing this poor sleep complaint rise dramatically during the menopause transitional phase and into post-menopause.

More than 40% of women in their late 40s and early 50s experience sleep disruptions. And the problem appears to get worse with age. More than 60% of postmenopausal women suffer from regular sleepless nights.

Why Does Menopause Cause Insomnia?

The average woman reaches menopause at 52. For several years before this, she will experience perimenopause. This is a time when the reproductive hormones estrogen and progesterone are in a state of constant flux. This can lead to several undesirable symptoms, including insomnia.

As a woman gets closer to menopause, the hormones produced by her ovaries gradually decrease. During this time, sleep deprivation become even more common. Research suggests that this is partially caused by lower levels of estradiol, a specific type of estrogen.

I know from my own experience how these hormonal shifts can impact sleep cycles. As I began my journey through the menopause transition phase, I could no longer fall asleep as easily as I used to. And often, when I would finally drift off, I’d wake again in the middle of the night, and be unable to fall back asleep.

Yet while hormonal shifts are a major driving force behind insomnia in perimenopausal and post-menopausal women, they aren’t the only cause. Other symptoms of menopause, particularly hot flashes and night sweats, can also lead to sleep difficulties.

Hot flashes are sudden and intense feelings of heat that sweep across the body at seemingly random intervals. They can cause flushing and perspiration. Night sweats are essentially hot flashes that occur during the night.

Maybe you’re already familiar with waking up with soaked sheets. This type of vasomotor symptom affects more than 75% of women around menopause transitional time. And when it happens regularly, the quality and duration of sleep in women can take a big hit.

Other Causes of Insomnia During Menopause

Menopause-related insomnia is the result of a reduction in estrogen and progesterone levels and an increase in symptoms such as hot flashes and excessive sweating. But some other factors can also contribute to the problem.

Anxiety and Depression

The quality of your mental health can have a huge impact on the quality of your sleep. This explains why more than half of all adults with generalized anxiety disorder also suffer from insomnia.

Anyone can develop a mental health disorder at any time during their lives. But conditions such as anxiety and depression are particularly common in women going through menopause.

Lower Levels of Melatonin

Melatonin is a naturally occurring hormone produced by the body. It’s crucial for sleep, as it regulates our circadian rhythms and sends signals to the brain that it’s time to drift off.

Yet, as we age, our levels of melatonin begin to decrease. This means less overall sleep and an increase in sleeplessness.

Sleep-Disordered Breathing

Post-menopausal women are more likely to develop sleep-disordered breathing issues such as chronic snoring and sleep apnea. The latest science seems to show that these conditions are influenced by lower levels of progesterone, a hormone that dips dramatically during menopause.

Both chronic snoring and obstructive sleep apnea can reduce the amount of time you spend in the deeper, more restorative stages of sleep.

Will My Insomnia Go Away After Menopause?

Every woman is different. Some may find relief once they reach menopause (when they haven’t had a period for more than 12 months.) For these women, their insomnia was most likely caused by a sudden fluctuation of hormones in the body. Once these fluctuations stabilize, insomnia (and symptoms like nocturnal hyperhidrosis) reduce or go away. I’m grateful that I was in this camp. I struggled with insomnia symptoms throughout the menopause transitional phase, and other aspects of my health suffered as a result. But thankfully, by the time I reached the milestone of menopause, I’d naturally returned to more healthy and good sleep habits, and now, the problem is completely resolved.

But unfortunately, many women experience sleep deprivation for several years into their post-menopausal journey.

There’s no way to predict how long your menopause-related insomnia will last. However, there are plenty of ways to ease your sleeplessness and maybe even get rid of them altogether.

How to Find Relief from Menopause-Related Insomnia

If you regularly struggle to drift off or wake up frequently in the middle of the night, you’re probably feeling exhausted. But thankfully, there are treatments and interventions that can boost the quality and duration of your sleep.

