Sleep Solutions for Perimenopause: Why Sleep Changes, Plus Natural Solutions for Restful Nights

Perimenopause can be a rocky road, affecting all aspects of your life: your metabolism, your mood, your period.  But for many of us, it’s the unexpected changes in sleep that are most disturbing. And the effects of sleep deprivation can spiral outwards, further slowing down your metabolism, dampening your mood, and silently wreaking havoc on your (already unpredictable) periods. 

If you’ve found yourself tossing and turning at night, you’re not alone. Hormonal shifts during this stage of life can disrupt sleep patterns, leaving you feeling drained during the day. 

In this article, we’ll break down why these changes happen and provide simple, actionable tips to help you reclaim restful nights.

Why Sleep Becomes Harder During Perimenopause

During perimenopause, hormone levels like estrogen and progesterone begin to fluctuate. 

Estrogen helps regulate the sleep cycle, while progesterone has a calming effect on the brain. When these hormones drop, it can disrupt your sleep structure, leading to difficulty falling or staying asleep. Additionally, fluctuating hormones can trigger night sweats, anxiety, and mood swings, all of which further interfere with restful sleep.

Estrogen and Healthy Sleep

Estrogen plays an important role in helping women sleep well by improving sleep quality and keeping the sleep-wake cycle balanced. It helps regulate melatonin, the hormone that makes you feel sleepy, and supports deep, restful sleep. 

When estrogen levels drop during perimenopause, sleep problems often occur, such as waking up more during the night (this is especially common with declining estrogen levels), lighter sleep, and less REM sleep. Hot flashes and other symptoms, like restless legs, can make these issues worse. Poor sleep caused by low estrogen can also affect memory and increase the risk of health problems like dementia.

Progesterone and Healthy Sleep

Progesterone also influences sleep: it is known for its sedative properties and ability to enhance deep, restorative sleep. 

Progesterone helps with sleep by promoting deep sleep, regulating REM sleep, and supporting steady breathing through its effects on the brain. During the luteal phase of the menstrual cycle, higher levels of progesterone improve sleep quality and boost brain activity that supports memory. 

As women enter perimenopause progesterone levels drop, causing more fragmented sleep, frequent wake-ups, and even breathing problems during sleep. This decline reduces the positive effects of progesterone on sleep. 

During perimenopause, the combined loss of both estrogen and progesterone contributes to more significant sleep disturbances. 

Natural Sleep Support

While sleep problems can feel overwhelming (believe me, I know), there are a lot of simple things to try that can improve sleep quality. 

Sleep Hygiene: Setting the Stage for Restful Sleep

Sleep hygiene means having good habits and creating a healthy environment to improve sleep, like going to bed and waking up at the same time, reducing stress, avoiding caffeine, and keeping your bedroom quiet and comfortable.

Here are some tips to support good sleep hygiene: 

• Stick to a consistent bedtime. Your body thrives on routine, and it helps set your circadian rhythm. Aim to go to bed and wake up at the same time every day, even on weekends.

• Turn off screens an hour before bed. The blue light from phones, tablets, and TVs interferes with melatonin production, making it harder to fall asleep.

• Keep your bedroom dark, quiet, clean and cool. A pitch-black room and a white noise machine can make all the difference.

Ideal Sleeping Temperature

A cooler room, between 60 and 67 degrees F, is ideal for sleep. If you often feel too warm, try lightweight, breathable bedding or a fan.

Keep Your Bedroom Allergen-Free

Dust and allergens can disrupt your breathing and sleep quality. Use a high quality air filter (Austin Air Filters are pricey but excellent), and regularly clean your room, including vacuuming and washing bedding.

Build a Nighttime Ritual

Creating a calming evening routine can prepare your mind and body for rest. Here are some ideas:

• Journaling: write down your worries or ruminating thoughts to clear your mind before bed.

• Keep a notepad on your nightstand: if a “to-do” pops into your head, jot it down and let it go until morning.

• A relaxing bath or shower: warm water can help relax tense muscles and lower your heart rate, getting you ready for a good night’s sleep.

• Enjoy a nighttime tea: herbal teas like chamomile, passionflower, or lemon balm can help you unwind.

The Benefits of Herbal Support for Sleep

Certain herbs are known to promote relaxation and better sleep:

• Chamomile: chamomile helps improve sleep by reducing how often people wake up and making it easier to stay asleep, but it doesn’t change how long people sleep or how efficient their sleep is. It’s considered safe and works by helping people relax and reducing stress due to its effects on benzodiazapine and GABA receptors. 

• Passionflower: passionflower (Passiflora incarnata) helps increase the time spent in deep sleep (slow wave sleep or SWS) and reduces the time spent awake. It has mixed effects on REM sleep. Its calming effects on sleep may come from how it interacts with the brain's GABA system, making it a natural option to improve falling asleep and getting deeper rest.

