Sleep and Menopause

Falling oestrogen during perimenopause and menopause disrupts the hypothalamus's temperature regulation, triggering hot flushes and night sweats that wake you repeatedly. Many women also develop new anxiety or low mood in this period, which independently worsens sleep.

Keep the bedroom cool (16-18°C), use breathable, moisture-wicking bedding, and keep a change of nightwear within reach. A fan pointed at the bed helps more than most people expect.

Avoid alcohol and spicy food in the evening — both are common hot-flush triggers. If night sweats are severe and frequent, it's worth discussing hormone replacement therapy (HRT) with a doctor, since it treats the underlying cause rather than just the sleep disruption.

CBT-I remains effective even when hot flushes are the trigger for waking — the goal shifts to falling back asleep quickly rather than lying awake fighting it, using the same stimulus-control and relaxation techniques used for any insomnia.