“Why am I so exhausted?”

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Why Sleep Suddenly Becomes So Difficult in Perimenopause

It’s something I hear from so many women. You go to bed feeling tired, but then you wake up at 3am and your mind is suddenly wide awake. Or you lie in bed struggling to fall asleep even though your body feels exhausted. Sometimes you sleep through the night but still wake up feeling completely drained, as though the sleep you had wasn’t restorative at all.

It can feel confusing, especially if you’ve always been someone who slept well. Nothing in your life has really changed, yet your sleep suddenly has. If this is happening to you, there is a very real reason for it. Sleep disruption is one of the most common symptoms during perimenopause, and it is closely connected to the hormonal changes happening in your body.

The Role of Progesterone in Sleep

One of the first hormones that begins to fluctuate and decline during perimenopause is progesterone. Progesterone has a naturally calming effect on the brain and nervous system. It supports relaxation and helps the body move into deeper, more restorative sleep. As progesterone levels start to drop, many women notice that falling asleep becomes more difficult. Sleep can feel lighter and more restless, and waking during the night becomes more common. For some women, sleep disruption is actually one of the earliest signs that perimenopause may be beginning. If you find that falling asleep has suddenly become a struggle, it can be worth speaking to your GP about whether progesterone support might be appropriate for you.

How Oestrogen Affects Your Mind at Night

Oestrogen also plays an important role in how well we sleep. When oestrogen levels fluctuate or decline, it can affect several systems in the brain that regulate mood, stress and emotional balance. Many women notice that their mind becomes much more active at night. Thoughts that normally wouldn’t linger during the day suddenly feel louder in the quiet of the evening. You might find yourself replaying conversations, worrying about things that usually wouldn’t bother you, or simply feeling unable to switch your mind off. Lower oestrogen levels can also increase feelings of anxiety and make the nervous system more sensitive, which can make it harder for the body to relax into sleep.

Why Alcohol and Caffeine Start Affecting Sleep

Another thing that often catches women by surprise is that habits which never used to affect sleep suddenly start to. You may have always been able to enjoy a glass of wine in the evening, drink coffee in the afternoon, or eat dinner later without any problem.

During perimenopause, the body often becomes much more sensitive to these things.

Alcohol, for example, can make us feel sleepy initially, but it tends to disrupt the deeper stages of sleep later in the night. As the body processes alcohol, it can cause you to wake up in the early hours of the morning, often around two or three o’clock. Caffeine can also become more disruptive. It stimulates the nervous system and increases cortisol, which is the body’s main stress hormone. As hormonal changes make the nervous system more sensitive, caffeine can stay in the system longer than it used to, which is why many women find that avoiding caffeine in the afternoon can help improve their sleep.

The Impact of Blood Sugar and Late Eating

Food can also play a role in disrupted sleep. Eating late in the evening means your body is still digesting while you are trying to sleep. This can lead to fluctuations in blood sugar levels overnight. When blood sugar drops, the body releases cortisol to bring those levels back up, and that spike in cortisol can wake you during the night. Giving your body a few hours between your last meal and bedtime allows digestion to settle and can help support more stable sleep.

Stress and the Overactive Night-Time Mind

Stress is another important piece of the puzzle. Most of us have busy lives with many responsibilities, and it’s not always possible to remove the sources of stress we face. However, during perimenopause our tolerance for stress can change. Hormonal shifts can make the nervous system more reactive, which means stress can feel more intense and harder to switch off from at the end of the day. When cortisol levels remain elevated, the body stays in a more alert state, which makes it much harder to relax into sleep.

Simple Ways to Calm Your Mind Before Bed

Although we can’t eliminate stress completely, we can take small steps to help the nervous system unwind before bed. One simple but effective tool is writing down everything you need to do the next day. When tasks are swirling around in your mind, your brain keeps trying to hold onto them so you don’t forget. Putting them on paper allows your mind to let go of that responsibility for the night. Many women also find it helpful to look more closely at what is actually causing their stress. Sometimes it isn’t one big thing, but a long list of small tasks that feel overwhelming when they all sit in your mind together. Shifting a few of those tasks to another day, asking for support, or simply acknowledging what is realistically possible can help reduce that mental load.

If your mind tends to race at night, calming the nervous system can also help. There are many excellent meditation and relaxation apps available now that guide you through breathing exercises, calming music, or sleep stories designed to help your body move into a more relaxed state. These tools can be particularly helpful if you struggle to quieten your thoughts when your head finally hits the pillow.

Small Evening Habits That Support Better Sleep

There are also some gentle habits that can support your body as it adjusts to these hormonal changes:

• Eating earlier in the evening

• Dimming lights as the evening progresses

• Reducing screen time before bed

• Reading a book to help calm the mind

These small changes help signal to your brain that it is time to wind down and prepare for sleep.

Sometimes you may not even be able to identify exactly what is waking you up. If that’s the case, starting a journal can be a helpful place to begin. Writing your thoughts down regularly can help you organise what is going on in your mind and gradually uncover patterns or worries that may be sitting beneath the surface.

Movement during the day can also support better sleep at night. This doesn’t have to mean intense exercise. Even a short walk outside and a little fresh air can help regulate your body’s natural rhythms and support deeper sleep later on.

Listening to Your Body During Perimenopause

Perhaps one of the most important things to remember during this stage of life is that your body is changing, and it may be asking for something different from you now. Many of us have spent years pushing through tiredness and ignoring the signals our body sends us. Perimenopause can be a time when those signals become harder to ignore.

Learning to listen to your body again, rather than pushing past its limits, can be a powerful shift. If you feel exhausted, it is often a sign that your body needs rest. Pushing through fatigue may get you through the day, but it often leaves you even more depleted the next.

Sleep is foundational to our wellbeing. When sleep begins to stabilise, many other things begin to improve alongside it. Energy returns, mood becomes more balanced, and the ability to cope with daily stress often feels much easier.

You Don’t Have to Navigate This Alone

If you’re struggling with your sleep right now, please know you don’t have to figure it all out on your own. Sometimes having the space to talk things through, understand what’s happening in your body, and explore small changes that could support you can make a huge difference. This is something I work with many women on through my coaching.

We’ll also be exploring sleep, hormones and practical tools to support your wellbeing at our upcoming The Unpaused Next Chapter retreat, where you’ll have the opportunity to learn from experts, reconnect with your body and start making sense of the changes you may be experiencing.

If you missed it on social media you can watch/listen to my personal stories about sleep.