By Ginna Johnson, NBC-HWC
Menopause is “the cessation of menses” and is often preceded by a period of perimenopause, meaning “around menopause,” that begins this transition that lasts typically four to six years before the actual cessation of menses. Perimenopause and menopause are associated with fluctuating hormone levels and a variety of potential physiological and psychological symptoms.
Sleep disturbances are a major complaint of women transitioning through menopause. Many women experience sleep disturbances during this time, which often have a negative impact on quality of life, mood, productivity, and physical health. The severity and duration of sleep difficulties during perimenopause vary greatly. Some women have occasional poor nights of sleep, which are irritating and only occasionally impact quality of life, while others have chronic and severe sleep difficulties leading to greater and prolonged negative effects on daytime functioning, quality of life, and overall wellbeing. The most common sleep-related menopausal complaints are nighttime awakenings, hot flashes, and sweating.
Managing perimenopause/menopause sleep difficulties to prevent chronic disease
Sleep deprivation in general is a risk factor for cardiovascular disease, diabetes, obesity,
neurobehavioral dysfunction, and depression, thus making it even more of a women’s health priority to manage sleep difficulties that arise during this time. The good news is there are natural ways to minimize the impact menopause has on your sleep, which include behavioral and nutritional habits.
Below are suggestions of behavioral habits/changes you can make to improve your
- Avoid clock watching.
- Develop a nightly “wind down” routine. Start to wind-down each day with a relaxing
activity at least one hour before bedtime. This practice is helpful to fall asleep and to
avoid waking up in the middle of the night.
- Develop a consistent sleep schedule. Go to bed and get up at the same time every day,
including on weekends and holidays.
- Limit blue light exposure late in the day and evening. Blue light is naturally radiated from
the sun and can be artificially emitted from phone, computer, and TV screens. It sends
triggers to the brain to tell us it is time to be awake; therefore, blue light should be
avoided 1-2 hours prior to bedtime.
- Practice light movement. Engaging in low intensity movement such as stretching or yoga
can help muscles prepare for a night of rest.
- Be mindful of intended in-bed behavior. Use the bed for sleep and sex only (not to watch
TV, hangout, or work).
- Cool your bedroom temperature. Your body temperature drops around bedtime, which
signals your body that it is time to sleep. Lowering the thermostat to between 60 and 67
degrees Fahrenheit is recommended for sleep.
- Use scents. An essential oil, such as lavender, bergamot, chamomile, or cedarwood,
used in a diffuser or as a spray on the pillow is known to be calming and reduce the
anxiety and stress that sometimes prevent us from dozing off.
Below are suggestions of nutritional habits/changes you can make to improve your
There are certain foods and drinks that hinder sleep, and some that can improve it. For
example, foods higher in natural melatonin and/or tryptophan can help promote sleep.
Specifically, during menopause, the rise and fall of certain chemicals can impact the body’s
ability to absorb nutrients. This can have negative and positive consequences. Following is a
short list of foods to avoid or include for better sleep.
Foods and drinks that are known to impair sleep:
- Alcohol – In moderation, drinking alcohol may help to relax and unwind when consumed
early in the evening. If consumed too close to bedtime (within 3-4 hours), it may
negatively impact sleep.
- Caffeine – Consuming caffeine, such as from tea, coffee, sodas, energy drinks, and dark
chocolate, can make it difficult to fall asleep and stay asleep if consumed late in the day,
close to bedtime, and/or in high quantities throughout the day.
- Large meals – Eating a large meal (particularly ones that are high in carbohydrates, fried
or sugary goods) within three hours of bedtime should be avoided. Spicy or acidic foods
may trigger hot flashes or night sweats.
Foods that may improve sleep quality (containing melatonin and/or tryptophan):
Natural sources of melatonin (the hormone that regulates the sleep cycle):
- Nuts and seeds – In particular: almonds, cashews, pistachios, walnuts, and pumpkin
- Fatty Fish – salmon, white fish, bluefin tuna, and anchovies, for example
- Tart cherries and tart cherry juice
Natural sources of tryptophan (an amino acid which the body converts into serotonin which
affects mood and sleep):
- Lean meat – Turkey and chicken
- Eggs – in any form
- Dairy – Milk (especially warm milk), plain yogurt, and cottage cheese
- Bananas (with peanut butter) – Bananas are a good source of potassium, which can help
you sleep through the night. Pair it with peanut butter, which contains magnesium and
tryptophan, for a great snack to promote sleep.
Other foods which support sleep:
- Legumes – Beans and chickpeas are high in amino acids which are important for the
production of serotonin.
- Chamomile tea – This calming beverage is rich in flavonoids, which may help improve
The transition through perimenopause/menopause can be a challenging time for many
women. This time is unique to all women, and not every woman experiences symptoms in the same way. For many, sleep disturbances are a complaint, as it can dramatically impact overall wellbeing. The use of behavioral and nutritional strategies can make noticeable and positive changes in your sleep experience during the transition through menopause. We know that good sleep impacts your body physically and mentally. – Adequate sleep is important for managing blood sugar, blood pressure, and weight, and it also allows the body to “detox” and reset for the next day. Further, quality of sleep impacts your cognitive functioning necessary for problem-solving, decision-making, focus and concentration, energy level and mood. The bottom line: prioritizing a good night’s sleep and implementing personal lifestyle habits to support it is the foundation for an energized, ready-to-take-on-the-world day!
Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition:
prevalence, impact, and management challenges. Nat Sci Sleep. 2018 Feb 9;10:73-95. doi:
10.2147/NSS.S125807. PMID: 29445307; PMCID: PMC5810528.
Baker FC, Lampio L, Saaresranta T, Polo-Kantola P. Sleep and Sleep Disorders in the
Menopausal Transition. Sleep Med Clin. 2018 Sep;13(3):443-456. doi:
10.1016/j.jsmc.2018.04.011. PMID: 30098758; PMCID: PMC6092036.
Schaedel Z, Holloway D, Bruce D, Rymer J. Management of sleep disorders in the menopausal
transition. Post Reprod Health. 2021 Dec;27(4):209-214. doi: 10.1177/20533691211039151.
Epub 2021 Nov 8. PMID: 34748453.