Peri-Menopause & Sleep Issues

Series Post #2
Sleep Disruptions: Why You’re Tossing and Turning: It’s Not You, It’s Menopause

It’s 3:00 a.m., and you’re wide awake.
Maybe you have just thrown off the covers, sweat-soaked and frustrated, or perhaps you’re staring at the ceiling, unable to quiet your racing mind.

You know you need sleep, yet it feels increasingly elusive.

If you’re in your 40s or 50s and dealing with sleep issues and peri-menopause or menopause, you are not alone. Sleep disruptions are one of the most common complaints during this transitional phase and they’re not just frustrating; they’re a physiological response to the hormonal changes happening in your body.

Let’s dive into why menopause wreaks havoc on sleep and, more importantly, what you can do to finally get the rest you deserve.

Why Menopause Impacts Sleep
Sleep disruptions during perimenopause and menopause are, more often than not, tied to hormonal chaos.

Let's dive into the main players impacting sleep: 

Estrogen 

• Estrogen plays an important role in regulating your sleep cycle.
• It helps maintain serotonin levels, which influence the production of melatonin.  Melatonin is the hormone that controls your sleep-wake cycle.
• As estrogen levels decline, melatonin production can become erratic, making it harder to fall asleep and stay asleep.
• Low estrogen levels also contribute to night sweats and hot flashes, two common culprits for disrupted sleep.

Progesterone 

• Progesterone is often referred to as nature’s sleep aid.
• It is also considered the “calming hormone” because it promotes relaxation and enhances GABA activity in the brain, which is a neurotransmitter that helps you relax.
• When progesterone levels drop during perimenopause, many women experience increased anxiety, restlessness, and insomnia.

Cortisol and Stress Response

• Hormonal changes strain your adrenal glands, which can lead to elevated cortisol levels at night.
• High cortisol disrupts your natural circadian rhythm, making it difficult to wind down for restful sleep.

Testosterone and Sleep Regulation

• Testosterone is most often associated with energy and libido, but it also supports restful sleep by influencing muscle repair and relaxation.
• A decline in testosterone levels during menopause can cause restlessness at night.

Hot Flashes and Night Sweats

• Fluctuating estrogen levels impact your hypothalamus, the part of the brain that regulates body temperature.
• These fluctuations lead to sudden, intense heat waves and sweating during the night, waking you up multiple times and making it challenging to fall back asleep.

The Vicious Cycle of Poor Sleep
Sleep deprivation during menopause isn’t just about feeling tired. It creates a domino effect throughout your life. 

• Mood Swings and Irritability:
  • Poor sleep makes mood issues like anxiety and depression, worse which are already heightened during menopause due to hormonal fluctuations.
• Weight Gain and Metabolism:
  • Lack of sleep disrupts hunger-regulating hormones like ghrelin and leptin.  This ncreases cravings and contribute to weight gain.
• Weakened Immune System:
  • Chronic sleep deprivation impacts your body’s ability to repair itself, leaving you more susceptible to illness.
• Worsened Hormonal Imbalances:
  • Sleep is essential for hormonal regulation.
  • The less sleep you get, the more intense your hormonal symptoms can become.

Strategies to Improve Sleep
The good news? Yes there is some!
There are plenty of holistic, functional medicine-based strategies to help you reclaim restorative sleep.

 Cool Down for Better Sleep

• Use breathable, moisture-wicking bedding and pajamas to reduce night sweats.
• Keep your bedroom cool, ideally between 60-67°F (15-19°C).
• Drink herbal teas like peppermint or chamomile, which have cooling and calming properties.

Optimize Your Evening Routine

• Dim the Lights:
  • Reduce exposure to bright light and blue light from screens at least 1–2 hours before bed to help support melatonin production and circadian rhythm.
• Create a Sleep Ritual:
  • Calming activities like a warm bath, gentle stretching, meditation, or journaling send a signal to your body that it’s time to wind down.
• Limit Alcohol and Caffeine:
  • Both can worsen hot flashes and disrupt your sleep cycle.

 Mind-Body Practices

• Meditation and Breathwork:
  • These practices reduce cortisol levels and help regulate your nervous system, preparing your body for sleep.
• Yoga for Sleep:
  • Gentle, restorative yoga postures, like child’s pose or legs-up-the-wall, can promote relaxation.

