Doctors Explain How To Get Better Sleep

Here’s how menopause affects your sleep—and a few ways to get more Zzzs.

Meet the experts: Stephanie S. Faubion, MD, is an internal medicine doctor, the director of the Mayo Clinic Center for Women’s Health, and the medical director of the North American Menopause Society. Susan Loeb-Zeitlin, MD, is an OB-GYN at NewYork-Presbyterian and Weill Cornell Medicine. Raj Dasgupta, MD, specializes in pulmonary, sleep, internal, and critical care medicine and is the chief medical advisor at Sleepopolis.

How Menopause Can Mess With Your Sleep

During menopause, estrogen and progesterone levels drop. While this leads to side effects and symptoms that can interrupt your sleep (more on those below), the decrease in these hormones itself can also impact your slumber and can lead to generalized insomnia.

Estrogen helps your body regulate its internal 24-hour clock (a.k.a. your circadian rhythm), which is important for a good night’s rest, says Raj Dasgupta, MD, a sleep specialist and chief medical advisor at Sleepopolis. The regulation of circadian rhythm may happen through body temperature, according to a 2023 study in the Journal of Clinical Sleep Medicine, and estrogen plays a role in that, too.

Meanwhile, progesterone has a mild sedative effect and is even called the “relaxing hormone,” says Dr. Dasgupta, and it also encourages the production of melatonin. So you can imagine what happens when levels of it decrease. In fact, a small 2011 study in the Journal of Clinical Endocrinology and Metabolism found that the group who supplemented with progesterone experienced significantly less sleep awakenings throughout the night than the placebo group.

And, an important reminder: These hormonal changes can start way before you get your last period. “We are starting to understand that there’s less distinction between perimenopause and menopause than we thought,” says Dr. Faubion. Across both stages, you might experience many of the same sleep-disrupting symptoms. Not to mention, this is an age when you also might be dealing with other responsibilities, like kids, a partner, or aging parents, that don’t have anything to do with hormones but can still impact your sleep.

The Most Common Sleep-Disrupting Menopause Symptoms

Hot Flashes

The biggest menopause-related reason you might have trouble sleeping is night sweats—basically, hot flashes at night. Experts are not exactly sure what causes hot flashes, but a 2019 review in The Journal of Midlife Health found that more than 80 percent of people experience them. Researchers do know that they come with hormonal changes; dropping estrogen levels during menopause can throw off your body’s thermal regulation, says Susan Loeb-Zeitlin, MD, an OB-GYN at NewYork-Presbyterian and Weill Cornell Medicine.

Sleep Apnea

The image of obstructive sleep apnea (OSA), a potentially life-threatening disorder where your airway becomes intermittently blocked during sleep, is a man snoring, but that’s not the full story. Women are also at risk of developing the disorder, especially during menopause. “It’s much less common in women than men before menopause, but we catch up with them significantly after menopause,” says Dr. Faubion.

There are a couple reasons for this: The first is that you might gain weight during menopause, which can increase your risk of developing OSA. This weight gain can cause fat deposits in the neck and throat area to narrow your upper airway and make it more likely to collapse while you sleep. The second is that, as your estrogen drops, muscle tone in the upper airway might decrease too, which can also allow it to collapse and obstruct airflow, says Dr. Dasgupta.

BTW, even if your partner isn’t complaining about you suddenly starting to snore, you could still be dealing with OSA, says Dr. Dasgupta. “Sometimes we don’t do a great job of diagnosing OSA in women because we’re looking for the classic signs and symptoms of heroic snoring and excessive daytime sleepiness,” he says. “But women—especially women in menopause—could be presenting with fatigue, depression, and even insomnia.”

Mood Disorders

Menopause makes people more vulnerable to depression and anxiety, potentially because of how estrogen fluctuations affect GABA and serotonin (two neurotransmitters that play a role in mood), according to a 2023 systematic review in Australasian Psychiatry. You might even see the biggest impact on your mental health during perimenopause, per a 2024 review in the Journal of Affective Disorders.

At least 40 percent of people in menopause experience mood changes including anxiety or depression, says Dr. Loeb-Zeitlin, and, you guessed it—these changes in mood can also impact your ability to get a good night’s sleep, per 2019 research in Frontiers in Neurology.

