In their late forties, women's bodies begin to experience a significant hormonal shift, which is known as menopause. This natural transition occurs when a woman has not had a menstrual period for 12 consecutive months. While it is an inevitable part of ageing, menopause often comes with a range of symptoms, some of which can significantly disrupt sleep.
According to the National Sleep Foundation, 61% of peri- and postmenopausal women report frequent insomnia. When combined with other menopause-related issues, such as hot flushes and mood swings, achieving restful sleep can feel like an impossible dream.1
Perimenopause is the phase leading up to menopause, during which the ovaries gradually produce less estrogen and progesterone. This transitional period can last anywhere from a few months to several years, depending on the individual.2
During perimenopause, many women experience irregular periods, with heavier or lighter bleeding and skipped cycles.3 Alongside these changes, symptoms such as hot flushes, mood swings, irritability, overactive bladder, and headaches can all interfere with sleep quality.3
One key factor affecting sleep during this time is the increased risk of obstructive sleep apnea (OSA). Prior to menopause, women generally have a lower risk of OSA compared to men.4 However, as hormone levels fluctuate, the prevalence of OSA in women rises, heightening the risk of further health complications.4,5
Lastly, many women in perimenopause suffer from restless leg syndrome (RLS). This condition, which is more common in women than men, can be difficult to diagnose due to its symptom overlap with other conditions.6 Menopause often exacerbates RLS symptoms, suggesting a link between reproductive hormones and the development of RLS.
Postmenopause begins after a woman has not had a menstrual period for 12 consecutive months, typically around the age of 52. During this stage, the ovaries cease producing estrogen and progesterone entirely, marking the end of menstrual cycles. Despite this, many women continue to experience sleep disturbances, with up to 60% of postmenopausal women reporting issues such as insomnia, OSA, and RLS.7
Sleep problems during postmenopause are often compounded by other health conditions associated with ageing. For example, postmenopausal women are at an increased risk of developing osteoporosis, cardiovascular disease, diabetes, and dementia.8-11 These conditions can all disrupt sleep due to physical discomfort, emotional stress, or cognitive decline.
Hot flushes are one of the most well-known and disruptive symptoms of menopause. These sudden sensations of heat, often accompanied by excessive sweating and skin redness, can be particularly troublesome at night, leading to fragmented sleep.12
While not every hot flush directly causes sleep disruption, studies indicate a strong correlation between the severity of hot flushes and poor sleep quality, with research showing that nearly 70% of women who experience hot flushes report early awakenings.12
Sleep disorders don’t come in isolation. As women navigate menopause, they are more likely to develop sleep-related conditions that only worsen their quality of life. The mental health toll is especially brutal.
Research consistently shows an increase in poor sleep quality among menopausal women, with insomnia being one of the most common and severe complaints.12 Insomnia, defined as difficulty falling or staying asleep, is often linked to the frequency of hot flushes during menopause, which can severely impact daily functioning and overall wellbeing.12
The risk of depression also increases during menopause, often independent of other contributing factors.12 Studies indicate that women are 2 to 4 times more likely to develop depression during menopause compared to earlier stages of life.12
Anybody experiencing menopause-related sleep disorders should contact their healthcare provider for proper examination, diagnosis, and treatment. Individuals who continue to seek sleep remedies to help through menopause can try some of the following tips:
Lifestyle changes: Maintaining a healthy weight through diet, exercise, and even through the use of clinically proven medications can reduce the risk of sleep disorders such as OSA and alleviate some menopause symptoms.13
Limiting alcohol and smoking: Both alcohol and smoking can significantly disrupt sleep patterns. Reducing or eliminating these habits can lead to better sleep and overall health improvements.14
Establishing a sleep routine: Setting a consistent bedtime, avoiding heavy meals late in the evening, exercising regularly, and limiting screen time before bed can all promote better sleep hygiene.15
Menopause doesn’t have to mean the end of a good night’s sleep. If your sleep problems persist, seek help. Talk to your healthcare provider, because sleep is not just a luxury—it’s a necessity.
Pacheco, D., & Pacheco, D. (2022). Menopause and Sleep. Sleep Foundation. https://www.sleepfoundation.org/women-sleep/menopause-and-sleep
Santoro, N. (2016). Perimenopause: From Research to Practice. Journal of Womens Health, 25(4), 332–339. https://doi.org/10.1089/jwh.2015.5556
Tandon, V. R., Sharma, S., Mahajan, A., Mahajan, A., & Tandon, A. (2022). Menopause and sleep disorders. Journal of Mid-life Health, 13(1), 26. https://doi.org/10.4103/jmh.jmh_18_22
Jehan, S. (2016). Obstructive Sleep Apnea: Women’s Perspective. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323064/
Perger, E., Mattaliano, P., & Lombardi, C. (2019). Menopause and Sleep Apnea. Maturitas, 124, 35–38. https://doi.org/10.1016/j.maturitas.2019.02.011
Seeman, M. V. (2020). Why Are Women Prone to Restless Legs Syndrome? International Journal of Environmental Research and Public Health, 17(1), 368. https://doi.org/10.3390/ijerph17010368
Jehan, S. (2015, August 1). Sleep Disorders in Postmenopausal Women. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621258/
Ji, M., & Yu, Q. (2015). Primary osteoporosis in postmenopausal women. Chronic Diseases and Translational Medicine, 1(1), 9–13. https://doi.org/10.1016/j.cdtm.2015.02.006
Rosano, G. M., Vitale, C., Marazzi, G., & Volterrani, M. (2007). Menopause and cardiovascular disease: the evidence. Climacteric, 10(sup1), 19–24. https://doi.org/10.1080/13697130601114917
Pérez, S. C. (2023). Menopause and diabetes. Climacteric, 26(3), 216–221. https://doi.org/10.1080/13697137.2023.2184252
Conde, D. M., Verdade, R. C., Valadares, A. L. R., Mella, L. F. B., Pedro, A. O., & Costa-Paiva, L. (2021). Menopause and cognitive impairment: A narrative review of current knowledge. World Journal of Psychiatry, 11(8), 412–428. https://doi.org/10.5498/wjp.v11.i8.412
Baker, F. C., Lampio, L., Saaresranta, T., & Polo-Kantola, P. (2018). Sleep and Sleep Disorders in the Menopausal Transition. Sleep Medicine Clinics, 13(3), 443–456. https://doi.org/10.1016/j.jsmc.2018.04.011
Noll, P. R. E. S., Campos, C. a. S., Leone, C., Zangirolami-Raimundo, J., Noll, M., Baracat, E. C., Júnior, J. a. a. C., & Sorpreso, I. C. E. (2020). Dietary intake and menopausal symptoms in postmenopausal women: a systematic review. Climacteric, 24(2), 128–138. https://doi.org/10.1080/13697137.2020.1828854
Spadola, C. E., Guo, N., Johnson, D. A., Sofer, T., Bertisch, S. M., Jackson, C. L., Rueschman, M., Mittleman, M. A., Wilson, J. F., & Redline, S. (2019). Evening intake of alcohol, caffeine, and nicotine: night-to-night associations with sleep duration and continuity among African Americans in the Jackson Heart Sleep Study. Sleep, 42(11). https://doi.org/10.1093/sleep/zsz136
Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23–36. https://doi.org/10.1016/j.smrv.2014.10.001
