Hormonal shifts are a root cause of menopause-related insomnia. Changes to your estrogen and progesterone levels can lead to night sweats, hot flashes, and mood changes that prevent you from sleeping soundly. Menopause hormone therapy (also known as hormone replacement therapy or HRT) includes estrogen and, if you have a uterus, progesterone, which has a sedating side effect. Both can help curb those 2 a.m. wake-ups and improve sleep quality.

Melatonin is naturally produced by your body, and its job is to signal that it’s time to sleep. During perimenopause, your melatonin levels may decrease, making it harder to get the shut-eye that you need. Taking a low dose of of melatonin before bed (studies show between 0.3 and 5 milligrams) may help improve your sleep quality so you can get some rest.

Magnesium is a mineral involved in hundreds of bodily processes, including nervous system regulation. The glycinate form is well-absorbed, and some people find it has a calming effect that helps them sleep better. 

Your body temperature naturally drops as part of the sleep process, but hot flashes and night sweats can disrupt this, keeping you awake and frustrated. Maintaining cooler temps in your bedroom at night may help support the temperature drop your body needs to fall asleep and stay that way. 

Cognitive behavioral therapy for insomnia (CBT-I) is a structured, talk-based approach that helps identify the thoughts and habits disrupting your sleep and swap them for ones that work. It’s one of the most well-researched tools available for navigating menopausal sleep struggles. You can work with a mental health provider, or you can try CBT-I apps available for your phone. 

Your body’s internal clock thrives on regularity. Going to bed and waking at the same time every day reinforces the sleep-wake cycle. Sticking to a regular schedule can make it easier to fall and stay asleep.

The stress of insomnia may cause you to reach for a cup of coffee to stay alert or a nightcap in the evenings to relax. But late-day caffeine can keep you up at night — and while alcohol may help you drift off, it actually makes it harder to stay asleep. Sleep may improve if you limit caffeine or alcohol, especially later in the day. 

Certain antidepressants, even at doses below those used for depression, may help reduce hot flashes and night sweats, contributing to better sleep.
 

Mindfulness practices can reduce symptoms like anxiety and stress, and they may also help improve your sleep. You may want to try meditating, doing yoga poses, or practicing deep breathing exercises. 

Cooling mattress toppers, bed cooling systems, or cooling sheets may help with night sweats. These may be a better option than changing the thermostat, especially if you don’t want to freeze the rest of your family. Low-cost options are available, but you can also splurge on a high-tech system.