The first time I heard about perimenopausal sleep disturbances was in naturopathic school. I was in my late 20s, and one of my professors—who was probably about the age I am now—told us that she used her insomnia as an opportunity to deepen her spiritual practice with nighttime meditation. I thought that was fantastic and enthusiastically passed the advice along to every woman in the clinic who complained about sleep issues.
If you were one of those women, I sincerely apologize. Because if a 27-year-old told me that right now, I’d probably want to punch them. (I wouldn’t, of course. I’d smile, nod, and quietly seethe.)
Back then, I had no idea how brutal sleep deprivation could be. I also didn’t understand what it felt like to be responsible for a family, a career, and a million other things—constantly juggling more than seems humanly possible. Add insomnia to that mix, and it can feel like everything is unraveling.
So why does perimenopause wreck sleep? There are a few reasons:
- Hot flashes can jolt you awake.
- Melatonin naturally declines with age, making it harder to fall and stay asleep.
- Cortisol and other stress hormones can spike at night, leaving you wide-eyed at 3 AM, heart pounding for no apparent reason.
- Fluctuating estrogen and progesterone can throw everything off balance.
What Can You Do?
The best place to start is with your bedtime routine:
- Cut down on screens at least an hour before bed. If you must use them, switch to night mode and avoid stressful content like the news or work emails.
- Dim the lights and wind down with something relaxing—reading, meditation, or gentle stretching.
- Consider melatonin. Since it naturally declines with age, supplementing with 3mg can help.
- Try herbs that lower cortisol. I like Cortisol Manager by Integrative Therapeutics, but there are many options.
What About Progesterone?
Depending on where you are in your perimenopause journey, oral progesterone can be a game changer. Taken at night, it can improve sleep and ease anxiety. If you’re still cycling, you’d typically take it during the second half of your cycle (around days 14–28).
And Then There’s the Bigger Picture…
I have to admit—there is a spiritual component to all of this. What’s on your mind when you wake up? Are there changes you’ve been avoiding? Ways you wish you were living but don’t feel able to?
Perimenopause is a time of profound transformation, and while that can feel disorienting (like being tossed around in a washing machine), it’s also an opportunity. Journaling can be helpful—keep a notebook by your bed to jot down thoughts or ideas that surface in the early hours.
The difference between my perspective at 27 and 45? Back then, I thought of this as a beautiful invitation to spiritual growth. Now, I see it as messy and uncomfortable, but often necessary. It is also something we can support with practical tools. You don’t have to just endure it. You can honor the deeper shifts while also taking steps to help yourself sleep better.
