Are you a woman over 35 who is tossing and turning at night? Or maybe you’re waking up at 3:00 AM, staring at the ceiling, unable to get back to sleep? If this sounds familiar, you might be in perimenopause, and it could be impacting your sleep.

Perimenopause refers to the years leading up to menopause, which can begin as early as the late thirties and last up to ten years. It officially ends after 12 consecutive months without a period. The first day after this 12-month period marks the start of menopause, and from that point on, a woman is considered post-menopausal. During perimenopause, significant hormonal changes occur which can lead to disrupted sleep as well as a variety of other symptoms.

During this stage of life, we want to aim for quality sleep. Regular inadequate sleep can result in a diminished ability in handling stress, heightened irritability, anxiety and even depressive symptoms. It can also bring forgetfulness, brain fog, difficulty concentrating, weight gain, and a weakened immune system. Quality sleep is about more than feeling rested upon waking, it is about supporting overall health and wellness.

3 Common Sleep Challenges During Perimenopause

Difficulty Falling Asleep & Staying Asleep
One of the most common challenges during perimenopause is disrupted sleep. You may find yourself wide awake in the middle of the night simply unable to fall back asleep or you may find yourself dealing with racing thoughts, nervous energy and nighttime anxiety. Poor sleep can worsen anxiety, creating a cycle where poor sleep exacerbates nighttime anxiety, and nighttime anxiety makes it difficult to fall back to sleep. Enough nights like this, and you may choose to go to sleep later in the evening in hopes that you will sleep through, however this may not work and leave you feeling more exhausted the following morning.

Night Sweats and Hot Flashes
Many women experience hot flashes (sudden surges of heat during the night), and/or night sweats (excessive sweating during sleep), both of which can result in disrupted sleep. Though this is a common occurrence during perimenopause, certain foods/drinks, stress, lack of exercise, blood sugar instability and certain medications can also exacerbate these symptoms. Learning about what contributes to your night sweats and hot flashes is helpful in managing them.

Blood Sugar Imbalances
Many women in this stage of life experience unstable blood sugar levels which can contribute to disrupted sleep. Blood sugar naturally fluctuates throughout the day, but during perimenopause the changes in hormone levels make these fluctuations more pronounced. If blood sugar drops too low overnight, it can cause a night waking that leaves you anxious and sweaty. If blood sugar it too high, it can lead to restlessness during the night and frequent urination. Stabilized blood sugar is a key factor in better sleep during this stage of life, and beyond.

Nutritional Tips to Support Sleep During Perimenopause

Nutrition plays an important role in managing sleep disruptions during this stage of life. The right balance of nutrients for your body’s needs, and eliminating foods that impact your sleep can help promote better sleep quality.

Balancing Blood Sugar
Choose complex carbohydrates (ex: quinoa, brown rice) as they provide a slow-release source of energy and help prevent blood sugar crashes that could disrupt your sleep. Incorporate protein sources at each meal to balance blood sugar while you sleep and include healthy fats such as avocados, nuts, seeds, and olive oil to help stabilize glucose levels and help keep you feeling full throughout the night.

A bedtime snack can be beneficial especially if you are struggling with sleep disruptions. A balanced snack that includes a combination of protein, healthy fats and complex carbohydrates can help stabilize blood sugar levels overnight, supporting quality sleep. Aim to eat at least 30-60 minutes before bed to give your body time to digest. It is also important to avoid heavy, rich, or sugary snacks that can spike blood sugar and disrupt sleep.

Include Magnesium Rich Foods
Magnesium is known for its muscle-relaxing and calming properties, which can improve sleep quality. Include magnesium-rich foods such as leafy greens (spinach, kale), almonds, pumpkin seeds, and legumes in your diet. Some women will benefit from a magnesium glycinate supplement to support sleep; working with a natural practitioner on dosing will be beneficial.

Limit Caffeine and Alcohol
Many women in perimenopause find that caffeine and alcohol start to affect them differently during this stage of life. You may find that you can no longer handle as much caffeine as you once did because it leaves you anxious, jittery and unable to sleep. Likewise, you may find that alcohol helps you fall asleep but makes your hot flashes worse and leaves you feeling exhausted in the morning. Y

You can start by cutting back on your caffeine intake and limit consumption before 2:00pm to avoid interference with your sleep. Become familiar with the different coffee choice and caffeine content in each, you may be surprised to learn how much caffeine you are consuming daily. You will likely have to experiment to see what your maximum caffeine intake amount is per day. Likewise, start to experiment with limiting or eliminating alcohol intake.

Sleep Tips for Perimenopausal Women

In addition to nutrition, sleep hygiene plays a role in improving sleep quality. Here are some strategies that can help you optimize your sleep:

Creating a Relaxing Bedtime Routine: A calming bedtime routine signals to your body that it’s time to wind down and get ready for sleep. Take an hour before your bedtime to calm your body and mind by reading, deep breathing, or practicing gentle stretches to relax before bed. Try to avoid stimulating activities like watching intense television shows, using electronics or engaging in stimulating conversations that will keep you up at night.

Control the Bedroom Temperature: Hot flashes and night sweats can make it difficult to get a good night’s sleep. The consensus is 65F or 18 degrees for a good night’s sleep. This may be too chilly for some, experiment with it to see where you are most comfortable. If adjusting the house/room temperature is not really an option for you, you can use fans and/or sleep in light breathable fabrics. If you are struggling with night sweats, try moisture wicking fabrics to sleep in. Keeping hydrated throughout the day can also help with regulating body temperature at night.

Set a Consistent Sleep Schedule: Going to bed and waking up at the same time every day helps regulate your body’s natural circadian rhythm. Try to stick to a consistent sleep schedule, even on weekends, give or take 30 minutes. 

Caring for Young Children: With women having children later in life, it is possible to be in perimenopause and have young children waking at night.  Creating a supportive bedtime routine for both you and your child, seeking help from your partner or another family member when it comes to night wakings and taking naps during the day, when possible, can help minimize the sleep deprivation.

Movement for Better Sleep: Adding movement to your day can make a big difference when it comes to sleep. Regular movement can help you both fall asleep faster and stay asleep. It helps reduce stress, balance blood sugar, supports mood, supports sleep and more. Start by finding simple ways to move more during the day. This could look like parking farther from the store, taking the stairs instead of the elevator, doing squats throughout the day, taking a 30-minute brisk walk a few times a week or having a dance party in your house.

Please note, if your sleep struggles are sudden, severe, accompanied by other symptoms, or you are concerned a medical check-up is the best first step. If no medical issues are found (or alongside medical treatment), working with a holistic nutritionist can help optimize sleep through diet, lifestyle, and targeted supplementation.

To dive deeper into natural ways to support your sleep, download our free Calm Your Mind: A Guide to Managing Nighttime Anxiety and Stress for Better Sleep Guide below. In this guide, you'll find more strategies, tips, and actionable steps to help you get the sleep you need during this stage of life. If you are interested in personalized support, we would be happy to help!