Restless Legs Syndrome

Similar to hot flashes, restless legs syndrome will also jolt you awake at night and interrupt your sleep. It’s categorized as an “inactivity-induced, mostly nocturnal, uncomfortable sensation in the legs and an urge to move them” in a 2020 study in the International Journal of Environmental Research and Public Health.

Basically, with this neurological condition, you get repeated uncomfortable feelings in your legs—followed by the need to move them to ease the feeling. It’s twice as common in women (per the 2020 study), and it also might arise during menopause due to decreased estrogen, which impacts dopamine and helps regulate movement control, says Dr. Dasgupta. Iron deficiency can also play a role in restless legs syndrome, so make sure to get those levels checked, too.

How To Get Better Sleep During Menopause

There’s unfortunately not a one-size-fits-all solution to getting better sleep. If you’re having any challenges, especially if they’re interrupting your daily functioning, it’s not a bad idea to go to a doctor for help, says Dr. Dasgupta. You can start with your primary care doctor or OB-GYN, who can refer you to a sleep specialist if necessary (especially if you might have sleep apnea and require a sleep study).

Specifically around menopause, though, chances are you’ll be experiencing more than just sleep challenges. “These menopause symptoms don’t come in a vacuum,” says Dr. Faubion. That’s why it’s always a good idea to chat with your doctor—they can help you treat multiple symptoms and help you get better sleep.

Still, here are some options for treatments to try and chat through with your doc:

Sleep Hygiene

Sleep hygiene encompasses all those things you know you should be doing for better sleep, like turning off screens at least two hours before bedtime, avoiding alcohol and caffeine, keeping your room cool and dark, and following a regular sleep-wake schedule where you give yourself enough time in bed to actually get enough sleep, the doctors say.

While sleep hygiene is important and everyone can benefit from practicing it, it’s not exactly a treatment for insomnia, says Dr. Dasgupta. Still, if you’re having trouble sleeping during menopause, this step is the first one you should take. But if you feel like you’re doing all the “right” things and you still can’t sleep, it might be time to chat with your doc.

Cognitive Behavioral Therapy (CBT) For Insomnia

CBT is the “cornerstone” treatment for insomnia, says Dr. Dasgupta. It’s a short-term form of therapy that has been found to have moderate to large effects on improving sleep (both subjectively and objectively) and have better-lasting results than medication interventions, per a 2025 review in Current Opinion in Obstetrics and Gynecology.

CBT is about training your brain to get better sleep. Some CBT for insomnia techniques include limiting the amount of time you spend in bed to let your sleep drive build up, only using your bed for sleeping (and sex), reframing anxious or negative thoughts about sleep, using relaxation techniques like mindfulness and meditation, and practicing sleep hygiene, per a 2019 article in the American Journal of Lifestyle Medicine.

A therapist specializing in CBT for insomnia can help you learn and implement these techniques. If you can’t work with a therapist, there are some pretty helpful CBT apps out there, says Dr. Dasgupta. CBT-i Coach, Headspace, and Sleepio all offer CBT for insomnia training from the comfort of your home.

Hormone Therapy And Other Medications

Depending on your menopause symptoms, you also might benefit from hormone therapy, which involves taking supplemental hormones, say Dr. Faubion and Dr. Loeb-Zeitlin. It might be especially helpful if you’re dealing with hot flashes and night sweats. There are also non-hormonal meds like off-label gabapentin and paroxetine that can help treat side effects ranging from hot flashes to restless legs to anxiety, which all affect sleep.

After a discussion aboutall of your symptoms, your doctor and you will be able to come up with the best way forward, and hopefully, get you back to snoozing better than ever.

Olivia Luppino is an editorial assistant at Women’s Health. She spends most of her time interviewing expert sources about the latest fitness trends, nutrition tips, and practical advice for living a healthier life. Olivia previously wrote for New York Magazine’s The Cut, PS (formerly POPSUGAR), and Salon, where she also did on-camera interviews with celebrity guests. She’s currently training for her first half marathon, inspired by her many colleagues at WH who have run one.