Targeted Supplements

• Melatonin:
  • Short-term use can help reset your sleep-wake cycle, especially if it’s been disrupted by hormonal changes.
• L-Theanine: 
  • Promotes relaxation and reduces anxiety without sedation.
• Vitamin C:
  • Supports adrenal health, which helps regulate cortisol levels and reduce nighttime awakenings.
• Valerian Root:
  • Known for its calming effects, valerian can help you fall asleep faster.
• Tryptophan
  • Tryptophan is an essential amino acid and a precursor to serotonin, which is later converted to melatonin.  As mentioned earlier, this is the hormone that regulates your sleep-wake cycle.
  • By boosting serotonin production, it helps improve mood and promote relaxation, making it easier to fall asleep.
  • Research shows that tryptophan-rich foods or supplements can increase sleepiness and decrease the time it takes to fall asleep.

• GABA (Gamma-Aminobutyric Acid)
  • GABA is a calming neurotransmitter that helps to reduce brain activity, promoting relaxation and a sense of calm.
  • Low levels of GABA are linked to anxiety, restlessness, and difficulty falling asleep.  These symptoms are all commonly associated with menopause.
  • GABA can help ease an overactive mind and improve sleep quality.

• Magnolia Bark Extract
  • Derived from the bark of the magnolia tree, this natural remedy has been used in traditional medicine for centuries to reduce stress and promote relaxation.
  • Magnolia bark contains honokiol, a compound that supports GABA activity in the brain. This helps lower cortisol levels, reduce anxiety, and enhance sleep quality—particularly for women experiencing stress-induced insomnia during perimenopause.
• Magnesium Glycinate
  • Magnesium is an essential mineral involved in over 300 biochemical processes in the body, including muscle relaxation and neurotransmitter regulation.
  • Magnesium glycinate, is a highly absorbable form that is is particularly effective for relieving tension and anxiety that can interfere with sleep while supporting GABA production, and reduceing night-time wakefulness.

Stay Active During the Day

• Regular exercise regulates cortisol levels, promotes deeper sleep, and reduces menopausal symptoms like anxiety and depression.
• Aim for 30 minutes of movement most days, but avoid vigorous exercise too close to bedtime.
• Morning or early afternoon workouts are ideal for reducing cortisol and improving sleep quality.
• During this phase of life, the type of activity you choose matters just as much as consistency.
• It advised to avoid high intensity training (HIT) during peri-menopause.  These workouts can significantly increase cortisol. During peri-menopause and menopause, cortisol levels are already elevated due to the hormonal fluctuations that strain the adrenal glands.
• The adrenal glands play a compensatory role in hormone production as ovarian function starts to decline. Overloading the adrenals with intense exercise can lead to adrenal fatigue, worsening symptoms like fatigue, mood swings, and poor sleep.
• Recommended exercise includes
  • Moderate-Intensity Cardio
    • Activities like walking, cycling, swimming, or hiking provide cardiovascular benefits without spiking cortisol excessively. Aim for 30–45 minutes most days of the week.
  • Strength Training
    • ​ Incorporating resistance exercises 2–3 times per week helps build muscle, increase metabolism, and protect against bone loss. Use weights, resistance bands, or bodyweight exercises to keep your workouts effective yet manageable.
  • Yoga and Pilates
    • These practices enhance flexibility, core strength, and balance while promoting relaxation and reducing cortisol levels. Yoga also incorporates breathwork, which can help manage anxiety and improve sleep quality.
  • Low-Impact Aerobics
    • For women who enjoy group classes or rhythmic movement, low-impact aerobics are a fantastic way to boost mood and cardiovascular health without overtaxing the body.
  • Mindful Movement Practices
    • Tai Chi and Qi Gong combine gentle movement with mindfulness, reducing stress, improving circulation, and supporting overall hormonal balance.
  • Active Recovery Days
    • Include activities like stretching, foam rolling, or light swimming to help your body recover while staying active.

When to Seek Additional Support
If sleep remains a struggle despite these strategies, it may be time to consult with a practitioner who specializes in hormonal health.

Testing for hormone levels, adrenal function, and nutritional deficiencies can provide helpful insights into underlying imbalances that may be contributing to your sleep issues.

The next time you find yourself tossing and turning, remember: it’s not just insomnia, it’s your body’s way of navigating a profound life transition.

Stay tuned for the next post in this series, where we explore the world of menopause-related brain fog and how to regain mental clarity.

Sleep well!