Insomnia in Perimenopause

There are very few things more important than sleep. You know that, especially if you're not getting enough.

Unfortunately, many of my fellow perimenopausal travelers in their 40s and 50s are not getting enough. Suddenly you're 44 and your sleep is disrupted by awakenings at 2am, 3am, 4am. The most common patterns fall into one of two categories of altered sleep architecture: poor sleep maintenance (the afore-mentioned awakenings, often with the mind racing and the editor telling you all the ways in which you fall short of expectations) or poor sleep latency (e.g., they have adrenal dysregulation and get a second wind at night, which keeps them up late and unable to fall asleep).

The short version for perimenopausal seekers of a good night's sleep is the following.
1. Stop all caffeine
2. Get regular cardiovascular exercise, preferably 5-6 days per week for 45 min at moderate to high effort
3. Stop all wine
4. Sleep in a room at 64 degrees F or cooler
5. Consider daily estrogen and progesterone. Micronized progesterone has been shown to be the most effective.

These simple 5 steps are non negotiables if sleep is elusive. I've had many patients retort that they just have one cup of black or green tea in the morning, or just one glass of wine at dinner. Yes, even one serving makes a difference.


Artificial lights put us out of sync with nature. Limit your exposure at night. Get all LEDs out of the bedroom. Sleep in a very, very dark room at 64 degrees. For more data on how to eat, the effect of carbs, and best ways to game sleep, consider reading TS Wiley's Lights Out. Or join our next Gottfried Center Cleanse -- it's amazing how the group structure assists us with getting off of toxins such as caffeine, sugar and alcohol, and deeply benefits your sleep.

And if you're part of our current Cleanse-in-Progress, let us know how you're sleeping!