Sleep versus Menopause: How to Reclaim Restorative Sleep

The advice below is general advice. For any specific tailored advice relevant to your health conditions, please talk to your health professional.

Sleep is essential for health and wellbeing, but during menopause, many of us will find our nights disrupted. Hormonal shifts, increased stress, and symptoms like hot flushes and night sweats can all interfere with restful sleep. For post-menopausal women, sleep-disordered breathing such as snoring and sleep apnoea may also play a role.

The impact of poor sleep is real – it can affect our energy, mood, and overall outlook. But the good news is restful, restorative sleep is possible. With the right strategies, knowledge, and support, we can reclaim our nights and wake up feeling strong, clear-headed, and ready to face the day.

This week, we’re diving deeper into the connection between sleep and menopause, exploring why sleep is disrupted and, more importantly, the practical steps we can take to reclaim restorative sleep.

Why Restorative Sleep Matters in Menopause

Restorative sleep is a deep, refreshing sleep that improves alertness, mood, and energy (1).

Poor sleep in midlife is linked to a range of health risks, including:

• Cognitive health: Sleep disruption affects memory, attention, and concentration, and is linked to subjective cognitive decline. Ongoing sleep problems may increase the risk of dementia later in life.
• Mental health: There’s a bidirectional link between poor sleep and anxiety or depression, with an increased risk of developing new depression.
• Metabolic health: Poor sleep disrupts glucose control, alters appetite hormones, and increases insulin resistance. It’s linked to higher risks of hypertension and diabetes.
• Cardiovascular health: Poor sleep increases risk of heart disease and stroke (1).

What is Normal Sleep

Normal sleep consists of four stages that cycle during the night (2).

The sleep cycle includes:

• Stage 1: Light sleep
• Stage 2: Deeper sleep
• Stage 3: Deepest sleep (slow-wave sleep)
• REM sleep: Dreaming and memory consolidation

Each sleep cycle lasts about 90 minutes, and we typically experience around five sleep cycles per night (2).

Waking during sleep is normal

Adult women are awake for an average of 55 minutes during the sleep period (3). This increases with age, from around 30 minutes in early adulthood to up to 80 minutes in older age (3).

Why is Sleep Disrupted in Menopause

Alongside sleep changes from ageing, menopause can further disrupt sleep.

Some key contributors to disrupted sleep in menopause are (2):

• Hormone changes: Oestrogen and progesterone help regulate sleep. As levels decline, falling asleep and staying asleep becomes more difficult. Higher levels of follicle-stimulating hormone (FSH) are associated with more frequent waking and poorer sleep quality.
• Hot flushes and night sweats: Hot flushes and night sweats can wake women multiple times a night, making it hard to fall back asleep.
• Mood changes: Anxiety and depression can interfere with relaxation and sleep onset.
• Sleep-disordered breathing: Snoring and obstructive sleep apnoea become more common after menopause and can significantly impact sleep quality.
• Restless legs syndrome: An uncomfortable feeling in the legs, more prevalent during this life stage and at night. This can make it difficult to sleep due to the need to walk to relieve the uncomfortable sensation.

How to Get Restorative Sleep During Menopause

Investing in better sleep is one of the most powerful ways to support our health and wellbeing.

Some of the actions we can take to improve sleep are (2):

• Address underlying sleep disorders
  If you experience snoring, gasping, or excessive daytime fatigue, get screened by your GP for sleep apnoea. Restless legs syndrome and other conditions should also be discussed.

• Manage vasomotor symptoms
  Hot flushes and night sweats (vasomotor symptoms) are among the most common sleep disruptors during menopause. Strategies like layered bedding, cooling pillows, and temperature regulation can help. For some women, Menopausal Hormone Therapy (MHT), recognised as the gold standard treatment, can be an effective option to reduce these symptoms and improve sleep quality. Read more here: Feeling Flushed.

• Stick to a consistent sleep schedule
  Go to bed and wake up at the same time every day, including weekends. Avoid long daytime naps that can interfere with nighttime sleep. Exposure to morning light can be helpful to reset your circadian (body clock) rhythm.

• Create a sleep-friendly environment
  Keep your bedroom cool, quiet, and dark. Limit screen time. Use breathable bedding and moisture-wicking sleepwear to reduce discomfort from night sweats.

• Manage stress and anxiety
  Practice relaxation techniques such as deep breathing, meditation, or gentle yoga before bed. Cognitive Behavioural Therapy for Insomnia (CBT-I) is also highly effective.

• Watch what you eat and drink
  Limit caffeine (tea, coffee, energy drinks), alcohol, and heavy meals close to bedtime. Herbal teas like chamomile may help promote relaxation (2).

• Consider supplements with guidance
  Magnesium may support better sleep. Melatonin (sleep hormone) can be helpful to decrease time to get to sleep and improve sleep quality but should be used for short periods. Always seek medical advice before starting any new supplement or therapy (4).

Restorative sleep is essential for maintaining brain, heart, and emotional health. While menopause can present real challenges to sleep, it’s not a lost cause. With practical changes to daily habits and the right support, you can significantly improve your sleep quality. Prioritising sleep is a meaningful step toward feeling better, thinking clearer, and living well in menopause and beyond.

References

1. Anekwe, C. V., Cano, A., Mulligan, J., Ang, S. B., Johnson, C. N., Panay, N., … Nappi, R. E. (2025). The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions. Climacteric, 28(5), 478–496.
2. Australasian Menopause Society. (2022). Menopause and sleep [Information sheet]. https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Menopause_and_sleep.pdf
3. Boulos, M. I., Jairam, T., Kendzerska, T., Im, J., Mekhael, A., Murray, B. J. (2019). Normal polysomnography parameters in healthy adults: a systematic review and meta-analysis. Lancet Respir Med, 7(6), 533–543.
4. Jehan, S., Jean-Louis, G., Zizi, F., Auguste, E., Pandi-Perumal, S. R., Gupta, R., Attarian, H., McFarlane, S. I., Hardeland, R., & Brzezinski, A. (2017). Sleep, Melatonin, and the Menopausal Transition: What Are the Links? Sleep Science, 10(1), 11–18. https://doi.org/10.5935/1984-0063.2017000