Why Perimenopause Messes With Your Sleep (and 5 Ways to Rest Better Tonight)
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Do you ever feel exhausted but wired? You climb into bed ready to crash, only to find yourself tossing and turning… or waking up at 3 a.m. drenched in sweat, staring at the ceiling. If this sounds familiar, you’re not alone.
Lately, this has been my reality too. At first, I brushed it off — of course I was tired, I’m a mom of (almost) two-year-old twin boys! Interrupted nights had become the norm, so I chalked my restless sleep up to motherhood. But then the pieces started to click together: the middle-of-the-night hot flashes, the extra irritability, the brain fog the next day. This wasn’t just the “twin mom exhaustion” I’d been used to. Hello, perimenopause.
Sleep has felt elusive for me for the past two years (or more — twin pregnancy was its own adventure in insomnia!). But once I realized my shifting hormones were playing a role, I knew I couldn’t just keep powering through. I needed to rethink how I approached sleep and create a nighttime system that would actually support my body in this season of life. Here’s what I’ve learned about why perimenopause makes sleep so tricky — and what’s been helping me reclaim my nights.
Why Sleep Changes in Perimenopause
The hormonal shifts of perimenopause are no joke. Estrogen and progesterone, which help regulate sleep and keep our bodies cool at night, start to fluctuate. Cortisol, your stress hormone, can get thrown off too, which means racing thoughts and restless nights.
For me, the 3 a.m. wake ups weren’t just from a crying toddler anymore — I’d find myself lying wide awake with a racing mind and sweaty sheets. That’s when I realized my body needed different support than it did a few years ago.
Tips for Better Sleep During Perimenopause
These are some of the strategies that have helped me. You don’t need to overhaul your entire routine — even small shifts can make a big difference.
1. Create a Consistent Bedtime Routine
Our bodies thrive on routine, especially when hormones are fluctuating. I noticed that if I scrolled on my phone after putting the twins down, I was wired for hours. Now, I dim the lights, put my phone away, and do a few minutes of gentle stretching before bed.
✨ Tip: Pair your routine with something calming like herbal tea or a warm shower.
2. Support Your Body with Magnesium
As recommended by my provider, I started using a magnesium glycinate supplement in the evenings, and it’s been a game-changer for helping me unwind, and have better quality sleep. Always talk with your healthcare provider before starting a new supplement.
I also apply magnesium lotion to my feet before bed — it’s a little ritual that signals “time to rest” AND has helped with my restless legs! This ONE is SO good! Smells like lavender too!
3. Keep Cool at Night
Hot flashes and night sweats can make restful sleep almost impossible. I swapped my heavy comforter for a breathable cotton blanket, and it’s made a surprising difference. I also have a fan in the room that I turn on every night (fortunately my husband runs hot too and doesn’t mind these tweaks to our bedroom setup). I love this tower fan with various settings AND a remote control.
✨ Note: These are no longer evidence-based recommendations, but have personally helped me with managing hot flashes.
4. Calm a Busy Mind
I used to lie awake replaying the day or stressing about tomorrow. Now, I’m working on reading before bed to help calm my mind and shift my focus away from the to-do list. Journaling has never been something I can stick with, but if it’s a practice that works for you, it can be another helpful tool to quiet racing thoughts before sleep.
Some nights, I’ll also do a few rounds of diaphragmatic breathing AND bowel massage — two things I teach my clients for pelvic floor support that also helps signal the nervous system to relax.
My Nighttime Routine (Step by Step)
Here’s what my evenings look like now:
Skincare ritual – Once the boys are asleep, I wash my face and apply my extra skincare essentials (my current favorite, affordable night cream) — a small ritual that makes me feel like myself again.
Magnesium support – I take my magnesium glycinate supplement and apply magnesium lotion to my feet.
Wind down – I dim the lights, stretch for a few minutes, and (TRY to) keep my phone away from the bed.
Bedtime – By the time I crawl under the covers, my body feels calmer and I actually have a shot at staying asleep.
It’s not perfect every night (toddler life!), but having a consistent system has helped me feel more rested and less overwhelmed by perimenopause sleep struggles.
When to Seek Extra Support
If sleep is still elusive, it’s worth bringing up with your healthcare provider. This is beyond my scope as a physical therapist, but your PCP or GYN may suggest options like:
Hormone replacement therapy (HRT)
Cognitive behavioral therapy for insomnia (CBT-I)
A sleep medicine evaluation
Final Thoughts
Perimenopause doesn’t have to mean endless sleepless nights. With a few intentional shifts — cooling your sleep space, moving your body, limiting disruptors, and building a simple nighttime routine — you can reclaim the rest your body craves.
✨ Want more support? Download my Free Perimenopause & Menopause Guide to get practical, evidence-based strategies for navigating this season with confidence.
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Disclaimer: This post is educational and not a substitute for medical care. If you have concerning symptoms, please consult your healthcare provider.