When Sleep Goes Missing: Understanding Insomnia During Menopause

By Amy Van Arsdale, Ph.D., Clinical Psychologist

Tired but can’t sleep? You’re not imagining it — and you’re not alone.

For many women, menopause brings an unexpected nighttime challenge: sleep that used to come easily suddenly becomes harder to find. You may lie awake for hours, wake up several times during the night, or find yourself wide awake at 3 a.m. and wondering why.

The good news? Though poor sleep during menopause is common, there are ways to improve it.

Why Is Menopause Affecting My Sleep?

Hormonal changes during perimenopause and menopause can affect the body’s ability to regulate temperature and maintain sleep. Hot flashes and night sweats may wake you up, while changes in mood, stress, or anxiety can make it harder to fall back asleep.

Even without night sweats, some women notice that their sleep simply becomes lighter or more interrupted.

Start with a Few Simple Changes

You don’t need to completely overhaul your life to support better sleep. Try:

• Keep a consistent schedule: Go to bed and wake up around the same time each day.
• Cool things down: A cool bedroom, breathable bedding, and lightweight sleepwear may help with night sweats.
• Watch afternoon caffeine: Coffee, tea, energy drinks, and some medications can interfere with sleep.
• Move during the day: Regular physical activity can support healthier sleep.
• Create a bedtime ritual: Give yourself 30–60 minutes to unwind with calming activities such as reading, stretching, or breathing exercises. Avoid bright screens before bedtime.
• Don’t lie awake indefinitely: If you can’t sleep, get up briefly and do something quiet in dim light until you feel sleepy.

How Can a Psychologist Help?

If sleep problems continue for weeks, leave you exhausted during the day, or interfere with your work, relationships, or quality of life, talk with your healthcare professional. Many women turn to alcohol or cannabis to help them sleep, which may feel like a quick fix but can cause long-term sleep disruptions.

Fortunately, you have other options. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective, evidence-based treatment for chronic insomnia. And remember: persistent sleep problems aren’t always caused by menopause. Stress, anxiety, and depression can also affect sleep.

As a clinical psychologist, I use CBT-I as just one component of a patient’s individualized treatment plan to promote better sleep and overall emotional health. Together with the collaborative care team at Well&Boulder, you can feel rested again.

Menopause is a natural transition — but struggling to sleep night after night doesn’t have to become your new normal. Pay attention to your symptoms, make sleep a priority, and don’t hesitate to ask for support.