Is Menopausal Insomnia Causing My Sleep Problems?

By: Holly L. Thacker, MD • Posted on November 29, 2011 • Updated March 03, 2021

Is Menopausal Insomnia Causing My Sleep Problems?

Sleep Issues For Women During Perimenopause, Menopause and Postmenopause

According to the National Sleep Foundation (NSF), women in their perimenopause through postmenopausal years report experiencing menopausal insomnia. The NSF also states that women experiencing sleep issues report symptoms such as:

  • Hot flashes
  • Mood disorders
  • Insomnia
  • Sleep-disordered breathing
  • Depression
  • Anxiety

Do these symptoms sound familiar? They just might if you are going through menopause.

So, is menopause causing your sleep problems? Not exactly. But, the symptoms of menopause can have an impact on your sleeping. For instance, menopausal hot flashes occur more frequently at night, causing you to wake regularly and leaving you sleep deprived during the day. Anxiety and the stresses of the day can surface once the lights go out. This can cause you to focus on everything, but falling asleep.

Treating Menopause Sleep Problems

The good news is a hormone therapy can help you get a good night’s sleep by minimizing menopause-related symptoms such as:

  • Hot flashes
  • Anxiety
  • Depression
  • Mood swings

I also advise my patients to take their hormone therapy medications at night so the dose lasts through the sleeping hours, making it less likely that menopausal symptoms will wake them.

Be Sure To Establish a Bedtime Routine

Yes, just like toddlers, a bedtime routine can be beneficial even in your 40s through 70s, especially during the menopause transition. Establishing a bedtime routine such as taking a warm bath, reading a favorite book or writing in a journal can help set the mood for sleep, as well as help you relax and calm your mind. I know this can be hard to achieve with busy schedules, but consider this “your time” to take care of yourself, your mind and your body!

Is it Menopause Insomnia or a Sleep Disorder?

Make sure to talk to your doctor about your sleep-related problems, as they may be connected to a deeper sleep issue that can be helped through a sleep study or sleep journal. In fact, I recommend starting a sleep journal before you go to your appointment. This will help you and your doctor uncover the possible root of your sleeping problem. To start your journal, begin recording the following information:

  1. What time do you go to bed?
  2. What time do you wake up?
  3. How many times do you wake up during the night?
  4. Do you fall asleep again quickly after waking?
  5. How many minutes/hours do you stay awake during the night?
  6. What are your caffeine, alcohol, nicotine, and food intake before bedtime?
  7. Are there any environmental disruptions that cause awakenings (noisy neighbors, an uncomfortably hot room, too much light)?

Based on your answers, your doctor might recommend you go for a sleep study. If you snore, have restless legs, or fall asleep during the day, you need a sleep study! During a sleep study a sleep professional will monitor and record your sleeping behaviors, such as your breathing, heart rate and brain waves. This will help your doctor determine the problem and prescribe the right treatment for your sleeping disorder or menopause insomnia.

Be Strong, Be Healthy, and Be in Charge!

- Dr. Holly L. Thacker

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Dr. Thacker is also the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause. Her special interests and areas of research including menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health.


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