Medical Treatments for Menopause-Related Insomnia

Conventional medicine offers several different treatment options for menopause-related insomnia, including:

1. Hormone therapy

Insomnia caused by fluctuating hormones can be treated by therapy, also known as hormone replacement therapy (HRT).

There are several different types of hormone therapy available, but each one works by replacing the missing hormones responsible for your symptoms.

And the good news is that many women do indeed see a huge improvement in their symptoms. Insomnia can decrease, and perspiration can be reduced. In some cases, they may even disappear completely.

The therapy can be administered topically in patches, creams, and gels, and it can also be taken in pill form or via an implant.

However, it’s important to remember that this therapy isn’t for everyone.

If you’re interested in learning more about the therapy and how it can help treat insomnia, talk to your doctor. They’ll let you know if you’re a suitable candidate and discuss the pros and cons with you so that you can make an informed decision.

2. Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are medications normally prescribed to treat depression. But, they can also be used off-label to ease some of the menopausal symptoms.

These medications are particularly useful when it comes to treating vasomotor symptoms. So, if waking up drenched in sweat each night is costing you sleep, it’s worth talking to your doctor about your options.

However, just like hormone therapy, SSRIs and SNRIs also carry several risks. One of the most common side effects of these drugs is actually insomnia. So, they should always be taken with caution and under medical supervision.

3. Sleeping pills

There are many sleep aids available for short-term use. Doctors are often reluctant to prescribe sleeping pills to aid menopause-related insomnia because due to potential side effects and addiction potential. They are not recommended as a long-term solution. 

Supplements for Menopause-Related Insomnia

When it comes to tackling insomnia, many women prefer to avoid harsh pharmaceuticals and instead opt for over-the-counter supplements and natural remedies.

These interventions come with far fewer potential side effects and are generally considered a safer alternative. However, certain over-the-counter supplements can still carry risks, and in some cases, they can interact with other medications. So, always speak to your doctor before starting a new supplement.

In my own battle with menopause-related insomnia, I researched a wide variety of supplements and natural interventions to try and ease my symptoms. Here’s what worked for me.

1. Melatonin

Our bodies naturally produce melatonin. But as we age, the levels drop. This can make it harder to fall and stay asleep. But melatonin supplements may help. 

Evidence suggests that melatonin supplementation at a daily dosage of 3mg and above can significantly improve your sleep disorders and every other menopausal woman. On top of that, it can also have a positive impact on body mass index (BMI) and bone density.

2. CBD

In recent years, many have found success using CBD as an aid. Our bodies contain something called an endocannabinoid system, which plays an important role in the sleep-wake cycle. CBD (a compound found in Cannabis) binds to our endocannabinoid receptors and may help to induce sleep.

Other Supplements That May be Helpful

Magnesium L Threonate, L Theanine, Apigenin, Inositol, supplementation is recommended by some experts to help with poor sleep quality.

Other Ways to Find Relief from Menopause-Related Insomnia

Other Ways to Find Relief from Menopause-Related Insomnia

Along with the medical treatments and supplements above, several other interventions and lifestyle changes could help you fall asleep quicker and sleep for longer.

While the supplements above were helpful in relieving my own insomnia, it was the lifestyle interventions below that made the most difference for me.

1. Cut out caffeine, nicotine, and alcohol

Caffeine and nicotine are stimulants that can keep you awake long past your bedtime. Alcohol is a depressant, but while it may make you feel drowsy, even just a glass or two of wine can have a great impact on sleep quality and sleep disorders. 

So, experts recommend cutting out smoking and carefully limiting your coffee and alcohol consumption to maximize your sleep.

2. Yoga

A National Health Statistics Report published by the CDC suggests that more than half of people who practice yoga notice their sleep improves.

Yoga can also ease many of the psychological menopausal symptoms. A whopping 85% of yoga practitioners say their stress levels are reduced. I certainly notice the difference. After adopting a regular yoga practice, I feel much more relaxed throughout the day, and I’m able to handle potentially stressful situations in a calmer and more level headed manner.

