← All posts · 12 November 2026

Why does menopause cause sleep problems?

Menopause and sleep: tired all day, wide awake at night?

You’ve felt tired all afternoon. You’ve nearly nodded off on the sofa. But once you get into bed, you’re suddenly wide awake, remembering something you haven’t done or worrying about something you can’t possibly sort out until morning.

Or perhaps getting to sleep isn’t the problem. You drop off quite happily, then wake up hot and sweaty, throw the duvet off, get cold, pull it back on again… and repeat.

By morning, you’re exhausted, but everyone still expects you to get on with your day.

Sleep problems are common during perimenopause and menopause, but that doesn’t mean you have to accept feeling dreadful. There are things worth trying, and there’s help available if you need it.

Why has sleeping become so difficult?

Hormonal changes can affect sleep, and hot flushes and night sweats certainly don’t help. But midlife usually brings a few other things into the bedroom too: worries about work, elderly parents, children, money and the enormous list of things you’re supposed to remember.

Pain, bladder symptoms, medicines and other sleep conditions can also play a part. It’s worth looking at the whole picture rather than assuming everything is down to menopause.

And when you’re tired, things that you’d normally cope with can feel much harder. You might be more irritable, less able to concentrate and wondering where your patience has gone.

So, where do you start?

Put yourself to bed like a toddler

Remember bath, story and bed? We wouldn’t expect a small child to go straight from a noisy party to being fast asleep, but we seem to expect ourselves to switch off immediately after answering emails, watching the news and sorting out everyone else’s problems.

Give yourself a little time to wind down. That might mean a shower, putting your phone away and reading a few pages of a book. It doesn’t need to involve scented candles and an elaborate routine you’ll abandon by Thursday.

If bedtime is the first quiet moment you’ve had all day, it’s tempting to stay up scrolling. I understand the appeal, but try giving yourself some of that quiet time a little earlier.

Have a look at your caffeine

Before you tell me you only have two coffees a day, what time is the second one?

Caffeine can still affect you hours after you’ve finished your drink. Tea, cola and energy drinks count too, so it’s worth looking beyond your morning coffee.

Try leaving at least six hours between your last caffeinated drink and bedtime. Some women find an earlier cut-off suits them better. You could experiment with lunchtime and see how you get on.

And yes, I do love my Earl Grey. This is about noticing what works for you, rather than banning everything you enjoy.

Is wine helping you sleep — or just helping you fall asleep?

A glass of wine can make you feel pleasantly sleepy. Unfortunately, getting to sleep and staying asleep aren’t quite the same thing.

Alcohol can disturb sleep later in the night. If you’re regularly waking in the early hours, try a few alcohol-free evenings and notice whether your nights feel different.

You don’t need to judge yourself or make a grand announcement. You’re simply finding out whether it’s affecting you.

Get outside and move during the day

When you’ve slept badly, exercise might be the last thing you fancy. But regular movement can support sleep, and it doesn’t have to mean an exhausting workout.

A walk outside is a good place to start. Morning daylight can help your body recognise when it’s time to be awake and when it’s time to sleep. “Sky before screen” is a useful little reminder to get outside before disappearing into your phone.

During the week, include movement you enjoy and can manage: walking, strength work, Pilates, dancing or whatever gets you away from your chair.

You’re looking for a routine you can keep going, rather than trying to wear yourself out enough to sleep.

Make the bedroom comfortable for you

If one of you is roasting and the other is complaining about the open window, separate duvets might be worth considering!

Keep the room comfortably cool, dark and quiet where possible. Think about bedding and nightwear you can easily adjust, and whether a fan would help.

Try to keep work out of bed too. It’s hard to switch off when your pillow has become an extension of your office.

Are night sweats waking you up?

If you’re waking up hot and throwing the duvet off, my free two-week Hot Flush Diary could help you spot whether there’s a pattern.

For the first week, jot down when your flushes and night sweats happen and what’s been going on beforehand. In week two, try one or two small changes and see whether they make a difference.

You might find something that seems to make yours worse — or at least have a clearer picture to discuss with your GP. There won’t always be an obvious trigger, and that’s useful to know too.

Get my free Hot Flush Diary

How about a simple “sleepy pudding”?

Now this is something a bit more enjoyable to try: a small bowl of Greek yoghurt, a chopped kiwi fruit and a sprinkling of unsalted pistachio nuts. You can lightly toast the nuts if you fancy, but there’s no need to make extra work for yourself.

Why those ingredients? Greek yoghurt gives you protein and calcium, while pistachios add some fibre and healthy fats. Kiwi fruit has also been studied for its possible benefits for sleep. The research is small, so we can’t promise it will have you sleeping through the night, but it’s a perfectly nice pudding to experiment with!

If you’re hungry in the evening, other simple options include a small bowl of porridge made with milk, an oatcake with a little nut butter, or a warm milky drink. Choose something you enjoy and that sits comfortably in your stomach.

These aren’t sleeping tablets in food form. But a small, satisfying snack can be more comfortable than going to bed hungry. You don’t need to add one if you’re already comfortably full, and a large meal just before bed may make you uncomfortable.

What if you’re awake and getting cross about it?

Watching the clock and calculating how little sleep you’ll get before the alarm goes off rarely makes you feel better.

If you’re lying awake getting increasingly frustrated, get up and do something quiet in low light for a while. Read a book or listen to something calming, then return to bed when you feel sleepy. Try to avoid turning it into an opportunity to catch up on emails or the washing.

A notebook can be useful earlier in the evening too. Write down the things you need to remember and anything you can deal with tomorrow. You don’t have to solve it all before bed.

Aim for a reasonably consistent getting-up time, even after a difficult night, and go to bed when you feel sleepy rather than forcing an early bedtime.

When small changes aren’t enough

If sleep problems have been going on for months, or they’re making everyday life hard to cope with, speak to your GP. You don’t need to work through every suggestion in this blog before asking for help.

HRT may help when menopause symptoms such as night sweats are disturbing sleep, if it’s suitable for you. If you can’t take it, don’t want to, or are still struggling while taking it, there are other options.

Ask about cognitive behavioural therapy for insomnia, usually called CBT-I. It’s a treatment that helps address the thoughts and habits that keep insomnia going. Menopause-specific CBT can also help with sleep difficulties linked to hot flushes and night sweats.

Mention loud snoring, waking up gasping or marked daytime sleepiness too, because these can point to another sleep condition. Don’t drive if you feel sleepy.

Pick one thing to start with

Please don’t turn getting a better night’s sleep into another enormous project.

Choose one thing that feels manageable: an earlier last coffee, some time outside in the morning, a quieter end to the evening or keeping a note of your night sweats.

Give yourself time to notice whether it helps. And if it doesn’t, that’s information — not something else you’ve failed at.

Sam x

Would a little help with movement be useful?

My Midlife Movement Hub offers friendly online classes to help you build strength, keep moving and make time for yourself. Many classes are just 30 minutes, so you can fit them around the rest of your day.

Find out about the Midlife Movement Hub and four-week trial