How Can I Sleep Better During Menopause? Your Comprehensive Guide to Reclaiming Rest

Are you on your phone right now? Maybe it’s around 3:00 AM. Your partner is asleep beside you, and you’re lying there, staring at the ceiling.

Take one more big breath. You are not losing your mind. And this isn’t just about getting older.

Menopause affects millions of women. The place that used to help you relax can start to feel uncomfortable or restless. You may find yourself unable to go to sleep. Or, you will fall into a quick slumber but wake up after a couple of hours. Your heart races. You may begin to get hot (and possibly even sweating) and then lie there wide awake until the first light of dawn.

It’s tiring and infuriating.

Poor quality of sleep has an impact on every aspect of your being. Poor sleep doesn’t just leave you tired. It can affect your mood, metabolism, focus, and even your relationships.

However, since the 1960s and ‘70s, the medical community pretty much dismissed women’s complaints regarding poor sleep during menopause. Many doctors would say something like “you should wear lighter pajamas” or give you a prescription for some type of sedative. 

These medications leave many women feeling tired and foggy and out of touch with reality. We understand scientifically exactly why your sleep cycle falls apart during menopause and most importantly, we have tailor-made interventions based on science to restore it.

This complete guide is designed to break down what biologically sabotages your sleep patterns, provide information from major women’s health studies across the country, and help answer perhaps the most asked question: How do I get better sleep during menopause? 

From changing your sleep environment to learning about Cognitive Behavioral Therapy for Insomnia (CBT-I), using transdermal magnesium sprays and sleep patches, we’ll cover everything you need to help you regain control over your sleep.

Sleep problems are caused by many different things. To solve a problem, you need to know what caused it. Women have a very specific relationship between their bodies’ biological systems and sleep. Their hormones control how their circadian rhythms work, regulate their core body temperature and function as key regulators of the central nervous system.

In addition to controlling fertility, women’s hormones also regulate their bodies’ sleep cycles. Therefore, when a woman enters her perimenopausal stage (transition from fertile period to the menopause), her ovaries do not gradually shut down. 

Instead, the ovaries produce large amounts of hormones that fluctuate wildly, sometimes skyrocketing and then dropping like a stone, before finally shutting down completely in menopause. All of this wild hormone production can seriously disrupt a woman’s sleep patterns.

One of the first hormones to significantly drop in perimenopausal women is progesterone. And once that happens, women really miss the natural sedative effects of that hormone.

Progesterone works as a natural sedative due to its ability to calm the central nervous system (CNS). The way this occurs is through the action of GABA (gamma-aminobutyric acid) receptors within the brain. As such, progesterone has been labeled as “nature’s valium”.

GABA helps calm your brain and slow things down, which makes it easier to fall asleep and stay asleep. Lowering your brain wave rate decreases your anxiety, while also allowing you to quickly fall asleep into deep and restful sleep.

With the dramatic drop in progesterone levels, there is less GABA available to perform these functions. Since GABA cannot function appropriately without adequate progesterone present, women will find themselves wide awake and their brains will be firing wildly, making it very hard for them to relax and go to bed.

Estrogen is the ultimate caretaker of the female body, playing a massive role in regulating the hypothalamus, the small, almond-sized region at the base of your brain that acts as your body’s central thermostat.

If estrogen drops dramatically, the hypothalamus begins to lose its way. It becomes more sensitive to small changes in temperature, which can trigger hot flashes and sudden wake-ups. When that happens, your body reacts quickly to cool itself down.

Hot flashes, often referred to as night sweats, are a big problem for many reasons. They cause discomfort, create an inability to achieve good-quality sleep, and each time a woman experiences a hot flash, an adrenaline burst occurs within their body. An adrenaline response is given to us when our body perceives a threat or risk in our environment.

Melatonin is the hormone that is secreted by the pineal gland that regulates our sleep-wake cycle. It basically tells us when we should go to sleep. Like other hormones, however, melatonin levels naturally begin to decline with age in both men and women. 

However, because estrogen and progesterone play a supporting role in melatonin production, declining hormone levels cause women to have reduced melatonin levels as well, resulting in weaker biological sleep drives.

Postmenopausal women are 2-3 times more likely to suffer from obstructive sleep apnea than premenopausal women, according to Johns Hopkins Medicine experts. High levels of estrogen and progesterone helped protect the muscle tone of the airway. After these hormones disappear, the airway tends to collapse and partially cut off breathing during sleep.

This partial blockage results in a lack of oxygen to the brain. As a result, the brain panics and temporarily awakens the sleeper to breathe. Many women do not realize they awaken during this time. However, the brain is still being triggered multiple times per hour.

Menopause causes sleep disturbances. We’re not just talking about anecdotes - the SWAN study has some pretty amazing statistics.

