"Between the ages of thirty and sixty, many women will wake up one morning and wonder what hit them. Whether it's uncontrollable sweating or a barrage of brain fog and anxiety, any one of us can be confronted with an onslaught of peculiar changes sudden enough to quite literally make her head spin." Dr Lisa Mosconi, author of The Menopause Brain.

If you’re in perimenopause and finding yourself wide awake at 2am - too hot, too restless, or too wired to fall back asleep - you are far from alone. And you’re not doing anything wrong. Your body is changing, your hormones are shifting, and your sleep system is trying to recalibrate.

For many women, this phase brings a confusing mix of disrupted nights, groggy mornings, and days where focus feels elusive. It’s not a character flaw, and it’s not “just getting older.” It’s biology - and with the right, simple strategies, it’s something you can influence.

Let’s take the fog off what’s happening and walk through realistic steps that genuinely help women in this season sleep more deeply, wake more refreshed, and reclaim their energy.

Why Sleep Gets Harder in Perimenopause

During perimenopause, oestrogen and progesterone shift unpredictably. These hormones aren’t only about periods - they help regulate your temperature, mood, stress response, blood sugar, and sleep–wake cycle. When they fluctuate, sleep often becomes lighter, more restless, and easily disrupted.

Many women notice they fall asleep only to wake in the early hours feeling hot, anxious, or mentally “switched on.” Others lie awake at bedtime, even when exhausted. You might find your patience thin, your focus fuzzy, and your energy unreliable.

It’s not your imagination. And more importantly, it’s not permanent. Small, targeted daily habits can help your body settle and find a steadier rhythm again.

1. Balance Your Blood Sugar To Reduce Night Waking

This is one of the most overlooked - and most effective - ways to improve sleep during perimenopause.

As oestrogen shifts, your body becomes more sensitive to changes in blood sugar. When blood glucose rises quickly after dinner or evening snacks and then drops during the night, cortisol often rises to correct it. That cortisol surge can wake you abruptly, often feeling too hot or too anxious.

To help your blood sugar stay steady, build evening meals around a balance of protein, fibre and healthy fats. Try to avoid sugary snacks or large quantities of refined carbohydrates later in the day. And if you feel you need something before bed, a light, balanced option such as Greek yoghurt with berries or a small handful of nuts can help keep your energy stable through the night.

Keeping blood sugar on an even keel often leads to fewer night wakings and a calmer, more grounded start to the day.

2. Help Your Body Stay Cool Overnight

Temperature regulation becomes more challenging when oestrogen fluctuates, which is why hot flashes and overheating are so common at night. Because deep sleep relies on a slight drop in core temperature, anything that keeps you too warm can fragment your sleep.

A cool bedroom helps enormously - most women do best between 16–18°C. Choose breathable bedding such as cotton or bamboo, and consider using layers so you can easily adjust during the night. If you enjoy an evening bath or shower, keep it warm rather than hot to avoid raising your core temperature just before bed.

Small changes like these can make deep sleep more accessible again.

3. Create An Evening Ritual

Perimenopause often brings higher evening cortisol and a mind that refuses to switch off. Lower progesterone can make you feel more wired, anxious or overwhelmed - all of which make falling asleep harder.

This is when a consistent wind-down routine helps enormously. Think of it as guiding your brain into “rest mode.”

A few minutes of light stretching releases tension. A warm (not hot) bath with Epsom salts and lavender can help you relax and unwind. Dimming the lights and reducing stimulation in the final hour before bed gives your nervous system the signal that it’s time to slow down. And if your mind starts to race the moment your head hits the pillow, a short breathing pattern - like inhaling for four counts and exhaling for six - can help calm your system. A quick “brain dump” in a notebook can also clear the mental clutter.

You don’t need a long routine - just a predictable one.

4. Support Your Hormonal System Naturally

While you can’t stop hormonal fluctuations, you can strengthen the systems that help regulate your sleep–wake cycle.

Start with morning light. A few minutes of daylight within the first hour of waking helps set your circadian rhythm, priming your brain to release melatonin later that evening. Gentle daily movement, particularly a short walk after meals, regulates blood sugar and calms the nervous system. Strength training two or three times a week supports metabolic health, mood, and sleep quality.

Alcohol deserves a special mention: many women find that even a small amount in the evening leads to hotter nights and more fragmented sleep. It doesn’t mean you can never enjoy it - but noticing how it affects your sleep is empowering.

5. Nourish Your Brain For Better Sleep

Your brain and sleep are deeply connected, and the way you eat during the day can influence how restful your nights feel.

• Omega-3 rich foods - like salmon, walnuts and chia seeds - help calm inflammation and support mood.

• Magnesium-rich foods such as leafy greens and pumpkin seeds help your nervous system relax.

• Tryptophan-containing foods, such as chickpeas, almonds, eggs, bananas, wholegrains and fish in an evening meal can help you sleep.

• Staying hydrated throughout the day (not just in the evening) supports energy and reduces irritability, both of which influence sleep.

Think of this as giving your brain the raw materials it needs to unwind.

6. Adjust Your Environment To Match Your Changing Needs

Perimenopause is a season of adaptation, and your sleep environment can adapt with you. Simple, practical changes often make a noticeable difference.

Keep a glass of water at your bedside. A light cotton top nearby can help if you wake feeling sweaty. A small fan can bring immediate relief during a hot flash. And avoid bright lights and electronic devices around bedtime.

These aren’t luxuries. They’re supportive tools for a body navigating a transition.

7. Find A Consistent Rhythm - Even If Your Nights Aren’t Perfect

Consistency doesn’t mean strict rules; it means giving your brain familiar anchors. Waking at roughly the same time each day helps stabilise your internal clock. Stepping into daylight early in the day strengthens that effect. Reducing screen exposure in the hour before bed supports melatonin, and a short, simple bedtime routine signals that it's time to rest.

You don’t need to do any of this perfectly. Think of it as supporting your body through a season of change.

When Sleep Still Feels Difficult

Sometimes, even with supportive daily habits in place, sleep can continue to feel elusive. If that’s the case, it’s worth having a conversation with your GP to explore what else might be influencing your sleep.

Simple checks such as iron or ferritin levels, thyroid function, and B12 can uncover issues that are quietly undermining your energy and rest. Support for hot flashes may also be appropriate, depending on your symptoms. Sleep apnea, which becomes more common in midlife, is another often-overlooked contributor to fragmented sleep.

In some cases, doctors may also prescribe melatonin, which can be particularly helpful during perimenopause when the body’s natural melatonin production may be disrupted. Melatonin works by supporting your natural sleep–wake rhythm rather than sedating you, and for many women it is a preferable option to traditional sleeping pills, which don’t address the underlying biology and can come with unwanted side effects.

The key message here is that support exists - and seeking it is a proactive, empowering step, not a failure.

A Compassionate Reminder As You Navigate This Phase

Perimenopause is not a malfunction - it’s a transition. Your body is doing what it’s designed to do, even if it feels messy or unpredictable at times. With small, consistent steps, you can absolutely support your system, reclaim your energy, and feel clearer and more grounded again.

Begin gently. Choose one or two strategies that feel doable, and give yourself time to settle into them. Your future self - calmer, brighter, sharper - will be so grateful you did.