As women, we’re no strangers to hormonal changes, but unfortunately for us, sleep is one of the very first things to suffer when our hormones shift… and it’s one of the hardest to actually get back on track.
Fluctuations in estrogen and progesterone, especially, can wreak havoc on our rest at any point during our lives, whether it’s part of our menstrual cycles, pregnancy, postpartum period, or menopause transition. It’s all a bit unfair as far as I’m concerned, but understanding what is happening (and why, and when) is the first step toward finding the right approach that will support your sleep and help you to wake up feeling like yourself again.
Table of Contents
Table of Contents
How (and when) do Hormonal Changes Affect Your Sleep?
Hormonal changes can affect your sleep at virtually any point during your life, and common problems you might experience include insomnia, early waking, light or fragmented sleep, night sweats, hot flashes, vivid dreams, restless leg syndrome, anxiety, and even sleep apnea.
There are four particular hormones that can affect your sleep the most.
- Estrogen: This not only helps your body to regulate its temperature overnight, but it also helps to promote REM sleep. When estrogen levels decline, you might experience hot flashes, night sweats, fewer hours of sleep with more frequent waking, and a lower quality of rest that leaves you feeling more fatigued during the day.
- Progesterone: This hormone acts as a natural sedative, promoting relaxation and helping to induce sleep. When progesterone levels decline, so does the sedative effect, which can contribute to insomnia, restlessness, and anxious thoughts when you’re trying to go to sleep.
- Melatonin: Your body releases more melatonin at night to promote sleep, but when estrogen levels decline, melatonin production does too. When that happens, you might find yourself falling asleep later at night or waking up later in the morning, or experiencing general insomnia.
- Cortisol: This is known as the “stress hormone” because it’s responsible for your body’s fight-or-flight response. Higher cortisol production is most common during perimenopause and menopause, when it can disrupt your body’s natural circadian rhythm in conjunction with lower melatonin production. Where melatonin normally increases at night and decreases during the day, cortisol is supposed to decrease at night (to promote sleep) and increase during the day (to promote wakefulness). When cortisol levels are high, the length of restful sleep can decrease and you might find it harder to fall asleep, period.
Any or all of these hormones can fluctuate at various points in your life, whether it’s related to your menstrual cycle, pregnancy, postpartum, or during the menopause transition.
Menstrual Cycle
During the second phase of your menstrual cycle, which is the stretch after ovulation and until your period begins, progesterone increases and estrogen drops. The increase in progesterone can lead to drowsiness, but the decrease in estrogen can reduce REM sleep.
Just before menstruation, however, hormone levels drop sharply, which can make it harder for your body to regulate its temperature (causing night sweats or even hot flashes), and you might find it difficult to fall asleep or stay asleep.
Pregnancy
The worst sleep disruptions during pregnancy generally occur in the first and third trimesters, although they can happen at any point along the way.
During the first trimester, high levels of progesterone can cause excessive sleepiness and disrupt your normal sleep cycle. Estrogen also slowly increases during this phase, which can affect your mucus membranes, leading to nasal congestion, snoring, and breathing-related disorders during sleep.
During the third trimester, you’re not only dealing with all the physical changes that make it harder to get comfortable (and stay that way), but by 36 weeks, cortisol levels are increased at night, causing insomnia and highly-disrupted sleep overall.
Restless leg syndrome is especially common during the third trimester. My personal biggest problem was leg cramping at night. There was nothing worse than stretching my leg to get comfortable and launching it into a full-on, wake-me-out-of-a-dead-sleep cramp.
I don’t miss that. Not even a little.
Vivid dreams (and not always pleasant ones) are common throughout pregnancy, in part due to hormonal changes because of the effect they have on your sleep, particularly the frequent-waking part. When your REM sleep is disturbed and you wake up during a dream, you’re going to be more likely to remember it, for better or worse.
