When Sleep Stops Working the Way It Used To
About five years ago, I remember one of my friends – who is about ten years older than me – talking about insomnia. She regularly woke up at 4 AM, and stayed awake.
I thought she was crazy.
Or ill.
At the time, it didn’t register as a thing. Just something unfortunate that was happening to her.
Until I found myself in a similar place.
For me it usually looks like a few hours in the middle of the night when I am awake. Not “in and out of sleep.” Not dozing. Not even drowsy. But so alert that I have pounded out a detailed action plan in a spreadsheet—followed by a return to sleep about 90 minutes before the alarm rudely informs me that it’s time to walk the dog.
For a long time, I told myself it was just stress. The stress of starting—and running—a business. The stress of carrying a lot. The stress of being responsible.
Only later did I begin to notice that something else might be going on too.
That those stinkin’ hormones might now be changing the rules of the game.
What I didn’t realize at first was how disorienting that could feel. How quickly sleeplessness turns into self-doubt. How easy it is to wonder whether something is wrong with you when your body won’t do what it used to do so effortlessly.
This blog series, The Upgrade, is an invitation to notice moments like this—not to fix them right away, but to name them. To recognize when a season has shifted, and to get curious about what that shift might be asking of us.
Sleep is often one of the first places women feel that change.
So for this post, I invited my friend Dr. Vickie Kasper to share what she knows about sleeplessness and menopause—not as a prescription, but as a way of putting language to an experience many women are quietly living through.
Understanding Sleeplessness in Menopause
Dr. Vickie Kasper, a board-certified lifestyle medicine physician, shares what’s happening in the body during menopause—and why sleep is often one of the first places women feel the shift.
When the Night Refuses to Cooperate
Lying in the dark staring at the ceiling, your mind begins to spin. Sleep is swept away by rehearsals of the day’s conversations or tomorrow’s agenda. It’s going to be another long night.
The thermostat in your body malfunctioned when menopause arrived and now you throw the covers off in a grand sweep to keep from spontaneously combusting. Or you wake up shivering from night sweats that soaked your pajamas in the weirdest places. Yes indeed, it’s going to be a long night.
If only you could sleep…
But trying harder to sleep only makes sleeping harder.
I Thought This Season Would Come With Rest
Things were going to be different when you got older. You thought, “Someday I’ll travel, or learn to play the piano, or write a book.” When you arrive at the new season of life, it’s not exactly what you thought.
Staying out late as a teenager felt like privilege. Then staying up to study during college was survival. After love and marriage, came the baby carriage, along with late night rocking and feedings. Then the tables turned, and you waited up for your teenager to get home before curfew.
After the nest emptied, you planned to sleep through the night. Instead, you’re lying in bed, wired and tired and unable to do what your body needs to do. Sleep.
This wasn’t how it was supposed to be. But, sleeplessness and menopause go together like puberty and acne. It’s equally maddening.
When Sleep Is Disrupted, the Whole System Feels It
Let me count the many ways menopause disrupts sleep. Most women experience hot flashes or night sweats. Forget the flannel pajamas during this season of transition. Try adapting the bedroom environment by sleeping on cooling sheets and in pajamas that wick moisture away. Keep a glass of cool water at the bedside and use a fan.
Some women choose to take hormone replacement therapy, which often helps with the symptoms of menopause. But sleeplessness can linger, even once you’re past hot flashes and night sweats.
After menopause the soft palate relaxes making women more prone to sleep apnea. This serious medical condition is associated with an increased risk of heart disease, high blood pressure, stroke, and type 2 diabetes. Not sleeping is risky business.
Insomnia can increase the risk of obesity and dementia. Mental health is also affected by depression, anxiety and plain ol’ crankiness. Understanding the consequences of poor sleep may perpetuate the cycle causing sleep anxiety.
Menopausal symptoms will pass, but insomnia can linger. But there is hope and it’s possible to reset your sleep. Simple steps can help you get started.
Resetting Your Sleep with Diet Changes
During this transition season it’s important to be mindful of foods that can disturb your sleep. Of course, caffeine is a known offender, and it can take your body between 5 and 7 hours to clear half of what you consume. So, the best practice is to establish a cut off time so that caffeine doesn’t interfere with your sleep.
Alcohol may help you fall asleep faster but prevents you from reaching the deeper stages of sleep. Deep sleep is important at restoring your brain physically and mentally.
Temperature regulation always plays a crucial role in sleep, but especially during perimenopause. Your body regulates temperature in part by dilating and constricting blood vessels. Too much salt can interfere with this process and cause restlessness at night. Avoid salty foods for better sleep.
Melatonin is the sleep hormone and its precursor, serotonin (the happy hormone) is mostly made in the gut. Therefore, a healthy gut microbiome promotes better sleep. A whole-food, nutrient-dense diet with plenty of fiber nourishes a healthy gut. By the way, fiber is only found in plants, not dairy or meat.
When the Body Is Tired but the Mind Won’t Rest
One of the biggest reasons women have trouble falling asleep is that they can’t turn off their minds. Often Christian women tell me they just pray. But honestly, that might backfire if you are praying about your problems. Difficulties always seem worse at night. If you are inclined to pray to help you relax and fall asleep, I suggest you try praise therapy. Instead of focusing on your problems, focus on God’s characteristics.
Cognitive shuffling is a powerful tool for stopping those spinning thoughts. As you drift off to sleep, thoughts normally become fragmented. With chronic worry, you can rehearse the same conversation all night long. Instead, you need to engage your brain without arousing it. There are a couple of different ways to do this, but I prefer thinking of a random word. Then think of 5 words that begin with the first letter of that word; then five words that begin with the second letter and so on until you get to the last letter of the word. If you are still awake, think of another word and go through the process again. I almost never get beyond two words.
Rest Still Counts—even When Sleep Is Elusive
Sleeplessness is normal during perimenopause and menopause and usually improves with time. If you can’t sleep, embrace non-sleep restorative rest. Lay there, relax, praise and practice gratitude. Hopefully, you’ll be sleeping soundly again soon.
Sweet dreams!
About Dr. Vickie Kasper
Dr. Vickie Kasper is a board-certified lifestyle medicine physician with a passion for helping women reclaim restorative sleep during midlife. Having navigated insomnia herself, she brings both clinical expertise and lived experience to her work. Learn more about Dr. Kasper and her approach to sleep health at https://healthylooksgreatonyou.com/sleep-solutions.
A Closing Reflection
If you’re in this season and sleep has become elusive, I hope this post has helped you feel a little less alone.
Not because you now have a list of things to try—but because you can see that something real is happening. That your body isn’t betraying you or failing you. It’s changing. And change, even when it’s uncomfortable, deserves our attention.
For many women, sleeplessness becomes the place where everything else feels harder—where patience runs thin, where confidence wobbles, where the stories we tell ourselves get louder in the dark. That doesn’t mean you’re doing life wrong. It may simply mean you’re standing at a threshold.
One of the subtle invitations of this season is to stop fighting for the way things used to work, and instead begin listening for what you need now. Not in a rush. Not perfectly. Just honestly.
For now, it’s enough to notice.
To name what’s shifting.
And to trust that paying attention is not indulgent—it’s wise.
If you find yourself lingering with this reflection, you might gently consider:
What do sleepless nights seem to amplify—emotionally or spiritually?
What might rest mean now, if it’s not measured by hours slept?
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