Sleep, stress and hormones: how they connect
“I used to sleep like a log. Now I’m wide awake at 3am.”
It’s one of the most common things we hear from women in perimenopause. Sleep, stress and hormones are closely linked, and when one shifts, the others tend to follow.
How hormones affect sleep
Progesterone has a naturally calming, sleep-supporting effect. It’s often one of the first hormones to become less reliable in perimenopause, which may be why sleep can change before periods do.
Oestrogen helps regulate body temperature and supports mood. As it fluctuates, night sweats and hot flushes can wake you, sometimes before you even notice feeling hot.
Melatonin, the hormone that signals it’s time to sleep, also tends to decline with age.
Where stress comes in
Cortisol, one of the body’s main stress hormones, naturally follows a daily rhythm. It should be highest in the morning to help you get going, and lowest at night so you can rest.
Ongoing stress can disrupt that rhythm. You might feel tired but wired at bedtime, or wake in the early hours with your mind racing. Falling oestrogen may also make the body more sensitive to stress, so things you once took in your stride can feel harder to manage.
The loop
Here’s where it becomes a cycle. Poor sleep makes it harder to handle stress. Stress makes it harder to sleep. Tiredness can also make hot flushes, low mood, cravings and brain fog feel worse. Before long, it can feel like everything is happening at once.
The good news is that a loop can be interrupted at more than one point. Small changes in any area can help the others.
Things that can help
Keep a steady rhythm. Going to bed and getting up at similar times each day, including weekends, supports your body clock.
Get morning light. Ten to fifteen minutes outdoors early in the day helps set your cortisol and melatonin rhythms.
Keep your bedroom cool, and use layers you can easily remove.
Watch alcohol and late caffeine. Both are common triggers for broken sleep and night sweats.
Wind down on purpose. A short routine before bed, such as a warm shower, stretching or reading, tells your body it’s time to switch off.
Don’t fight the 3am wake. If you’re awake for more than 20 minutes, get up, keep the lights low and do something calm until you feel sleepy.
Move your body regularly, ideally earlier in the day.
When to talk to your GP
If poor sleep is affecting your daily life, it’s worth a conversation with your GP. They can check for other causes, such as sleep apnoea, thyroid problems or low iron, and discuss options including menopausal hormone therapy (MHT) or cognitive behavioural therapy for insomnia, which has good evidence for improving sleep.
Support at Wild Heart Acupuncture
Many women find acupuncture a deeply relaxing part of their routine during perimenopause, and a chance to talk through what’s changing.
