As a hormone therapist, Suzanne speaks daily with women who notice that menopause increasingly affects their sleep, mood, energy, and daily functioning. In this column, she shares anonymised stories from her practice to provide recognition, highlight the factors that may play a role, and offer women practical pointers to explore further on their own.
Janna shared that she almost didn’t dare check the clock anymore when she woke up at night. It was almost always the same time. Around three o’clock, her eyes would open, and then the waiting for morning would begin. She sat across from me, trying to make light of it. But it didn’t really work. “I just wake up every night around three o’clock. And then I’m wide awake.”
Not just a little drowsy, the kind of moment where you turn over and drift back to sleep. She felt clear and alert. As if, for her, the night was over at that point. People often asked her if she was lying awake worrying. She had to admit that the answer was yes. There was always something to think about: the kids, her job, something that still needed to be arranged. But that wasn’t new. According to Janna, she had always been “a real thinker.” The difference was that it hadn’t woken her up in the middle of the night before.
At first, she thought it was temporary. A busy period, a bit more stress, or just bad luck. But the broken nights kept coming back. She tried everything: valerian, a warm shower, eating something before bed, not eating anything at all, and melatonin. Sometimes it seemed to help for a while. Then she’d be sitting upright in bed again.
She also started noticing it during the day. She was still functioning, but everything took more effort. Her concentration waned more quickly, stimuli hit her harder, and the fatigue didn’t seem to go away, no matter how early she went to bed. And there was something else she was almost ashamed to admit.
“My husband snores terribly, and I get annoyed at how easily and soundly he sleeps. Awful, isn’t it?”
Because Janna had always been a good sleeper, she couldn’t understand why things had suddenly changed.
What stood out to me about Janna was that it was no longer just about the broken nights. The expectation that she would wake up again had also started to play a role. Going to bed no longer felt naturally relaxing. There was always an underlying thought: I’ll probably wake up again. And as soon as she was awake, her thoughts had free rein.
Hormonal changes during menopause can affect your sleep. You might sleep more lightly, wake up more often, or find it harder to fall back asleep. That doesn’t mean every sleep problem is automatically caused by menopause.
With Janna, we also looked at her daily stress levels, her worrying, and the tension that had developed around sleeping. The combination was particularly striking: she would wake up, feel immediately alert, and her thoughts would start racing. At the same time, she increasingly went to bed expecting it to happen again.
With Janna, I didn’t just look at the time she woke up but also at what happened before going to bed and after waking up.
We started with her sleep-wake rhythm. Janna began going outside earlier in the morning to get daylight exposure and tried to go to bed and wake up at the same time every day. In the evenings, she limited exposure to bright light from screens. These weren’t major changes, but they were adjustments she could maintain daily.
Additionally, she practised calm breathing during the day. Not just when she was lying awake at three in the morning, desperately trying to fall back asleep, but during moments when nothing was wrong. This way, she consciously built in moments of relaxation during the day, making relaxation less of a task that had to succeed only when the night went wrong.
We also looked at her diet. We focused on a pattern that kept her blood sugar levels as stable as possible throughout the day. Not because diet was the sole explanation for her broken nights, but because I like to take a broader view of factors that can influence energy, tension, and recovery.
I also recommended magnesium and ashwagandha, tailored to her situation. Ashwagandha was used in her treatment as support for stress and sleep. Magnesium was also part of the approach to relaxation and sleep. When it comes to supplements, I always consider the individual’s personal situation, including health, medication use, and potential interactions.
For Janna, this mainly meant stopping the search for that one solution to fix her nights. Instead, we looked at the patterns surrounding her sleep and chose various changes that suited her situation.
When I spoke to Janna about eight weeks later, she came in enthusiastically. She had taken the advice seriously, from her sleep rhythm and breathing exercises to the dietary changes and supplements. She was determined to break the pattern. Not everything changed immediately.
At first, she noticed that she sometimes fell back asleep more easily after waking up. Then there were nights when she slept through for longer stretches. Other times, she still woke up but spent less time waiting for morning. There were also more mornings when she felt less exhausted.
Eventually, there were even nights when she slept through entirely. In hindsight, we can’t say that one specific adjustment was responsible for this. Janna made several changes at once, and sleep is influenced by multiple factors.
What stood out to her most was that the night felt less daunting. She no longer went to bed with the same tension. And if she did wake up, she was less likely to get caught up in the thought that the rest of the night was ruined.
She also noticed differences during the day. She felt less rushed, and the fatigue weighed less heavily on her days. Waking up at night didn’t disappear overnight. But the fixed pattern that her nights—and days—had increasingly revolved around gradually lost its grip.
What I mainly want to convey from Janna’s story is that when dealing with poor sleep, you don’t have to focus solely on the hours you spend in bed. What happens before, during, and after sleep can also provide valuable insights.
Do you wake up regularly? Keep track for a few days of when it happens and what you notice. Are you wide awake immediately? Do you start worrying? Are your nights different after busy days? And do you go to bed and wake up at roughly the same time? A small overview like this can help you recognise patterns.
If sleep problems persist or you increasingly notice their impact on your daily life, it’s worth exploring what might be going on. Menopause can significantly affect your sleep. But that doesn’t mean everything you experience is automatically related to it.
What worked for Janna may not be the right approach for another woman.
Poor sleep can be linked to menopause. Stress, medication, sleep habits, and other physical causes can also play a role. Especially when sleep problems are new, persist for a long time, or affect your daily functioning, it’s wise not to jump to a single explanation too quickly.
On SeeMe-nopause, you can read more about poor sleep during menopause and lifestyle changes you can try yourself. If you also have other symptoms, it may help to consider them in relation to one another.
An intake through SeeMe-nopause can help you better understand your situation and determine the next steps that suit you.
This article is based on the practical experiences of a specialist. To protect the patient’s privacy, the name and identifiable details have been changed. The information in this article is intended for educational purposes and does not replace personal medical advice.
