Why Sleep is Disrupted During Perimenopause and How to Find Rest Again
Sleep—the thing you once took for granted—can suddenly feel elusive during perimenopause. Whether it’s tossing and turning, waking up in the early hours, or struggling to fall back asleep, disrupted sleep becomes a common complaint for many women in this transitional phase. But why does it happen, and what can you do about it?
The Hormonal Connection: Why Sleep Suffers in Perimenopause
Progesterone
One of the main reason we may experience sleep disturbances in perimenopause is the decline in progesterone. Progesterone starts to slowly decline at around age 35. We know our fertility is waning at this age, but don’t often realise this is the early stages of our perimenopause transition.
Often called the “calming hormone,” progesterone plays a key role in promoting restful sleep. One key reason for this is that progesterone naturally enhances the activity of gamma-aminobutyric acid (GABA), the brain’s primary calming neurotransmitter. GABA helps quiet the nervous system, promoting relaxation and restful sleep. When progesterone drops, this GABAergic support diminishes, leading to increased anxiety, heightened stress sensitivity, and difficulty winding down at night.
This is why many women in perimenopause experience a “tired but wired” feeling—exhausted but unable to fully relax and may experience unrefreshed sleep.
Oestrogen
Then we have oestrogen which fluctuates significantly in early perimenopause before eventually declining. These shifts can have a major impact on sleep. One key reason is its role in serotonin and melatonin production—two hormones that regulate mood and sleep cycles. As oestrogen drops (late in our cycle and late in perimenopause), melatonin production can be affected, making it harder to fall and stay asleep, while lower serotonin can lead to restless, fragmented sleep.
Oestrogen also helps regulate cortisol, the body’s stress hormone. When oestrogen fluctuates, cortisol levels can become more unpredictable, leading to night-time waking or amplifying that wired-but-tired feeling. Additionally, oestrogen plays a role in temperature regulation, so its decline contributes to hot flushes and night sweats—common reasons for disrupted sleep in midlife.
What can make it worse?
Now before we move onto what can help during this time, lets quickly touch on what can amplify sleep issues.
Root Causes Beyond Hormones
While hormonal changes are a major factor, other lifestyle and health considerations may compound sleep issues:
Stress and Cortisol Dysregulation: Chronic stress can elevate cortisol levels, keeping your body in a heightened state of alertness when it should be winding down.
Nutrient Deficiencies: Magnesium, glycine, and taurine are nutrients that support relaxation and sleep. Deficiencies in these may contribute to difficulty sleeping. If sleep disruption is destroying your quality of life I an help you identify is nutrient deficiencies are a factor for you as not everything can be measured by blood tests.
Gut Health: An unhealthy gut can affect neurotransmitter production (those chemical brain messengers we discussed above) and lead to inflammation, which may further disrupt sleep.
If you think any of these are an issue for you it is important to take action on top of the lifestyle adjustments that are below.
How Poor Sleep Impacts Perimenopause Symptoms
When sleep suffers, it often amplifies other perimenopausal symptoms. Fatigue becomes more pronounced, mood swings intensify, and brain fog may worsen. Poor sleep also makes it harder to manage stress, maintain energy levels, and even support healthy weight management.
The cycle can feel relentless—but it’s important to know that small, consistent changes can have a big impact. So let’s look at what you CAN do now…
Restoring Restful Sleep: Actionable Strategies
Here are some steps to help you reclaim your nights:
- Prioritise Sleep Hygiene: Create a bedtime routine that signals your body it’s time to wind down. Limit screen time, keep your bedroom cool, and establish consistent sleep-wake times.
- Support GABA Naturally: GABA helps calm the nervous system, promoting relaxation and better sleep. Support its production with magnesium-rich foods (dark leafy greens, almonds, pumpkin seeds), fermented foods (kimchi, sauerkraut, kefir), and L-theanine from green tea.
- Optimise Nutrient Intake: Include glycine (found in collagen-rich bone broth, gelatin, and meat), taurine (found in seafood and poultry), and magnesium for nervous system balance.
- Regulate Stress Levels: Practices like deep breathing, yoga, and mindfulness help lower cortisol, reducing night-time wake-ups and that wired-but-tired feeling.
- Get Morning Sunlight: Natural light exposure within the first hour of waking helps regulate your circadian rhythm by signalling to your brain that it’s time to be alert. This supports melatonin production later in the day, improving sleep quality at night. Aim for at least 10–20 minutes of sunlight outdoors without sunglasses.
- Get Personalised Support: If sleep issues persist, underlying factors like thyroid imbalances, blood sugar dysregulation, or gut health could be contributing. I offer personalised assessments and testing to help you uncover and address the root cause plus holistic treatment plans and practitioner grade supplements to get you results faster.
Your Sleep Can Improve—One Step at a Time
Sleep disruptions in perimenopause are frustrating, but they’re not insurmountable. By understanding the root causes and making intentional changes, you can start to enjoy more restful nights and energised days.
Are you ready to take control of your sleep and feel energised again? Let’s uncover what’s holding you back and create a plan that’s tailored to your needs: Here’s How I Can Help
