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You have difficulty falling asleep. You wake up several times during the night, sometimes drenched in sweat. And in the morning, you feel just as tired as when you went to bed. These restless nights are not an inevitable part of aging. They have specific biological causes that can be identified and, to a large extent, treated.
Sleep disturbances are one of the most common symptoms of menopause. Understanding why they occur is the first step toward getting restorative sleep again.
Why does menopause disrupt sleep?
Sleep disturbances during menopause are not caused by a single mechanism.
Three distinct biological disruptions occur simultaneously, and their effects reinforce one another.
The decline in progesterone: the first mechanism
Progesterone is a hormone with natural sedative properties.
It influences nerve signal transmission through its action on GABA-A receptors in the brain, the same receptors targeted by synthetic sleeping pills. This mechanism helps promote sleep onset and maintain deep sleep [1].
When progesterone levels decline during menopause, this sedative effect gradually disappears. The brain loses an important regulator of its nighttime activity.
Science fact: a Canadian study involving 6,100 women found that postmenopausal women took an average of 30 minutes longer to fall asleep than perimenopausal women [1].
Night sweats: the second mechanism
Night sweats are the nighttime equivalent of daytime hot flashes.
The decline in estrogen production disrupts body temperature regulation by creating false signals of excessive heat [2].
The brain then mistakenly triggers a cooling response: blood vessels dilate and heavy sweating occurs, even though the body's actual temperature has not increased.
This cycle can occur several times during the night, preventing the body from reaching deep, restorative stages of sleep.
Night sweats affect 60% to 80% of women during the menopausal transition [2]. They are the most common direct cause of nighttime awakenings during this period.
Increased cortisol: the third mechanism
Cortisol is the hormone associated with stress and wakefulness.
Estrogen normally plays a regulatory role in cortisol production: it helps limit cortisol spikes and supports the body's recovery after stress [3].
When estrogen levels decline during menopause, this regulatory effect decreases. Cortisol can rise more easily and take longer to return to baseline, keeping the brain in a state of alertness even in the evening.
A study published in the medical journal Menopause (2009) found that postmenopausal women with insomnia had significantly higher cortisol levels than women without sleep disturbances [3].
What are the most common sleep disturbances during menopause?
Sleep disturbances during menopause can take different forms.
They are not limited to typical insomnia and several types can occur in the same woman.
Difficulty falling asleep
It takes longer to fall asleep.
The decline in progesterone reduces the brain's natural sedative activity. Increased cortisol maintains a state of alertness that delays sleep onset. Thoughts keep racing, and the body does not relax enough to fall asleep [1].
Repeated nighttime awakenings
Waking up during the night is often linked to night sweats.
An episode of intense sweating can cause a brief awakening that is enough to interrupt the sleep cycle. Falling asleep again can take thirty minutes or more, and this sequence may occur two to four times per night [2].
Light, non-restorative sleep
Even without noticeable awakenings, sleep can become less deep.
Progesterone deficiency reduces the amount of deep non-REM sleep, the stages that support physical recovery and memory consolidation [1]. The result can be sufficient sleep duration but insufficient sleep quality. Fatigue persists upon waking, even after seven or eight hours in bed.
A review of 41 studies published in 2023 found that sleep disturbances affect more than 51% of menopausal women, with prevalence ranging from 35% to 60% in postmenopausal women [4].
Key takeaway: The three forms of sleep disturbances during menopause have distinct mechanisms. Addressing night sweats alone may not be enough if declining progesterone or increased cortisol are not also taken into account.
Sleep disturbances during menopause: natural solutions
Several complementary approaches can help address these three mechanisms.
They are not mutually exclusive and can be combined for longer-lasting effects.
Improve your sleep habits
Good sleep habits directly influence evening cortisol levels.
Going to bed and waking up at consistent times strengthens the circadian rhythm, the body's internal clock that regulates sleep-wake cycles. Avoiding screens during the two hours before bedtime helps limit blue light-induced melatonin suppression. Keeping the bedroom cool, between 16 and 18°C, can reduce the frequency and intensity of night sweats [5].
Reducing caffeine intake after 2 p.m. and limiting alcohol in the evening can improve deep sleep quality. Alcohol can make it easier to fall asleep but fragments the second third of the night, worsening nighttime awakenings [5].
Occasional use of melatonin (1.9 mg/night) can be an effective way to restore a better sleep routine.
Physical activity and stress management
Regular physical activity can improve sleep during menopause through two distinct mechanisms.
It reduces the frequency of hot flashes and night sweats by improving central thermoregulation [5]. It also lowers baseline cortisol levels, which can help you fall asleep more quickly in the evening. Exercise should preferably be done in the morning or early afternoon. Intense exercise in the evening can have the opposite effect by stimulating cortisol at the wrong time.
Cognitive behavioral therapy (CBT) for insomnia is the best-documented non-drug approach. The MENOS 1 and MENOS 2 studies showed a significant reduction in night sweats and an improvement in sleep quality after six months of follow-up [6].
