Broken sleep is one of the most commonly reported symptoms of perimenopause, and one of the least well explained to the people living through it.
What is happening
Fluctuating oestrogen and progesterone affect temperature regulation and the depth of slow-wave sleep. Night waking is often preceded by a vasomotor event you may not consciously register.
Evidence
Cognitive behavioural therapy for insomnia has the strongest evidence base of any non-hormonal intervention for sleep in this stage of life.
Reasonable first steps
- Keep the bedroom cool — genuinely cool, not merely dark
- Keep the wake time fixed, even after a bad night
- Treat alcohol as a sleep disruptor, because it is
- Discuss hormone therapy with a clinician rather than dismissing it
You are not imagining it.
This article is educational and not medical advice. It isn’t a diagnosis or a treatment plan — talk to a qualified clinician before changing what you take.