Why Menopause Wakes You at 3 A.M., and What You Can Try

You fall asleep tired, and then, at 2 or 3 in the morning, you are wide awake. Sometimes you are hot, sometimes your heart is racing, sometimes your mind simply will not switch off. If this sounds familiar, you are not alone, and it is not a sign that you are weak or anxious.

This article summarizes the sleep chapter of The Menopause Reset, the first step of its 90-day plan. It is general information, not medical advice. If your sleep problems are persistent or affect your daily life, talk with your doctor.

What may be happening in your body at night

The book explains that the hormones that change during perimenopause and menopause also take part in sleep:

• Estrogen helps regulate body temperature. When it fluctuates, hot flashes and night sweats can pull you out of deep sleep.
• Progesterone has a calming effect. When it goes down, falling asleep and staying asleep can feel harder.
• Cortisol, the alerting hormone, should be low at night. If its rhythm shifts, you may feel wired late in the evening.
• Melatonin timing depends on light and darkness, so late screens and bright evenings can push it later.

Keep the bedroom cool

Because body temperature has to drop for sleep to start, the book begins with the bedroom: keep it cool, use breathable cotton or bamboo sheets, and leave a dry set of sleep clothes on the nightstand in case you wake up sweating.

It also suggests a warm bath or shower 60 to 90 minutes before bed. It sounds backwards, but as your body releases that heat afterwards, its temperature drops, which is part of what helps you feel sleepy.

Morning light and a steady wake time

Your internal clock is set mostly by light. The book recommends 10 to 15 minutes of daylight within the first half hour after you get up, and waking up at about the same time every day, weekends included. In the evening, less screen time and dimmer light help your body get ready for sleep.

Give yourself a one-hour wind-down

Your nervous system needs a runway. For the last hour before bed, the book suggests no work email, no news and no difficult conversations. Choose quiet things instead: a novel, gentle stretching, a bath, an easy conversation.

For the first two weeks of the plan it also recommends leaving alcohol out. A glass of wine can help you fall asleep, but it can make sleep lighter and more broken, and it can make hot flashes worse.

If you wake at 3 a.m. and cannot fall back asleep

If 20 minutes pass and you are still awake, the book suggests getting out of bed, going to a dim room and doing something quiet, like reading or light stretching, until you feel sleepy again. Lying awake in bed for a long time can teach your brain that the bed is a place for being awake. Leave the phone alone.

Some nights will still be hard. The goal of the first two weeks is not perfect sleep but better conditions for sleep, built night after night.

When to talk with your doctor

Talk with your doctor if you sleep badly most nights, if you feel exhausted during the day, or if hot flashes or night sweats are frequent. There are treatment options for menopause symptoms, and your doctor can review which ones make sense for you. Check with your doctor or pharmacist before taking any supplement or sleep aid.