A recent, national multi-site study called The Study of Women’s Health Across the Nation (SWAN) was conducted over many years to track the health of thousands of American women transitioning into menopause. The data clearly shows a strong link between menopause and sleep disruption.

According to the data collected by the SWAN researchers, significant increases in sleep disturbances occur among women as they go through the menopausal transition. Between 43% and 69% of women reported sleep issues, and about one-third met the criteria for insomnia.

It’s also interesting to note how the SWAN researchers gathered objective measures of each woman’s sleep patterns and discovered a consistent, identifiable pattern: rather than having trouble falling asleep, most women in this age group consistently woke up multiple times during the course of the night and woke up before they wanted to.

While many women may be able to fall asleep once their heads hit the pillow at 10:00 PM, according to the SWAN researchers’ studies, there is a direct correlation between the frequency of hot flashes/night sweats/early morning awakening experienced by these women during the perimenopausal phase, and the likelihood of experiencing chronic sleep disorders for years after reaching full menopause.

Learning about how menopause affects your body and accessing information on what’s happening in your body can certainly provide some comfort. However, this knowledge will not alleviate your fatigue. There are many other factors at play when treating insomnia caused by menopause. 

Hormonal changes cause fluctuation in hormone levels. Your body temperature is regulated. And your nervous system is stimulated. For these reasons alone, you cannot treat your insomnia using just one strategy. You must develop a multi-strategy approach to establish a “sleep protocol.”

One of the first things to fix is your sleep environment. It is the nighttime sweating, especially during those very early morning hours (like 3:00 AM), that is probably causing you to wake up at night.

• The 65-Degree Rule: Lower your bedroom temperature below the rest of your home. All sleep professionals agree that there are only two acceptable temperatures for your bedroom: 60°F to 67°F (15°C to 19°C).

• Breathable Bedding: Only use bedding that breathes. This means when you choose bedding, make sure you can get air through it. You can choose bedding made with natural fibers. When you start flushing, you can always take off one layer of bedding.

• Cooling Technology: If you suffer from extreme nighttime sweating, there are active-cool mattress pads that can cool the water circulating through them so they pull heat off the middle of your body and reduce sweating.

Magnesium plays an important role in many processes in the body and may help support relaxation and sleep. Not only is it a critical component in many biochemical reactions in the body, but it also plays a key role in over 300 different biochemical reactions. Moreover, magnesium is truly a “miracle” mineral for women undergoing menopause.

Magnesium plays several roles that help with menopausal insomnia. 

Firstly, magnesium stimulates your parasympathetic nervous system which aids in both relaxation and digestion. 

Secondly, magnesium binds to GABA (gamma-aminobutyric acid) sites within your brain. This creates the same calming and sleep-promoting effects on your brain that were previously provided by declining progesterone levels. 

Finally, magnesium causes muscle relaxation, which often occurs when women experience restless leg syndrome or muscle spasms during their menopausal transition.

Oral magnesium supplements, particularly inexpensive forms like magnesium oxide, have poor absorption rates. Once ingested orally, they pass through the digestive system, where acidic gastric juices destroy much of the magnesium. What remains unabsorbed in the digestive process then enters the small intestine, where it absorbs water from surrounding tissues, resulting in bloating, cramping and diarrhea.

As the plusOne brand continues its dedicated pivot into comprehensive female wellness and healthcare, prioritizing bioavailable symptom relief has become a paramount goal. This led to the development of the plusOne Restful Magnesium Sleep Spray.

By applying magnesium topically to the skin, you bypass the digestive system entirely. The mineral is absorbed directly through the epidermis into the cellular tissue and the localized bloodstream. 

Applying a few sprays of the plusOne Restful Magnesium Sleep Spray to your calves, the soles of your feet, or your stomach 30 minutes before bed delivers rapid muscle relaxation and nervous system soothing without any of the gastrointestinal distress associated with pills. It is a targeted, immediate intervention that physically prepares your body for deep rest.

Menopausal insomnia isn’t always about falling asleep. For a lot of women, it’s staying asleep that’s harder. Sleep aids or melatonin can help at the start of the night, but the effect doesn’t always last. By around 2:00 AM, it can wear off, and that’s when a hot flash or sudden wake-up can happen. Before you know it, you’re awake again at 3:00 AM, struggling to fall back asleep.

That’s where longer-lasting support can make a difference. Sleep patches work differently since they release ingredients slowly through the skin instead of all at once.

The plusOne Blissful Sleep Patch uses that kind of steady release. It delivers a small amount of calming ingredients like L-theanine and valerian extract over several hours, around 8 to 12. That steady support can help reduce those middle-of-the-night wake-ups and make it easier to fall back asleep if you do wake up.

