How to Sleep Better During Perimenopause?

It can feel like it came out of nowhere. One night you’re sleeping fine, and the next you’re tossing and turning, waking up soaked in sweat or staring at the ceiling at 3am. If that sounds familiar, you’re not imagining things — many women start noticing sleep problems during perimenopause, and there’s a real reason for it.

As your body moves through this transition, your hormone levels start to shift — especially estrogen and progesterone, the two key hormones that help you sleep well.

💧 Estrogen: Helps Keep You Cool and Calm

Estrogen does more than people think. It helps your body stay cool at night, supports your mood, and even helps with making melatonin — the hormone that tells your body it’s time to sleep.

When estrogen levels drop, your body can get confused. You may feel too hot, wake up sweaty, or just feel restless. You might also notice more mood swings or anxiety, which can keep your mind busy when all you want is peace and quiet.

🌙 Progesterone: The “Soothing” Hormone

Progesterone works like a natural calmer for your brain. It helps you feel relaxed and ready to drift off.

But during perimenopause, progesterone starts to dip too. When that happens, falling asleep can feel harder, and your sleep might become lighter. Some women describe it as always being “half awake” — like your body forgot how to fully rest.

And when both estrogen and progesterone are out of balance, stress hormones like cortisol can take over. That’s why even small worries feel bigger, and your body stays alert when you’re trying to wind down.

📊 Studies show that around 60% of women in perimenopause have trouble sleeping — often waking up in the middle of the night, feeling tired but wired, or struggling to fall back asleep.⁽¹⁾

Sleep isn’t just about being tired — it’s about your body knowing when and how to rest. And the ones giving out those instructions? Your hormones.

During perimenopause, four key hormones start shifting: melatonin, estrogen, progesterone, and cortisol. Each of them plays a unique role in your sleep cycle — and when they fall out of balance, it’s no wonder your nights feel different.

🌙 Melatonin – The Sleep Messenger

Melatonin is like your body’s gentle whisper at night: “It’s time to sleep now.”
It naturally rises in the evening and tells your brain to slow down.

But here’s the thing: melatonin works best when other hormones — like estrogen and serotonin — are in check. During perimenopause, estrogen dips, and that can mean less serotonin, and in turn, less melatonin. So you may not feel sleepy when you should, or you wake up too early and can’t get back to sleep.

Melatonin levels can also be affected by stress, blue light, and irregular routines — which all become more common in midlife.

💗 Estrogen – The Mood and Temperature Balancer

Estrogen does a lot of behind-the-scenes work to support sleep:

• It helps your body regulate temperature, so you don’t overheat at night. When estrogen falls, you might start waking up drenched in sweat or feeling too warm to rest.

• It supports the production of serotonin, which keeps your mood steady and helps convert into melatonin.

• Low estrogen is linked to lighter sleep, more midnight waking, and even increased sensitivity to sound or movement.
  
  

That’s why some women feel like they suddenly sleep “too lightly” or are always waking up — even when their body is begging for rest.

🕊️ Progesterone – The Gentle Calmer

Progesterone is often called the “soothing” hormone — and for good reason.

It boosts a brain chemical called GABA, which calms your nervous system and helps your mind slow down. Think of it like a natural sleep aid your body makes on its own.

When progesterone drops — which is common during perimenopause — that inner calm starts to fade. You might find it harder to fall asleep, or feel like your brain won’t “switch off” at night. Some women feel anxious for no clear reason. Others wake up multiple times or feel like their sleep is never deep enough.

🔥 Cortisol – The Stress Hormone That Steals Sleep

Cortisol is your “get up and go” hormone — it’s supposed to rise in the morning and fall at night. But when you’re under stress (emotionally or hormonally), that rhythm gets out of sync.

In perimenopause, estrogen and progesterone changes can cause cortisol to spike at the wrong times:

• Too high at night → can’t fall asleep

• Too early in the morning → sudden 3am wake-ups

• Too low in the day → fatigue, brain fog, low motivation
  
  

This cortisol confusion makes your body feel like it’s always “on guard,” even when you want to rest.

🌀 When Things Fall Out of Balance…

Imagine your sleep like a symphony. When all the instruments (your hormones) are in tune, everything flows. But when one starts to play off-key — or drops out altogether — the whole rhythm falls apart.

That’s exactly what happens in perimenopause.
The good news? Once you understand how these hormones work, you can gently support them — and help your body find rest again.