And, depending on the intensity of the dream, falling back to sleep might be a challenge. (I won’t scare you with any of the pregnancy dreams I had, but it’s safe to say they definitely kept me awake at night.)
Postpartum
After childbirth, estrogen and progesterone naturally drop, which can literally cause postpartum hot flashes. But if you’re breastfeeding, increased prolactin, the hormone that promotes lactation, can lower your estrogen levels even more.
On top of all of that, though, you’re also taking care of a newborn who has their own sleep/wake cycle, leaving you with even more fragmented sleep.
Menopause Transition
This is probably the most obvious hormonal change of all, but during perimenopause and menopause (known together as the menopause transition), the drop in estrogen and progesterone, along with decreased melatonin and increased cortisol (especially in late menopause) can lead to everything from hot flashes, night sweats, mood swings, anxiety, and a disrupted circadian rhythm.
The real bear of the menopause transition is that it may last for years, and symptoms can rise and fall like the tide.
Or the world’s worst roller coaster.
Tips for Getting Better Sleep Despite Hormonal Fluctuations
There are many ways to support your sleep and the best methods will ultimately depend on what you’re dealing with, specifically, in terms of causes and symptoms.
Optimize your Sleeping Environment
This really comes down to doing the things that help you to fall asleep and stay asleep the best, so consider what you need from your sleep environment, and incorporate those things:
- Blocking light from the windows, either with blinds or blackout curtains if need be.
- Using a white noise machine to block neighborhood sounds, if those tend to keep you awake at night. Sound machines that have various nature options (babbling brooks, rain, cicadas and night insects, whatever) can be relaxing if you prefer those.
- If your partner snores, there’s no shame in using ear plugs to mitigate noise. If you worry about not hearing your alarm clock, get one that vibrates the bed.
- Keeping your bedroom cooler at night, either through open windows, a fan, or air conditioning.
- Using bedding that’s comfortable against your skin, especially if you sleep in the nude.
Regulating Body Temperature
Hormonal changes can wreak havoc on your body’s ability to regulate its own temperature, especially at night. If you find yourself “running hot,” it’s a good idea to keep your bedroom cool at night (62ºF to 68ºF, depending on your comfort), and choose bedding that’s more breathable (sheets made from cotton percale or linen, for example).
You might also want to layer your bedding so you can adjust the coverage easily based on how hot (or cold) you get during the night.
My best advice, however, is investing in a mattress climate-control system that actually adjusts the temperature of your sleep surface. The Eight Sleep is brilliant for this, because it’s a “simple” cover that goes over your mattress without changing the firmness or softness of it, but the entire surface can be set to a comfortable temperature and it self-adjusts all night based on your body’s needs.
You read that right. Through Eight Sleep’s Autopilot, the cover’s sensors record biometric data that includes your body temperature, sleep stage, and other data along with the ambient room temperature, and it makes adjustments as you’re sleeping to keep you asleep.
Plus it has a Hot Flash Mode that lets you briefly cool the bed’s surface on demand. And with its dual-zone control, your partner’s side of the bed is their own: your temperature needs operate independently from theirs, so you can both tailor the climate for the best sleep possible.
It’s an investment, for sure, but I have an Eight Sleep Pod 4 myself and it’s made ALL the difference in my sleep at night. It tracks my sleep nightly, giving me a full report on everything that happened after my head hit the pillow, and those insights are invaluable to spot patterns and make adjustments to my routine to improve my rest. You can learn more about the Eight Sleep system here.
Try to Keep a Consistent Routine
If you’re postpartum, you might as well skip this section… there is no “consistent routine” when you’ve got a newborn at home. (May the odds be ever in your favor. If the baby is sleeping right now, please close this article and go take a nap.)
But going to bed and waking up at consistent times, even over the weekends, will help your circadian rhythm to stay predictable. Try to avoid screen time an hour or two before bed, but if you do watch television or enjoy a book on an e-reader, dimmer light settings may help.
