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If you’ve found yourself wide awake at 2 a.m. after years of sleeping soundly, perimenopause may be the reason. Hormonal changes can make restful sleep feel just out of reach. A 2024 survey found that half of women ages 45 to 64 said menopause symptoms disrupted their sleep at least sometimes.
Many women look into natural remedies for relief before turning to medical treatments. Research on some supplements and herbal remedies for perimenopausal symptoms shows promising results. However, more research is needed to know whether these remedies help with menopause insomnia.
Here’s what to know about sleep changes during menopause and how natural remedies may help you get better rest.
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Sleep problems during perimenopause are often related to changes in estrogen and progesterone levels. These hormonal changes affect the body’s sleep-wake cycle, temperature, and mood.
Estrogen helps control body temperature and affects serotonin, which plays an important role in sleep and mood. Progesterone has a calming effect that helps you fall asleep. Many women have trouble falling asleep and staying asleep as these hormone levels drop.
Another major cause is vasomotor symptoms, such as hot flashes and night sweats. Hot flashes can wake many women several times a night and disrupt their sleep.
Lower estrogen and progesterone levels can also weaken the throat muscles and raise the risk of obstructive sleep apnea (OSA). OSA is a sleep disorder in which the airway becomes blocked by the tongue or soft tissue in the throat, causing pauses in breathing. These breathing pauses can wake people several times during the night.
With so many supplements marketed for sleep, it can be hard to know which ones are worth trying. Although supplements can’t reverse the hormonal changes that happen during perimenopause, some may help improve sleep quality.
Talk with your doctor before adding supplements or herbal remedies to your routine. Some supplements may interact with other medications or cause serious side effects if used incorrectly.
Melatonin is one of the most popular sleep supplements. It is a sleep hormone naturally made in the brain that helps control the body’s circadian rhythm. This is your internal clock that tells your body when to sleep and wake up.
Low estrogen levels can cause melatonin levels to drop, which can affect your sleep-wake cycle. Research suggests that melatonin supplements may improve overall sleep quality in postmenopausal women who have sleep problems.
However, studies have also found that women who sleep well generally don’t seem to get extra benefits from taking melatonin. More research is needed to better understand melatonin’s role in women in perimenopause.
Melatonin is generally considered safe for short-term use. Daytime sleepiness is the most commonly reported side effect.
Magnesium is an essential mineral that helps your muscles relax.
Research suggests that magnesium supplements may help improve sleep quality in people who already have trouble sleeping. Research specifically involving women in perimenopause and menopause is limited.
Magnesium may be helpful for women whose sleep is disrupted by muscle cramps and symptoms of restless legs syndrome (RLS). RLS is a condition that causes an uncomfortable urge to move your legs, often while resting or at night. Magnesium may help ease muscle tension.
Most healthcare providers consider magnesium safe for healthy adults when taken at the recommended doses. Too much magnesium can cause diarrhea or gastrointestinal upset.
Lavender is widely studied for use in aromatherapy. While it won’t cure menopause insomnia, some research has found that using lavender aromatherapy before bed may help decrease anxiety and ease hot flashes, making it easier to sleep. However, more research is needed.
Found naturally in the leaves of the tea plant Camellia sinensis, L-theanine is an amino acid that may help you relax. Some studies suggest it may improve sleep quality. However, research in women going through menopause is limited.
Some women also try herbal teas, like chamomile, or supplements such as black cohosh, to help ease perimenopausal symptoms, which may make it easier to sleep. These herbal remedies may help, but they don’t treat the underlying hormonal changes.
For some women, menopause hormone therapy (also called hormone replacement therapy or HRT) may be another option to consider.
Some sleep problems related to perimenopause are directly caused by changing hormone levels.
For women whose sleep quality is affected by hot flashes and night sweats, HRT may significantly improve sleep quality by helping them sleep more deeply and wake up less often during the night.
Hormone therapy may not be appropriate for everyone, so it’s best to talk to your healthcare provider to see if it could be a treatment option for you.
Healthy sleep habits can make a big difference over time, whether or not you take supplements or hormone therapy.
Try these habits to support better sleep:
✓ Avoid caffeine and alcohol close to bedtime — They can worsen hot flashes and keep you awake.
✓ Follow a consistent sleep schedule — Try to go to sleep and wake up at the same times each day.
✓ Create a relaxing bedtime routine — Deep breathing, meditation, or a warm bath or shower can help you unwind before bed.
✓ Limit noise and distractions — Keep your bedroom dark and cool, and use your bed only for sleep.
If you’re looking to improve your sleep without medication, you may want to consider cognitive behavioral therapy for insomnia, or CBT-I. CBT-I teaches you how to improve sleep by changing behaviors and thought patterns that might make it difficult for you to fall or stay asleep.
CBT-I is usually the first treatment doctors recommend for long-term insomnia. Multiple studies have shown that CBT-I can improve sleep quality in women with menopause insomnia. Its benefits may also last longer than those of medications or supplements.
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