Q: I’m a woman in my 40s and never seem to get a good night’s sleep. How can I get some rest?
Maybe you toss and turn before dozing off, or you wake at 3 a.m., drenched in sweat, and can’t fall back asleep. These are common scenarios during perimenopause, the time of transition just before menopause when a woman’s period becomes irregular and her estrogen levels start to dip.
Perimenopause typically begins during a woman’s 40s, and having trouble sleeping is “probably the most distressing symptom,” said Dr. Karen Adams, director of the Program in Menopause and Healthy Aging at Stanford Medicine.
But the good news, she added, is that perimenopause-related sleep issues are “absolutely treatable.” Here is why they occur and how to mitigate them.
Why perimenopause affects sleep
Hormonal shifts during perimenopause (and later, during menopause) disrupt the body’s ability to regulate temperature, causing hot flashes and night sweats that can interfere with sleep, Dr. Adams said.
Anxiety and depression, which are also common during this stage, are big sleep sinkers, too, said Dr. Stephanie Faubion, director of the Mayo Clinic’s Center for Women’s Health in Jacksonville, Fla.
Women usually have a lot going on during the perimenopause years, Dr. Faubion said, including caring for children or aging parents and addressing work pressures and lengthy to-do lists. These problems alone may keep them up at night, and not sleeping can compound the issues, creating a vicious cycle, she said. Add in perimenopausal hormone shifts, and it can be even more difficult to get some rest.