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Insomnia and Menopause: The Link, Duration, and Remedies

Hayley Dawes
5 October 2023

Dream Distillery gives you the lowdown on everything you need to know about insomnia and the menopause

At Dreem Distillery, our bath and body products are a problem-solving way to support the sleep problems and insomnia associated with the perimenopause and menopause. Our proprietary blend of botanicals and organically grown broad-spectrum CBD helps to turn those elusive nights of restorative sleep into a regular, every night occurrence.

Are you struggling with sleepless nights as you journey through menopause? You’re not alone. Menopause and insomnia often go hand in hand, leaving many women feeling exhausted and searching for answers. In this blog post, we’ll explore the link between insomnia and menopause, along with effective strategies and lifestyle changes to help you sleep better during this transitional phase of life.

Short Summary

  • Menopause is associated with hormonal imbalances and sleep disturbances that can lead to insomnia.
  • Various strategies such as sleep hygiene practices, CBT-I, HRT and alternative therapies may provide relief from menopausal insomnia.
  • If lifestyle changes are not providing relief it is recommended to seek professional help from a healthcare provider specializing in cognitive behavioral therapy or hormone therapy.

The Connection Between Insomnia and Menopause

Many women experience sleep disorders during menopause, with hormonal imbalances, hot flashes, and night sweats contributing to sleep disturbances. Poor sleep during menopause can have a detrimental effect on everyday energy, performance, health, and quality of life.

To better understand the connection between menopause and sleep, it’s essential to delve into the underlying causes, such as hormonal imbalances and menopausal symptoms that disrupt sleep.

Hormonal Imbalances

During menopause, hormone levels such as estrogen and progesterone fluctuate, affecting sleep quality and contributing to insomnia. Estrogen plays a crucial role in sleep regulation, and when its levels decline during menopause, it can impact various aspects of sleep. Progesterone, on the other hand, has a sedative effect and stimulates respiration, promoting better sleep. However, as progesterone levels decrease during menopause, sleep difficulties can worsen, and breathing issues during sleep may become more pronounced.

Decreasing estrogen levels can affect sleep by leading to reduced sleep latency and increased nighttime awakenings, while also impacting obstructive sleep apnea, a disorder characterized by pauses in breathing during sleep. Decreases in testosterone have been linked to some sleeping disorders. This includes insomnia, sleep-disordered breathing, and a higher need to use the restroom during the night.

As hormonal changes continue throughout the menopause transition, sleep issues may persist or even worsen.

Hot Flashes and Night Sweats

Hot flashes and night sweats are common menopause symptoms that can disrupt sleep and contribute to insomnia. Night sweats during menopause are attributed to declining hormone levels, which can affect the hypothalamus, the region of the brain responsible for temperature regulation. About 75-85% of women during perimenopause and postmenopause experience night sweats.

Hot flashes can lead to frequent awakenings and uneasiness, resulting in sleep disturbances and insomnia during menopause. These symptoms can impede the ability to return to sleep and produce frequent awakenings, leading to decreased sleep quality and fatigue the following day. Hot flashes usually last for seven years. However, in some cases their duration may exceed ten years. Approximately 44% of women with extreme hot flashes have reported symptoms consistent with chronic insomnia. This meets the clinical criteria for diagnosing such a condition.

Duration of Insomnia During Menopause

The duration of insomnia during menopause varies for each individual, but it can persist throughout the menopausal transition and even into postmenopause. While some women may find relief from insomnia symptoms within a few years, others may experience sleep difficulties for a longer period, sometimes lasting up to a decade or more.

Understanding the varying duration of insomnia during menopause can help you prepare and seek appropriate treatment options.

Strategies for Managing Insomnia in Menopause

To overcome sleep disturbances during menopause, various strategies can help improve sleep quality. These strategies include sleep hygiene practices, cognitive behavioral therapy for insomnia (CBT-I), and hormone replacement therapy (HRT).

By incorporating one or more of these approaches, you can take control of your sleep and minimize the impact of menopause on your overall well-being.

Sleep Hygiene Practices

Sleep hygiene practices are essential for improving sleep during menopause. These habits include maintaining a regular sleep schedule, creating a calming bedtime routine, and ensuring a comfortable sleep environment. By practicing healthy sleep habits, you can set the stage for a good night’s rest and minimize sleep issues during menopause.

In addition to the practices mentioned earlier, it’s essential to avoid caffeine, nicotine, and alcohol before bedtime, as they can disturb sleep. Engaging in regular physical activity can also facilitate faster sleep onset, reduce the frequency of night awakenings, and improve insomnia symptoms. However, it’s recommended to avoid intense exercise within an hour of bedtime.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is an effective treatment for insomnia, particularly for menopausal women experiencing sleep disturbances due to hot flashes and other symptoms. This form of therapy helps individuals recognize and change behaviors and perceptions that impede sleep. Research has shown that CBT-I is effective for menopausal women, addressing sleep disturbances caused by:

  • hot flashes
  • night sweats
  • anxiety
  • mood swings
  • hormonal changes

CBT-I encompasses a series of changes in sleep-related behaviors, including:

  • Sleep consolidation
  • Stimulus control
  • Cognitive restructuring
  • Sleep hygiene
  • Relaxation techniques

By working with a therapist trained in CBT-I, you can develop a tailored treatment plan to address your specific sleep disturbances during menopause.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT) can help alleviate menopausal sleep problems by regulating night sweats and diminishing sleep disturbances. However, HRT may not be suitable for everyone and should be discussed with a healthcare professional. Research has indicated that HRT initiated more than a decade after menopause can be associated with an increased risk of heart attacks and breast cancer.