Plus, yoga has also been shown to have a positive effect on anxiety and depression disorders which often come hand in hand with menopause.

3. Aromatherapy

Aromatherapy has been used for millennia to help soothe physical and emotional ailments. So, it’s perhaps unsurprising that inhaling certain essential oils can have a positive impact on symptoms of menopause, including insomnia, hot flashes, and nocturnal hyperhidrosis.

A study of 100 menopausal women showed that after twelve weeks of lavender inhalation, hot flashes had reduced by an impressive 50%. Lavender is also a powerful sleep aid in its own right. So, consider using an oil burner or dabbing some lavender essential oil on your pillow before you drift off each night.

4. Exercise

Regular exercise balances circadian rhythms. This improves sleep quality and leads to a better night’s sleep. A regular perspiration session can also boost your mood by reducing stress and easing symptoms of menopause-related depression and anxiety.

I try to visit the gym 3-4 times a week for a medium-intensity workout. I also take a walk outside in the fresh air and sunlight for at least 30 minutes each day. This gets my blood pumping and keeps my circadian rhythms in check. 

5. Change your bedtime routine

Creating a healthy bedtime routine can have a surprisingly dramatic effect on the quality, duration, and management of sleep.

Here are a few things to try:

  • Remove blue light-emitting devices, for example, smartphones, laptops, and tablets, for at least one hour before bed. Blue light stimulates the production of cortisol, keeping you awake.
  • Practice a soothing activity to help you wind down. For example, reading a book, inhaling essential oils, or meditating.
  • Take a bath. Immersing yourself in a warm bath before you go to bed can help prepare your body for sleep and stimulate the production of melatonin.
  • Keep the lights low. Bright lights mimic the light of the sun, which sends signals to your brain that it’s daytime. Low (ideally red or orange) spectrum light mimics the setting sun, triggering your brain to prepare for sleep by releasing melatonin.

FAQs

How long does menopause-related insomnia last?

Each person’s experience is different. Some women have bouts of insomnia for weeks or months at a time during perimenopause. Then, once their periods stop and they reach menopause, their hormones subside, and the issue goes away. This was the case for me.
However, others find the symptoms of insomnia last well into post-menopause. And some women never suffer from issues of insomnia at all.

What other factors contribute to insomnia?

If you’re in your 40s or 50s, you might automatically assume that your insomnia is a direct result of menopause.
And that may well be the case. But there are plenty of outside factors that can cause or contribute to insomnia, including:
Stress
Trauma
Anxiety and depression
Chronic pain
Shift work
Jet lag
Poor diet
Excess screen time
Certain medications
Pregnancy

Can insomnia make my other menopause symptoms worse?

Unfortunately, the answer is yes. A lack of sleep has a huge impact on every aspect of your health, physically and psychologically.
When my insomnia was keeping me up all night, my other menopausal symptoms, such as brain fog, mood swings, and hot flashes, got worse, too. And sadly, this is the case for many women during menopause.
That’s why it’s so important to deal with menopause-related insomnia as soon as possible. After all, a good sleeping schedule is the cornerstone of good health.  good health. 

Conclusion

If you’re struggling with menopause-related insomnia, it’s likely to have an impact on many other areas of your life. After all, when you’re exhausted through lack of sleep, your emotional and physical health can take a big hit.

But it doesn’t have to be this way. There are plenty of interventions that can help you tackle insomnia, from supplements and yoga to lifestyle changes and a new bedtime routine. I was able to dramatically improve my insomnia symptoms related to menopause by incorporating these changes into my own life, and I hope that the tips above can help you, too.

However, if you’ve followed the advice I mentioned and you’re still not noticing an improvement, be sure to speak to your doctor. They can help you get to the bottom of the cause of your insomnia and suggest a treatment plan that can help.

References:

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.