How can I sleep better during menopause?

From insomnia to frequent night wakings, sleep disturbances are common for women in or approaching menopause. In fact, over 40 percent of perimenopausal women report sleep problems, according to the National Council on Aging.

“Poor sleep is associated with every phase of menopause and can be very disruptive,” says Terry Silvestrin, ARNP, a certified menopause specialist at MultiCare. “It can cause fatigue and brain fog, worsen mood and make it difficult to concentrate or get through the day.”

However, poor sleep isn’t something you have to live with. Learn why menopause affects sleep and what you can do to improve the quality of your rest.

Why menopause disrupts sleep

Menopause happens when the ovaries stop releasing eggs and producing most estrogen and other hormones. You’ve reached menopause when you haven’t had a period for 12 consecutive months.* On average, this occurs around the age of 52 for U.S. women.

However, you may begin noticing changes in your body in the eight- to 10-year period leading up to this transition, a phase of life known as perimenopause.

During perimenopause, the body begins to experience hormonal shifts. Levels of estrogen and progesterone fluctuate unpredictably before eventually declining altogether.

Spikes and drops in hormone levels can disrupt sleep patterns and cause other troublesome symptoms like night sweats and mood swings. These symptoms can continue after the transition to menopause and may make it difficult to fall asleep, stay asleep or both.

*If you have an intrauterine device (IUD) or have had your uterus surgically removed, then your menstrual cycle won’t indicate whether you’ve entered menopause.

Tips to help improve sleep during menopause

Over time, poor sleep can take a toll on your health and well-being, increasing your risk for high blood pressure, heart disease, dementia and other conditions.

The good news is there are steps you can take to improve the quality of your rest, from at-home interventions to medical treatments.

Tip 1: Consider hormonal or nonhormonal medications

Menopausal hormone replacement therapy (HRT) refers to medications that help replenish estrogen and progesterone. For some women in or approaching menopause, HRT can be a valuable tool for improving sleep.

“A growing body of evidence shows that hormone replacement therapy can safely ease menopause symptoms, allowing women to thrive, not suffer through menopause,” Silvestrin says. “It may be particularly beneficial for those experiencing night sweats or other temperature-related sleep disturbances. Some research shows HRT can also help relieve insomnia.”

Nonhormonal medications, such as antidepressants, may also be an option for some women. These medications can help alleviate symptoms like hot flashes in addition to improving sleep.

Silvestrin recommends talking to a menopause specialist about your concerns. They can help you decide whether you might be a good candidate for HRT or other types of medications. They can also talk you through additional approaches for menopause symptom relief.

Tip 2: Change your environment

If you’re frequently waking up hot or drenched in sweat, it may be time to reevaluate your sleepwear and your bedroom setup. Try:

• Wearing less clothing to bed so you’re less likely to get overheated; choose breathable, lightweight fabrics
• Sleeping with a fan on and pointing it directly toward you
• Leaving a window open (if it’s safe) to improve airflow
• Using cooling pillowcases, sheets, comforters and/or mattress pads — products designed to support temperature control and in some cases wick away moisture
• Using a dehumidifier to remove excess moisture from the room

If you do wake up hot, uncovering your feet can help your body cool down faster. The Sleep Foundation recommends keeping your room between 65-68 degrees Fahrenheit to promote quality rest.

What about over-the-counter sleep aids during menopause?

Over-the-counter (OTC) sleep aids can help you get through the occasional sleepless night. But they can leave you feeling groggy and don’t address the root cause of sleep problems. They may also interfere with other medications you’re taking. Avoid relying on OTC sleep aids, or supplements like melatonin, long-term without talking to your doctor or other health care provider.

Tip 3: Take a close look at your daily habits

Hormonal changes aren’t the only cause of sleep disturbances during the menopausal years. Stress, a busy schedule and increased responsibilities at work and home can make it challenging to relax at night.

“Many women are juggling a lot during this stage of life,” Silvestrin says. “This can make it difficult to calm the mind at bedtime.”

Fostering healthy habits during the day and in the hours before bed can help you wind down and sleep more soundly:

• Maintain a consistent sleep schedule as much as possible, even on the weekends
• Turn off screens at least 30 minutes before bed
• Drink plenty of water during the day, but avoid drinking a large amount of water or other fluids within the hour or two before bedtime
• Stop consuming caffeinated beverages at least six to eight hours before bed
• Avoid alcohol within three to four hours of bedtime
• Avoid heavy late-night meals; if you have a snack before bed, it should be easily digestible, such as a piece of fruit or handful of nuts
• Build physical activity into your day — it supports restful sleep and can help stabilize your mood; but vigorous exercise too close to bedtime can disrupt sleep for some

Tip 4: Talk openly and honestly with your provider

Regardless of what’s keeping you up at night, you don’t have to suffer in groggy silence. Talk with your provider about what you’re experiencing.

“There may be factors beyond menopause itself that are hindering your ability to get a good night’s sleep,” Silvestrin says. “For example, hormonal shifts during menopause can increase your risk for sleep apnea, which disrupts breathing during sleep.”

Your provider can help identify possible causes of sleep issues, review medications that may affect your sleep and recommend next steps, including a referral to a sleep specialist, if needed.

In addition to talking to your provider, it’s also important to keep current with checkups and screenings to support your overall health.

“Quality of life is the bottom line,” Silvestrin says. “Menopause is a major life transition, but it doesn’t mean that good sleep has to be a thing of the past.”

Editor’s note: This article was originally published in June 2018 and updated in July 2026.