After months of poor sleep, your brain can start to associate bedtime with stress instead of rest. At this point, you begin to fear going to bed. The place where you are supposed to relax and go to sleep becomes the source of tension and frustration.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is now recognized by the American College of Physicians as the definitive first-line treatment option for chronic insomnia, far superior in the long-term compared to any prescribed sleep aid. CBT-I is designed to work with a trained professional or utilize a structured online program to relearn how your brain associates with sleep.

Key components of CBT-I include:

• Stimulus Control: If you’ve been awake for approximately twenty minutes (or when you cannot stay in bed), you should leave your bedroom and go to another area where you can engage in relaxing activity at a low level of effort such as reading in dim lighting until you begin to feel drowsy once again. The purpose of this is to stop the habit of lying in bed while being awake and teach your body to relate your bed to sleeping.

• Sleep Restriction: Spending less time in bed than the amount you actually sleep. If you usually sleep for about five hours but spend more time in bed than that, reduce your total bedtime by a small amount to assist with falling asleep quickly and less frequent nighttime awakenings.

• Cognitive Reframing: Attempt to recognize and challenge those types of thinking which cause your mind to continue racing (i.e., concern about a poor night’s sleep negatively impacting the subsequent days). Thoughts such as these can produce a feeling of increased alertness within the body and can contribute to difficulty drifting off into a state of deep sleep.

What you do at 10:00 AM profoundly impacts how you sleep at 10:00 PM. Menopause drastically narrows your margin of error for poor lifestyle choices.

• The Alcohol Trap: Although drinking a small amount of wine may improve your chances of going to sleep sooner because of its effects on the central nervous system, once your body begins to break down the alcohol it creates a rebound arousal effect.
  It also has a tremendous effect on disrupting REM (Rapid Eye Movement) sleep and increasing both hot flashes and night sweats. Therefore, alcohol use should be stopped completely as soon as possible, especially during the final couple of hours before bedtime.

• Caffeine Curfews: Caffeine stays in your system longer than most people expect. On average, a person can still have about half the caffeine in their system hours after a cup of coffee by the end of the night. Thus, many people limit themselves to no consumption of caffeinated products beyond 11:00 AM.

• Morning Sunlight: Your body uses light to know when to wake up and when to sleep. Go outside once you have woken up and get some sunlight exposure. Two to three minutes is enough for your body to get a sense of daylight. When your eyes are exposed to sunlight (your face), your body sends a message to your brain telling you that it’s a new day. 

You’ve worked to improve your sleep environment, eliminated alcohol use, used topical magnesium spray and sleep patches, and taken excellent care of your sleep hygiene. Then, you continue to experience extreme levels of sleep deprivation. That’s a good time to speak with a doctor.

Hormone Replacement Therapy (HRT): Hormone Replacement Therapy (HRT) is most helpful for women who are experiencing severe hot flashes throughout their day and night, as well as heavy sweats due to the hot flashes causing them sleep disturbances, so that they can fall into deep sleep. 

HRT involves administering bioidentical estrogen and progesterone through systemic means. This results in stabilization of the "malfunctioning" thermostat located in the hypothalamus.

Sleep Studies: If you wake up feeling tired and your partner mentions you have been snoring loudly throughout the night, or you're making unusual respiratory sounds while you are sleeping, schedule a polysomnogram (a sleep study) as soon as possible. 

Untreated sleep apnea can put ongoing strain on your cardiovascular system over time. Treatment options, such as a CPAP machine or a custom-made oral device, can help improve sleep quality and support overall health.

There has been an enduring and medically unsound social misconception that, because of menopause, you will have to experience years of debilitating fatigue. Menopause presents many challenges; however, it does not present an unmanageable challenge.

By understanding why you’re having difficulty sleeping (progesterone’s decline as a neuroprotectant or the failure of your thermostat as a result of low estrogen), you’ll finally cease to beat yourself over the head concerning how tired you feel and focus on addressing the biological basis of your poor sleep.

Take a holistic approach. Optimize your bedroom temperature, strictly adhere to good sleep hygiene habits, consider utilizing topically-administered products such as plusOne Restful Sleep Magnesium Spray to relax your nervous system and utilize the consistent release of the Blissful Sleep Patch to prevent those awful 3:00 AM awakenings.

Your sleep is valuable. Quality sleep is essential to preserve your ability to think clearly, maintain emotional resilience, and enjoy optimal physical well-being. Do not accept chronic fatigue as part of your “new” norm. You have control over your life. Be proactive. Put these science-based solutions into action. And reclaim the quality of the deep and restorative sleep that you deserve.

This content is for informational purposes only and is not intended as medical advice. Please consult a qualified healthcare provider regarding any medical concerns or conditions.