(I’ve literally watched television with my sunglasses on late at night and it might be placebo, but I swear it helps.)
Light suppresses melatonin production, so minimizing light exposure during the hour or so leading up to bed may help you to fall asleep a little faster.
Likewise, having morning light exposure within an hour of waking can help to increase your cortisol levels in the morning (for alertness) and regulate your melatonin production later at night.
Calm Thyself Before Bed
If you’re dealing with hormone-related anxiety or restlessness, deep breathing exercises, yoga, and even gentle stretching can help, especially if you suffer from restless leg syndrome.
The goal is to relax your muscles and your mind, which can stop anxiety and racing thoughts in their tracks.
It might be helpful to create an evening “wind-down ritual” of sorts, something that trains your body to know that the time for rest is coming soon. In my case, I do my evening skincare routine (in the bathroom with only the night light on), sip a sugar-free electrolyte solution and read for a little while in bed. I have my Kindle on a pretty dim light setting.
These days, I’ve found myself falling asleep while reading within 15 minutes. I put the book down and just go right to sleep.
Manage your Nutrition to Support your Hormones
It’s a good idea to stabilize your blood sugar by eating a balanced diet, of course, but you’ll also want to avoid alcohol, caffeine, and sugar before bed.
If you enjoy drinking tea in the evenings (I do, too), switch to decaf or choose herbal teas that don’t contain caffeine.
You might consider supplements, but always consult your doctor beforehand.
Supplements that might aid relaxation and sleep include melatonin to reset your circadian rhythm, adaptogens like ashwagandha to balance cortisol and energy, L-theanine or magnesium glycinate for relaxation, or even hormone replacement therapy (HRT) if you’re in the menopause transition.
Track your sleep patterns
One of the best ways to understand your sleep is to actually track it night after night.
The Eight Sleep does this automatically, as I mentioned earlier, but there are small wearables that can do this too.
I have an Apple Watch, but the Oura Ring is another wearable that can help you to track your sleep and find patterns as they relate to your menstrual cycle or menopause transition.
When you begin to recognize patterns in your sleep disruptions or cycles, you can adjust things that need to be, whether that’s scheduling an earlier bedtime, eating dinner earlier in the evening (or not snacking after 9 p.m.), or even increasing your relaxation techniques.
Things to Avoid When Your Hormones Are Wrecking Your Sleep
When your hormones are keeping you up at night, there are some habits to examine that can help you avoid making that worse.
- Late-night workouts, as these raise your body temperature and your cortisol levels, neither of which is beneficial at bedtime.
- Caffeine after a certain point in the day or evening, since it’s a stimulant that can keep you awake. Sure, you might have “always” been able to drink coffee until 2 a.m. and still go to sleep five minutes later (I used to, myself!), but that may not always be so… our bodies change as we age, and caffeine is a habit that might need to change too.
- Eating heavy meals or snacks too close to bedtime, as digestion may prevent your body from winding down as easily. Sugars, especially, can result in a blood-sugar crash during the night as well.
- Drinking too much before bed which can lead to middle-of-the-night trips to the bathroom. I sip a sugar-free electrolyte solution so I can hydrate more effectively while drinking less actual liquid before bed.
- Drinking alcohol before bed, since it can make hot flashes worse but also fragment your sleep.
- Checking emails before bed, which might put your mind on either work or other stressful things that will keep your thoughts racing when they should be slowing down.
Conclusions on Enjoying Better Sleep Despite Hormone Changes
Hormones play a surprisingly huge role in how well (or how terribly) we sleep at night, but when they start to fluctuate, every night becomes an unpredictable obstacle course of insomnia, hot flashes, night sweats, restlessness, anxiety, or any combination of related symptoms.
The good news is that when you understand the science behind what’s going on in your body, you can make smart lifestyle adjustments that can improve your sleep at night and let you wake up feeling more rested and able to take on the day.