10 Proven Ways to Sleep Better In Menopause & Perimenopause
by Dr Caitlin Chasser
Sleep and Menopause Specialist
If restless nights and 3 a.m. wake-ups sound familiar, you’re not alone. In this article, expert sleep specialist and NHS doctor Dr Caitlin Chasser shares some of the proven strategies to help women restore calm, consistent sleep through perimenopause and menopause.
Drawing on her deep clinical experience, Dr Caitlin explains what’s really happening to your hormones, body temperature, and brain at night — and, most importantly, what you can do to sleep soundly again.
Plus, she’s kindly offering readers an exclusive discount on her Sleep Course — details at the end of the article.
When it comes to sleep, women often draw the short straw. Not only are we more prone to insomnia and disrupted sleep than men, but certain life stages, particularly menopause and the menopause transition (perimenopause), can make sleep even more elusive. For many, difficulties begin in the early 40s and peak shortly after menopause. As sleep quality declines, other menopausal symptoms, like hot flushes, anxiety, and mood swings, often intensify.
Oestrogen and progesterone receptors are found throughout the brain, influencing stress responses, mood, memory, temperature regulation, and sleep itself. In a typical menstrual cycle, many women experience better sleep in the oestrogen-rich first half (from the start of a period until ovulation). However, sleep can become lighter and more disturbed in the second half, especially just before menstruation. During perimenopause, hormone levels often become erratic. After menopause, they drop significantly, leading to much lighter sleep, more frequent night-time awakenings, and waking feeling unrefreshed.
Despite research showing women typically need 8–9 hours of sleep per night - often more than men - achieving this during menopause can feel near impossible. Fortunately, there are evidence-based strategies to restore restful sleep. Whether you’re dealing with night-time disruptions or persistent insomnia, here are 10 proven solutions to help you get the rest your body needs.
1. Hormone Replacement Therapy (HRT)
HRT is one of the most effective treatments for menopause-related sleep issues. By stabilising hormone levels, it reduces hot flushes, night sweats, and other symptoms that disrupt sleep.
If you're already taking HRT and still sleeping poorly, it may be a matter of finding the most 'sleep-friendly' combination—getting the right preparation, at the right dose, and at the right time. If your sleep remains a struggle, Cognitive Behavioural Therapy for Insomnia (CBT‑I) is the recommended next step.
Why it works:
HRT reduces the frequency and intensity of hot flushes—major culprits behind sleep disturbances. It also helps relieve anxiety and mood symptoms that are often linked to poor sleep. Research shows HRT improves sleep stability, reducing awakenings and promoting more restful nights.
2. Cognitive Behavioural Therapy for Insomnia (CBT‑I)
CBT‑I is the most effective non-medical treatment for insomnia—and works just as well as HRT for improving sleep. While it may seem counterintuitive to use a behavioural therapy when the root cause feels physical, CBT‑I enhances sleep by increasing deep sleep and teaching you how to get back to sleep quickly after waking—whether from hot flushes, anxiety, or other menopausal symptoms.
During a 4 week programme, you’ll learn proven techniques to fall asleep faster, reduce night-time awakenings, and improve the overall quality and quantity of your sleep.
Why it works:
When we have insomnia, the brain becomes hyper-aroused—too alert at night. CBT‑I teaches us how to quieten the mind and reshape negative sleep patterns. It improves both the quality and depth of sleep, even during hormonal fluctuations. Find out more.
3. Optimise Sleep Hygiene
Creating a sleep-supportive environment is crucial, especially when your sleep is more fragile. Keep your bedroom dark (use an eye mask if needed), cool (ideally 16–19 °C), and quiet (try earplugs or pink/white noise). Use layered bedding so you can easily adjust temperature, and consider a cool shower before bed to help lower your core temperature.
Why it works:
A cool, dark, and quiet room reduces night-time awakenings and helps maintain sleep despite hot flushes and night sweats. Good sleep hygiene creates the ideal conditions for better-quality rest.
4. Exercise Regularly
Physical activity supports your body’s natural sleep–wake rhythm and helps manage menopause-related anxiety and low mood, both of which can interfere with sleep. All forms of exercise help, but resistance or weight training may offer the most benefit for deep sleep.
