Perimenopause- Insomnia and Night Sweats

Why Your 3am Brain Won’t Switch Off?

If this is you:

• You drop into bed exhausted, but your brain refuses to switch off

• You wake soaked in sweat, have to change clothes, then can’t get back to sleep

• Your heart races, thoughts spiral, and you dread the next day at work

• By afternoon you feel like crying or shouting at everyone

…you’re not alone. This is one of the most common patterns I see recently in women in 40s.

How perimenopause messes with sleep

Perimenopause affects sleep through at least three pathways:

1. Vasomotor symptoms (VMS) – hot flushes and night sweats

2. Mood and anxiety – racing thoughts, hyper-vigilance

3. Changes in sleep architecture – shifts in REM and deep sleep

The result is that you can be both bone-tired and wired, a horrible combination.

What guidelines say about treating night sweats and insomnia

Mainstream evidence gives us a clear framework:

• MHT/HRT remains the most effective treatment for hot flushes and night sweats (vasomotor symptoms), and often improves sleep when VMS are the main driver. (Lippincott Journals)

• The 2023 non-hormone therapy position statement recommends CBT, clinical hypnosis and certain non-hormonal medicines as evidence-based alternatives for women who can’t or don’t want to use hormones. (Lippincott Journals)

• NICE guidelines now recommend menopause-specific CBT as a management option for vasomotor symptoms, sleep problems and low mood – either alongside HRT or instead of it. (NICE)

• Systematic reviews show that yoga and other mind–body therapies can improve menopausal symptoms, insomnia and quality of life in midlife women. (PubMed)

• Trials of mindfulness-based stress reduction (MBSR) in peri- and postmenopausal women show improvements in sleep quality and menopause-specific quality of life. (Nature)

So you’re not making it up – this is a recognised pattern, and non-drug, mind–body approaches are part of mainstream guidance, not fringe.

What non-drug support can realistically do for your sleep

No one can promise you’ll sleep like a teenager again, but evidence suggests we can:

• Reduce the intensity and bother of hot flushes

• Lower overall arousal (that wired, on-alert feeling)

• Improve sleep quality scores – even when total hours don’t change overnight

• Improve daytime fatigue, anxiety and mood

At Ayusha, this looks like:

• Deeply relaxing warm oil work that signals “safety” to your nervous system (especially around the head, neck, chest and belly)

• Gentle, floor-based movement to release tension without overstimulation

• Atma Shakti – guided mind–body relaxation, to set your sleep cycle

  Many women report that even if they still wake, the panic level drops and they can get back to sleep faster.

A note on when to see your doctor urgently

Sleep issues and night sweats are common in perimenopause, but please see your GP promptly if you have:

• Sudden, severe night sweats with weight loss or other systemic symptoms

• New chest pain, breathlessness or concerning palpitations

• Severe low mood, suicidal thoughts or complete loss of function

Ayusha is here to support your comfort, nervous system and coping, not to replace medical assessment.

If nights are becoming unbearable

If you’re in Newcastle, Lake Macquarie, Port Stephens, Hunter Valley, Central Coast or Sydney and your sleep has fallen apart:

• You can start with a longer perimenopause session focused on nervous system + sleep, or

• Book a short discovery call to discuss whether this is the right layer of support alongside your GP.

You may also find these blogs helpful:

• Perimenopause overview – to see the full symptom landscape.

• Perimenopause anxiety and rage – since mood and sleep are tightly linked.

• Perimenopause gut changes and fluid retention – since gut issues often worsen with poor sleep.