Other options instead of using HRT are:

  • Low-dose birth control pills that contain both estrogen and progesterone
  • SSRIs (selective serotonin reuptake inhibitors) also provide an alternative treatment
  • Estrogen therapy may also be beneficial in addressing hot flashes, aiding in falling asleep, and potentially contributing to weight loss.

The decision to pursue HRT or alternative treatments should be made in consultation with your healthcare provider.

Alternative Therapies for Menopausal Insomnia

If traditional treatments and lifestyle changes aren’t providing relief from menopausal insomnia, alternative therapies may be worth exploring. Herbal supplements, such as Valerian root and melatonin, and mind-body techniques like yoga and meditation can offer additional support for improving sleep during menopause.

Herbal Supplements

Herbal supplements may provide relief for sleep issues during menopause, but their effectiveness varies and should be discussed with a healthcare professional. Some recommended herbal supplements for menopausal insomnia include:

  • Valerian root
  • Magnesium
  • 5-HTP
  • Theanine
  • Melatonin
  • Black cohosh
  • Red clover
  • Dong quai
  • Evening primrose oil
  • Magnolia bark

Always consult your healthcare provider before trying new supplements to ensure their safety and appropriate dosage.

Mind-Body Techniques

Mind-body techniques, such as yoga, meditation, and deep breathing exercises, can help reduce stress and anxiety, which may contribute to insomnia during menopause. By incorporating these practices into your daily routine, you can create a sense of relaxation and calm, improving your sleep quality and overall well-being.

Research has shown that the following mind-body techniques are effective for menopausal insomnia:

  • Yoga
  • Meditation
  • Tai chi
  • Muscle relaxation
  • Breathwork

Additionally, acupuncture and aromatherapy massage have been found to have positive effects on decreasing insomnia and improving overall well-being.

By exploring various mind-body techniques, you can find the approach that best suits your needs and preferences.

Lifestyle Changes for Better Sleep

In addition to the strategies and alternative therapies mentioned earlier, making lifestyle changes can significantly improve sleep during menopause. Regular exercise not only helps with sleep onset and reducing night awakenings, but can also ameliorate insomnia symptoms and minimize weight gain, a potential risk factor for sleep apnea. Maintaining a balanced diet is also essential for overall health and can contribute to better sleep.

Avoiding caffeine, nicotine, and alcohol close to bedtime is crucial for improving sleep quality, as these substances can cause trouble sleeping. Creating a relaxing bedtime routine, such as reading a book, taking a warm bath, or practicing relaxation techniques, can also help signal to your body that it’s time to wind down and prepare for a good night’s sleep.

By making these lifestyle changes, you can set the stage for better sleep during menopause.

When to Seek Professional Help

If menopausal insomnia persists or worsens despite trying various strategies and lifestyle changes, it’s advisable to seek professional help. Therapists who specialize in cognitive behavioral therapy (CBT) and have experience working with menopausal women, as well as hormone therapy, can provide tailored treatment options and support.

Don’t hesitate to reach out to a healthcare professional to discuss your sleep concerns, including how to fall asleep, and find the most suitable approach for your needs


Menopause is a challenging time for many women, with hormonal imbalances, hot flashes, and night sweats often disrupting sleep and leading to insomnia. By understanding the underlying causes of sleep disturbances during menopause and exploring various strategies, such as sleep hygiene practices, CBT-I, and HRT, you can take control of your sleep and minimize the impact of menopause on your overall well-being.

Incorporating alternative therapies, such as herbal supplements and mind-body techniques, along with making lifestyle changes, can further improve sleep quality during menopause. Don’t hesitate to seek professional help if menopausal insomnia persists or worsens. Remember, you deserve a good night’s sleep, and finding the right approach can make all the difference in your journey through menopause.

Frequently Asked Questions

How do you treat insomnia during menopause?

To treat insomnia during menopause, low doses of melatonin and cognitive behavioral therapy can be beneficial. Additionally, it is recommended to keep the bedroom at a comfortable temperature, exercise regularly throughout the day, avoid eating large meals close to bedtime, and stay away from caffeine late in the day.

Does menopause insomnia go away?

Yes, menopause-related insomnia can be managed with treatment, and the good news is that it is usually temporary. Seeking help from medical professionals can be beneficial in finding relief for your sleep issues during menopause.

What is menopause insomnia like?

Menopause insomnia is characterized by difficulty falling and staying asleep, hot flashes, disrupted sleep due to hormone fluctuations, stress and anxiety, and non-restorative sleep. It affects up to 60% of women after menopause, making it one of the most common complaints.

What causes insomnia during menopause?

Hormonal imbalances, hot flashes and night sweats during menopause can lead to disturbed sleep and insomnia.

These symptoms can be disruptive to a woman’s daily life, making it difficult to concentrate and stay productive. They can also lead to feelings of depression and anxiety.

Fortunately, there are a few fortunately.

How long does insomnia last during menopause?

The duration of insomnia during menopause can vary greatly, but it can last throughout the menopausal transition and even into postmenopause.

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