Why it works:
Exercise boosts mood, reduces stress, and enhances sleep quality. Aim for 20–30 minutes of movement on most days—consistency matters more than intensity.
5. Limit Alcohol and Caffeine
Alcohol may make you feel sleepy, but it disrupts sleep later in the night by reducing REM (dream) sleep and increasing night-time wakefulness. It can also trigger hot flushes. Caffeine, a stimulant, can delay sleep if consumed too late in the day.
Why it works:
Cutting back on alcohol and caffeine improves sleep continuity and depth. Consider alcohol-free alternatives if you enjoy a relaxing drink in the evening.
6. Practice Mindfulness and Relaxation Techniques
Techniques like meditation, deep breathing, or progressive muscle relaxation help calm the mind and body before bed. These are especially useful if anxiety or stress is contributing to poor sleep. Try our Mindfulness Body Scan before bed or during the night if you wake and can’t drift back off.
Why it works:
A consistent, relaxing bedtime routine prepares your mind for rest and supports deeper, more restorative sleep.
7. Manage Hot Flushes
Hot flushes and night sweats are major sleep disruptors. Keep your sleeping environment cool with a fan or open window, wear moisture-wicking nightwear, and use breathable bedding. If symptoms persist, consult your doctor—medications like SSRIs can reduce flushes and support better sleep.
Why it works:
Minimising temperature fluctuations at night helps reduce awakenings triggered by hot flushes, allowing for more consistent sleep.
8. Try Melatonin
Melatonin supplements can help women over 55 fall asleep faster. While it’s not as powerful as CBT‑I, melatonin can still be a low-risk option—particularly for those who struggle with sleep onset.
Why it works:
Menopause can disrupt natural melatonin production. Supplementing melatonin helps regulate the body’s circadian rhythm, improving sleep timing and continuity.
9. Rule Out Underlying Sleep Disorders
Conditions like obstructive sleep apnoea (OSA) and restless legs syndrome (RLS) become more common during menopause. Signs of OSA include loud snoring, pauses in breathing, dry mouth upon waking, and excessive daytime tiredness. If you suspect a disorder, a sleep study may be necessary. Unsure? Try our Diagnose Your Sleep quiz .
Why it works:
Treating undiagnosed conditions such as OSA or RLS can significantly improve sleep quality and reduce long-term health risks.
10. Be Consistent
A regular sleep–wake schedule—going to bed and waking up at the same time each day—supports your body’s natural rhythm. If you’re struggling to fall asleep, you may be going to bed too early. Use our Bedtime Planning for a Great Night’s Sleep tool to find your optimal sleep window.
Why it works:
Consistency strengthens your circadian rhythm and improves overall sleep quality—particularly important during menopause, when sleep can become fragmented.
Final Thoughts
If you're struggling with sleep and think it's just something you have to endure during menopause—stop! Poor sleep can be fixed, and the solution is probably easier than you think. Often, it’s not one magic bullet, but a series of small adjustments that make the biggest difference. When you’re utterly exhausted, that first step can feel overwhelming—but deciding, this has to change, is the most powerful thing you can do.
Need support figuring out your next step? Our Menopause Support Package gives you everything you need to return to the restful, energising sleep you deserve. Find out more here. Plus, I am offering readers an exclusive discount to our Sleep Course until the end of November — details here: https://www.thesleepproject.life/offers/rkwLkNzc/checkout?cid=ab69c471-52cb-4706-bd68-e4d99ed07368&coupon_code=MENOMONTH30
About Dr Caitlin Chasser:
Dr Caitlin is a Sleep Practitioner with 20 years experience in General Practice. She also has a special interest in women's health and hormonal medicine. Her personal journey into the critical nature of sleep began 10 years ago with her own struggle to have children and consequent insomnia. This started her research into how we can process stress, maintain hormone balance, and re-establish healthy sleep patterns. Using her knowledge of physiology and medicine she was able to develop sleep therapies which can be used to trigger those essential biological switches in the steps toward sleep. So life-changing were these discoveries that she realised that, as a doctor, this was where she wanted to focus her energy... to bring good quality revitalising sleep back into people's lives and with it all the benefits it brings.
