Sleep and Menopause: Why Getting Your 7 Hours Matters More Than Ever
If you're in perimenopause or menopause and feeling like sleep has become your elusive best friend, you're definitely not alone. Let's talk about what's really going on with your sleep—and more importantly, what you can do about it.
The Science Behind Sleepless Nights
There's a major research study called the Study of Women Across the Nation (SWAN for short) that followed women's sleep, weight, and health outcomes through the menopause transition and beyond. The findings? They're pretty eye-opening.
Women who consistently got less than 6 hours of sleep per night experienced:
More weight gain
Increased mood swings
Brain fog
Cognitive impairment
More cardiovascular events
All compared to those who managed to get a full seven hours.
What's Happening in Your Brain?
As estrogen declines, your brain undergoes some organizational changes. One of the casualties? Your sleep architecture. To function optimally, our brains need 20-25% deep sleep, but during menopause, that often gets disrupted.
Here's what disorganized sleep typically looks like: You fall asleep quickly—like, head-hits-the-pillow-and-you're-out quickly. But then you wake up once, twice, three times or more throughout the night. You feel "tired-wired"—your body is absolutely exhausted, but your brain feels wide awake. You might even notice your heart palpitating. This is known as WASO (Wakefulness After Sleep Onset), and is extremely common in women at midlife.
Why Are You Waking Up?
Sometimes, your brain senses a big temperature change (either in your body or the room), and whether you're drenched in sweat or not, this counts as a hot flash. Other times, it's anxiety. Once panic sets in, your mind starts racing.
My patients often tell me they worry about things that seem completely inconsequential during the day but become huge worries at 3 a.m. Others are up multiple times to use the bathroom—though it's hard to tell if they woke up because they needed to pee, or if they just noticed the urge after waking up for another reason.
The Numbers Don't Lie
Dr. Lisa Mosconi shares some revealing statistics in her book "The Menopause Brain":
During Perimenopause:
1 in 4 women have trouble falling asleep
1 in 3 women have trouble staying asleep, waking up multiple times per night
Half of all perimenopausal women sleep less than 7 hours per night
Over half wake up feeling tired more than 4 days a week
After Menopause:
27% have trouble falling asleep
36% have trouble staying asleep
40% sleep less than 7 hours per night
Over half still wake up feeling tired more than 4 days a week
Unfortunately, sleep problems don't just magically disappear after menopause. For many women, they persist.
Why This Matters So Much
Notice that last statistic in both phases? Much of the problem with sleep difficulties lies in the impact of daytime fatigue and productivity. Poor sleep creates a domino effect:
Poor sleep → Irritability, depression, carbohydrate cravings, less energy → Heart disease, insulin resistance, cognitive decline, obesity, and many other health complications.
Poor sleep is often the triggering factor for numerous health issues. That's why sleep should always be your number one priority.
Rule Out Other Medical Causes First
Before we dive into solutions, it's crucial to rule out other potential medical causes:
If you snore or gasp in your sleep: Ask your doctor for a sleep study to rule out sleep apnea
If you have leg pain at night or feel like your legs have an internal motor: Rule out restless leg syndrome or iron deficiency
Assuming those things have been ruled out, let's look at some simple solutions to start with.
Your Sleep Toolkit: Simple Solutions That Work
1. Reimagine Your Bedtime Routine
Many of us are burning the midnight oil—putting kids to bed, cleaning the house, meal prepping, paying bills, answering emails, and doing everything we didn't get to during our already jam-packed day. But rushing to finish things at night won't help you achieve those crucial 7 hours.
Here's a game-changing tip from sleep expert Alanna McGinn: Take the final hour of your day and divide it into thirds—three 20-minute segments.
First 20 minutes: Prep for tomorrow. Write down things you need to do (to get them out of your head), lay out your clothes, pack your work bag and lunch.
Next 20 minutes: Get ready for bed. Take a shower, apply your face lotions, get into your pajamas—all the rituals.
Final 20 minutes: Set your brain up for sleep. Read a paper book, meditate, listen to relaxing music, or stretch (in-bed stretching is fantastic!).
Splitting up your nighttime routine this way helps you ease into bedtime mode instead of crashing into bed stressed.
2. Try White Noise
Studies consistently praise white noise machines for drowning out disruptive sounds and helping deepen sleep. Don't have one? There are free apps you can download on your phone or computer.
3. Cool Things Down
Adjust your room temperature to minimize overheating. A fan or cooling mat can significantly reduce the frequency and severity of hot flashes. Bonus: The fan doubles as a white noise machine!
4. Avoid Stimulating Substances and Events
Put that phone down and place it as far away as possible
Exercise earlier in the day or at least 2 hours before bedtime to avoid disrupting your sleep
Watch your caffeine intake—some experts say no caffeine after noon
Don't forget: Nicotine, alcohol, and THC are all sleep disruptors
Of course, each of these affects everyone differently, so keep track of your own limits.
Your Action Plan
As a preventative measure, aim for 8 hours in bed. That way, if you toss and turn more than expected, you can still get at least 7 hours of actual sleep.
Find your perfect nighttime routine and hold onto it for as long as possible. Those 7 hours of sleep? Make them your non-negotiable priority as often as possible.
Your future self—with better mood, sharper thinking, and improved overall health—will thank you.
Remember: This information is meant to educate and empower, not to replace professional medical advice. Talk to your healthcare provider about your specific sleep concerns and symptoms.