All guides

• Perimenopause insomnia: why it starts and what helps

  Perimenopause insomnia is trouble falling or staying asleep during the years before your final period. In the SWAN study, 31% to 42% of perimenopausal women reported insomnia symptoms in any given year (Obstetric and Neonatal Nursing, 2017). If hot flushes wake you, ask about treatment for them; if nights feel anxious, CBT-I has the strongest trial results.

• Why do I keep waking up at 3am after 40, and what helps?

  Waking at 3am is common after 40, and no single hormone explains it. Sleep gets lighter with age: each decade adds about 10 minutes awake after sleep onset (Boulos 2019, 169 studies). If you are still awake after 15 to 20 minutes, leave the bed and return when sleepy. If you snore or gasp, see a clinician.