• Lemon Balm: lemon balm contains compounds like rosmarinic acid, which boost the activity of GABA, a brain chemical that helps calm the mind and reduce stress. Research indicates that lemon balm can help people fall asleep faster, sleep longer, and wake up less during the night. It’s especially helpful for people dealing with stress, anxiety, or mild insomnia, making it a great natural option for better sleep.

• Ashwagandha: ashwaganda is an adaptogenic herb, meaning it helps regulate the hypothalamic-pituitary-adrenal (HPA) axis to support a healthy stress response. It can also help with sleep: one study showed that ashwagandha extract significantly improved sleep quality, efficiency, duration, and quality of life in adults with non-restorative sleep, with no reported adverse effects. Ashwaganda may be stimulating for some people when taken late in the day.

Nutrients and Supplements for Better Sleep

• Magnesium: an essential mineral for hundreds of enzymatic reactions in the body that supports muscle relaxation and calms the nervous system. Look for magnesium glycinate, which is easily absorbed and contains glycine, a relaxing amino acid that supports calm and relaxation.

• L-Theanine: found in green tea, this amino acid promotes relaxation without sedation. One study showed that L-theanine supplementation (50–655 mg) improves several sleep parameters, including sleep onset, duration, efficiency, and overall quality, although doses over 655 mg may reduce sleep quality,

• Vitamin D: vitamin D is an essential nutrient for just about everything, including sleep. Low vitamin D levels are associated with poor sleep quality and shorter sleep duration, potentially due to vitamin D receptors in brain regions involved in sleep regulation. 

Melatonin and Sleep

Melatonin is an important hormone that helps regulate our circadian rhythm. As a supplement, it is best used only occasionally, such as when adjusting to a new time zone. 

For sleep, take 0.5–2 mg about 3–4 hours before bed.

How Diet and Exercise Improve Sleep

A balanced diet and regular exercise can have a profound effect on sleep and hormone balance:

• Eat hormone-friendly foods: include leafy greens, fatty fish, whole grains, and foods rich in magnesium (e.g., nuts, seeds, and bananas).

• Limit sugar and caffeine: these can spike cortisol levels and interfere with your sleep cycle.

• Exercise regularly: aim for a blend of cardiovascular exercise and strength training. Morning workouts are best for promoting nighttime sleep.

Alcohol, Sugar and Caffeine: Their Effects on Sleep

Alcohol, sugar, and caffeine can significantly disrupt sleep by interfering with the body's natural sleep-wake cycle:

Alcohol

Alcohol can disrupt sleep by making you fall asleep faster and increasing deep sleep early in the night. However, as the alcohol wears off, it causes you to wake up more often and have poor-quality sleep. 

Long-term alcohol use can lead to worse sleep problems like less deep sleep, changes in dream cycles (REM sleep), and ongoing trouble sleeping, even after you stop drinking. This can make it harder to stay away from alcohol. More research is needed to understand why this happens and how to treat sleep problems caused by alcohol.

Sugar

Eating too much added sugar can harm your sleep quality and how long you sleep. A study with college students found that those who ate more sugar had worse sleep, including shorter sleep times and feeling less rested. 

Cutting back on added sugar to less than 10% of your daily calories may help you sleep better and improve your overall health.

Caffeine

Caffeine can interfere with sleep by lowering melatonin levels and messing with your natural sleep-wake cycle. Even drinking it hours before bedtime can make it harder to fall asleep and reduce the quality of your rest. 

Many people get stuck in a "coffee cycle," where poor sleep leads to drinking more caffeine, which then makes their sleep worse. Regular caffeine users might build some tolerance, but going without it for a night can cause withdrawal symptoms like irritability and trouble focusing, which can also affect sleep. 

While some people react differently, caffeine often makes getting good sleep harder.

Reducing or eliminating these substances, especially in the hours leading up to bedtime, can significantly improve sleep quality.

Technology to Track and Improve Sleep

Wearables can provide valuable insights into your sleep habits. My favorite is the Oura Ring, which tracks your sleep cycles, heart rate, and body temperature, giving you detailed feedback on your current sleep patterns, as well as tracking ovulation (this can be helpful as ovulatory cycles become fewer in perimenopause).

Other options like Fitbit or Apple Watch also offer sleep tracking.

When to Speak to a Doctor

If your sleep issues persist despite trying these tips, it may be time to consult a healthcare provider. Common issues to discuss include:

Hormonal imbalances: a simple hormone panel can help identify if low estrogen or progesterone is contributing to your sleep problems.

Sleep apnea: if you snore or wake up feeling unrested, you might need a sleep study to rule out underlying conditions.

Stress or anxiety: if mental or emotional troubles are keeping you up at night, your doctor can recommend therapies or medications to address these concerns.

Conclusion

Sleep challenges during perimenopause are common, but they’re also manageable. By understanding the root cause and implementing these natural strategies, you can take steps toward better, more restful nights. Remember, you don’t have to go through this alone—reach out for support when needed. 

You deserve to feel rested, energized, and ready to tackle your busy life!

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