Perimenopause insomnia: causes and support

Changing hormone signals can affect temperature control, mood and the sleep-wake cycle. A hot flash or night sweat may wake you, while worry about another poor night can make settling harder. Pain, restless legs, snoring, medicines, caffeine, depression and thyroid problems can also cause insomnia, so sleep difficulty is not automatically explained by perimenopause. Daytime effects may include fatigue, poor concentration, low patience and reduced enjoyment.

Keep a regular wake time, make the bedroom cool and dark, and use breathable bedding. Limit caffeine later in the day and avoid using alcohol as a sleep aid because it can fragment sleep. If you are awake for a long time, leave bed for a quiet activity in dim light and return when sleepy. Track bedtime, waking, night sweats, medicines and daytime alertness. A clinician may recommend cognitive behavioural therapy for insomnia, review medicines or discuss treatment for hot flashes and other symptoms.

Arrange an appointment when insomnia continues, affects driving or work, or leaves you struggling to function. Mention loud snoring, gasping, restless legs, persistent low mood or anxiety. Seek urgent help if sleep loss is accompanied by thoughts of harming yourself or someone else.

Ask what could be disrupting your sleep, whether night sweats or another condition are involved, and which behavioural or medical treatments fit your history. Bring your sleep diary and medication list.