Changes in Sleep ​​
​​
Changes in sleep continuity impact more than half of all women going through perimenopause (Coborn, et al, 2022).
TLDR. Perimenopause can impact a woman’s sleep with women in perimenopause waking 1.5x on average per night. There are actions which can help alleviate these sleep disturbances.
Changes in sleep continuity impact roughly 56% of women with an average of 1.5 wakings per night (Coborn, et al, 2022). Changes in continuity may also mean trouble getting to sleep. These changes are typically driven by hormonal shifts (Coborn, et al, 2022 & Pengo et al, 2018), physical manifestations of hormonal shifts like hot flashes (Baker, et al, 2018) and urinary issues (Carlson, K. & Nguyen. H, 2024 and Park, MG et al, 2023).
Sleep Specific Disorders
While night sweats can impact sleep quality and duration they are estimated to account for less than 30% of the sleep disturbances in perimenopausal women (Coborn et. al, 2022and Summer, 2024).
​
Insomnia. Approximately 22% of women are likely dealing with insomnia. If you’re unhappy with the sleep quantity or quality because of difficulties falling asleep, waking up too early with an inability to get back to sleep, or difficulties staying asleep, you’re likely dealing with insomnia (Haufe & Leeners, 2023)
​
Sleep related breathing disorders impact more than half of post menopausal women, with the incidence rate for women increasing after menopause. While the rate of sleep disordered breathing is higher for men of the same age bracket (70%), there are a few hypotheses as to why women may have lower diagnosis rates. One of these is that women may present with different symptoms. Men often present with snoring and daytime sleepiness while women may present with insomnia, restless legs, depression, nightmares, palpitations, and/or hallucinations. (Lin et al, 2008)
Sleep-Related Movement Disorders occur more often in women (9%) than in men (5%) and the risk of these increases with age and when pregnant. Symptoms include a continuous impulse to move the legs, most frequently during the night (Triola et al, 2025).
Hormones
Sleep disruption is linked to variations in the reproductive hormone levels, particularly estrogen and FSH as they interact with the kisspeptin/neurokinin B/dynorphin (KNDy) neurons in the hypothalamus. This network helps to regulate the temperature regulation network as well as sleep wake cycles (Maki et al, 2024).
Estrogen. For perimenopausal women estrogen has a positive effect on sleep. (Haufe & Leeners, 2023)
Progesterone. Progesterone declines during the menstrual cycle have been linked to declines in sleep quality so it makes sense that as progesterone fluctuates throughout perimenopause there may also be impacts on a woman’s sleep (Haufe & Leeners, 2023).
Hormone Treatment. Estrogen only, progesterone only, and combined therapy have all been demonstrated to have a positive impact on sleep quality for those struggling with sleep disorders.
This will go away right?
It is unclear whether issues will resolve on their own, as the research provides mixed results (Pengo, et. al, 2018). This highlights the need for additional research to illuminate risk factors and potential risk-profile-based solutions​
​
You're not alone. Not being able to rely on old habits and patterns to feel like your best self can be really challenging. Know you're not alone. More than half of the women going through perimenopause are also dealing with changes in sleep. The changes may persist into post menopause so addressing any concerns here may help to provide decades of relief.
The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer.