Why Menopause Can Disrupt Sleep and What Women Should Know

Sleep problems are one of the most common (and most often overlooked) symptoms of menopause. Many women are surprised to learn that changes in hormone levels during perimenopause and menopause can directly affect their ability to fall asleep, stay asleep and feel rested the next day. While night sweats and hot flashes are widely recognized, sleep disturbances can also contribute to anxiety, mood changes and daytime fatigue that impact daily life.

According to Carleara Weiss, Ph.D., M.S., RN, Aeroflow’s Sleep Science adviser, sleep issues during menopause are often dismissed as a normal part of aging. However, growing research shows that these symptoms are linked to hormonal changes and can be treated through a variety of approaches, including hormone therapy, behavioral strategies and medical treatments. Understanding the connection between menopause and sleep can help women recognize symptoms earlier and seek appropriate care.

Many women are surprised to learn that sleep problems can be linked to menopause. Why do sleep issues often begin during perimenopause and worsen over time?

Carleara Weiss, Ph.D., M.S., RN: A drop in hormones estrogen and progesterone impacts thermoregulation (making it difficult to fall asleep and stay asleep), reduces serotonin levels, and increases anxiety and mood swings. These problems get worse over time as these hormone levels continue to drop. In addition, women may experience a vicious cycle where sleep disturbances couple with their personal and professional responsibilities, culminating in increased anxiety and poorer sleep.

Despite how common these issues are, many women never seek help. Why do you think sleep problems during menopause are so under-recognized and undertreated?

CW: Historically, sleep disturbances in the perimenopausal transition have been dismissed by health care professionals and often normalized as “normal” and “part of getting old.” There was little research done on the causes and treatments of these issues. Luckily, this scenario is changing, and women can find better resources and care during their menopause journey.

What are some signs that menopause-related sleep issues go beyond “normal aging” and signal it’s time to see a doctor?

CW: Any symptom that affects your daily function should prompt you to seek help. That could include loud snoring, choking or gasping for air during sleep, persistent insomnia, irritability, mood swings, difficulty concentrating, brain fog and daytime fatigue.

What types of treatments are available today, including hormone-based and nonhormonal options?

CW: Regarding menopause-induced sleep disturbances, the treatment options include the following:

• Hormone therapy: New research indicates that hormone therapy for menopause improves sleep disturbances, such as insomnia, and symptoms, such as night sweats. These options include pills, patches or gels containing estrogen, progesterone or a combination of both.
• Nonhormone therapy: This includes cognitive behavioral therapy for insomnia with specific adjustments for menopausal symptoms.
• Medications: Antidepressants and anxiolytics can also help with sleep disturbances for those experiencing perimenopausal symptoms.

What practical sleep tips can women start using today while they decide whether to seek medical care?

CW: Some general behavioral changes that could be beneficial include maintaining a consistent sleep schedule; allowing time for winding down and relaxation; engaging in exercise; eating a healthy diet; and limiting alcohol, caffeine and smoking. I highly encourage seeking medical care for assistance during the menopausal transition, because these behavioral changes should be part of a holistic approach that will include hormone therapy or another option that you will decide with your doctor.