Sometimes, no matter how many calming teas or yoga stretches we try, sleep still feels far away. That’s where natural supplements may offer gentle support — especially when your hormones are shifting in ways you can’t control.

Below are some well-researched options that may help ease perimenopausal sleep issues. But remember: it’s always best to talk to your doctor before adding anything new to your routine.

 1. Magnesium Glycinate

What it does:

• Helps relax muscles and calm the nervous system

• May reduce night-time awakenings and improve deep sleep

• Supports bone and nerve health
  
  

Why it matters:
Many women are low in magnesium during perimenopause, especially when under stress. This mineral helps calm your body and ease tension, making it easier to fall — and stay — asleep.

 2. Black Cohosh

What it does:

• May reduce hot flashes and night sweats

• May support overall hormonal balance
  
  

Why it matters:
Night sweats often cause frequent awakenings. Black Cohosh helps regulate your body’s internal temperature and supports hormonal shifts in a gentle way.

 3. L-Theanine

What it does:

• Promotes relaxation without drowsiness

• Helps ease stress and racing thoughts at bedtime
  
  

Why it matters:
When hormonal changes make your mind feel overstimulated or anxious, L-Theanine brings calm without making you groggy the next morning.

 4. Vitamin B6 (part of B-Complex)

What it does:

• Supports serotonin production (a calming brain chemical)

• May help with mood swings, anxiety, and insomnia
  
  

Why it matters:
Fluctuating hormones can deplete B6, affecting your mood and sleep. Replenishing it helps keep emotions steadier and nights more restful.

 5. Melatonin

What it does:

• Signals your body to fall asleep and stay asleep

• May improve sleep onset and quality
  
  

Why it matters:
Melatonin naturally declines as we age — and perimenopause can disrupt its rhythm further. A small supplement can help reset your sleep cycle gently.

 6. Maca Root

What it does:

• Supports adrenal glands and stress response

• May help balance hormones naturally

• Some women report fewer night sweats and better sleep
  
  

Why it matters:
Maca acts like a natural “balancer” — helping your body cope with stress and hormonal dips without acting like estrogen itself.

 7. Passionflower

What it does:

• Has mild sedative effects

• May help with anxiety and nervous restlessness at night
  
  

Why it matters:
If you lie awake feeling tense for no clear reason, passionflower’s gentle calming effect can help your nervous system settle down.

 8. Diindolylmethane (DIM)

What it does:

• Supports estrogen metabolism in the liver

• Helps the body process excess estrogen or estrogen dominance
  
  

Why it matters:
During perimenopause, estrogen often rises and falls unevenly. DIM helps your body clear excess amounts and stay more balanced — which can reduce both mood swings and sleep issues.

 9. Omega-3 Fatty Acids

What it does:

• Supports mood regulation

• Reduces inflammation and may improve sleep quality
  
  

Why it matters:
Healthy fats help your brain, hormones, and mood all stay more stable. Omega-3s may also support deeper, more restful sleep by calming internal inflammation.

10. N-Acetyl Cysteine (NAC)

What it does:

• Boosts antioxidant levels

• Supports mood, liver health, and detox pathways
  
  

Why it matters:

Your liver helps process hormones, and NAC supports that work. It can also help manage low moods and keep your body feeling more balanced overall.

Even though sleep troubles are common during perimenopause, that doesn’t mean you have to “tough it out” or accept restless nights as your new normal.

Here are some gentle signs that it might be time to reach out for professional support:

🛌 You struggle to fall asleep or stay asleep most nights

Especially if it’s been happening for more than 3 weeks and nothing seems to help.

🌡 You’re waking up drenched in sweat or overheated

If night sweats are waking you up multiple times and disrupting your rest, your hormones might need extra support.

😓 You feel anxious, down, or emotionally overwhelmed

Sleep and mood are deeply connected. If insomnia is making you feel emotionally fragile, it’s worth speaking to someone who understands hormonal health.

💊 You’ve tried multiple lifestyle changes with no real improvement

Sometimes natural strategies just aren’t enough — and that’s okay. You might benefit from hormone testing, targeted supplements, or medication.

😴 Daytime fatigue is affecting your ability to function

If you’re feeling constantly foggy, forgetful, or exhausted during the day, even small tasks can feel like too much. That’s a clear sign to get help.

Medically reviewed by Clair Johnson, Hormone & Nutrition Coach