Targeted dietary supplements: magnesium, L-theanine, saffron and ashwagandha
Some micronutrients act directly on the biological mechanisms disrupted by menopause. This is why we formulated a Menopause supplement designed to provide support throughout the different stages and improve sleep.
Magnesium bisglycinate is a cofactor in melatonin production and contributes to the regulation of GABA receptor activity. Circadian rhythms depend directly on its availability in the body [4]. Eight weeks of supplementation showed improvements in sleep quality, fewer nighttime awakenings and a greater overall feeling of rest [4]. The bisglycinate form is preferable because of its high bioavailability and good digestive tolerance, as well as the calming properties of glycine.
L-theanine is an amino acid found in green tea that promotes the production of GABA, serotonin and dopamine. It induces a state of relaxation that supports falling asleep without causing direct sedation [7]. A review published in 2023 supports its effectiveness for sleep onset, overall sleep quality and sleep duration [7].
Safranal extracted from saffron modulates serotonergic pathways. In addition to its effects on mood, it improves sleep quality by promoting emotional relaxation and reducing nighttime performance anxiety [8].
Given the very high cost of saffron and the prevalence of counterfeit products, choose high-quality extracts with a well-controlled origin (such as Activ'Inside® extract produced in France).
Ashwagandha is another validated option that acts on stress and mood, among other plants with calming properties.
Science fact: A randomized, double-blind trial involving 165 adults with moderate insomnia showed a significant improvement in sleep quality with Safr'Inside™ (Activ'Inside) extract over twelve weeks. The results were published in Sleep Medicine: X (Schuster et al., 2025) [8].
When should you see a doctor about sleep disturbances?
Some sleep disturbances during menopause require medical attention.
Consult a doctor if sleep problems persist for more than three months despite lifestyle adjustments.
You should also seek medical advice if you experience heavy snoring or pauses in breathing during the night: menopause increases the risk of sleep apnea two- to fourfold, and the condition is underdiagnosed in women [3].
Finally, severe daytime fatigue that affects your ability to work or your safety (driving, concentration) always warrants prompt medical attention.
What you need to know about sleep and menopause
Sleep disturbances during menopause have three distinct biological causes: declining progesterone, night sweats and increased cortisol.
Several complementary approaches can help. Good sleep habits, physical activity and CBT act on cortisol levels and thermoregulation.
Among micronutritional approaches, magnesium, L-theanine and saffron support the neurochemical mechanisms of sleep disrupted by hormonal changes, with established scientific evidence.
These approaches complement one another and can provide better results when combined than when used individually.
Medical advice is strongly recommended if these lifestyle measures do not provide satisfactory results within a reasonable period of time (one to three months).
References
[1] Omena App. Troubles du sommeil et ménopause : trouver le repos. Étude canadienne sur 6 100 participantes citée. Disponible sur : omena.app
[2] MSD Manuals Professional. Ménopause. Révisé juillet 2023, modifié janvier 2024. doi:10.1097/GME.0000000000002187. Rance NE, et al. Neurokinin B signalling and the regulation of body temperature. Prog Brain Res. 2010;182:301-17.
[3] Therafemina. Troubles du sommeil à la ménopause : comment mieux dormir. Juillet 2025. Étude citée : Anxiety and insomnia in menopausal women: a population-based study. Menopause. 2009. Alexia Cornu. L'impact du cortisol à la ménopause. Disponible sur : alexiacornu.com
[4] Goldman Laboratories. Magnésium pour la fatigue ménopausique. Revue de 41 études, 2023. Disponible sur : goldmanlaboratories.com. Luo X, Tang M, Wei X, Peng Y. Magnesium depletion score and sleep quality in U.S. adults, NHANES 2005-2014. J Affect Disord. 2024;358:105-112. doi:10.1016/j.jad.2024.05.002
[5] Vitalité Québec. La connexion hormones-insomnie. Juillet 2024. Disponible sur : vitalitequebec-magazine.com. Journal of Midlife Health. Incidence des troubles du sommeil en pré et postménopause. 2022.
[6] Mann E, Smith MJ, Hellier J, et al. Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1). Lancet Oncol. 2012;13(3):309-318. doi:10.1016/S1470-2045(11)70364-3
[7] Joinmidi.com. Magnesium for Sleep During Menopause. Mars 2026. L-theanine review 2023 citée : Sleep Foundation. L-Theanine for Sleep. Septembre 2022. Disponible sur : sleepfoundation.org
[8] Schuster J, Mundhenke C, Nordsieck H, Pouchieu C, Pourtau L, Hahn A. Effect of a saffron extract on sleep quality in adults with moderate insomnia: A decentralized, randomized, double-blind, placebo-controlled trial. Sleep Medicine: X. 2025;10:100147. doi:10.1016/j.sleepx.2025.100147
