By: Jennifer Ellis, FNP-C

In perimenopause it is common for women to complain of difficulty sleeping. Insomnia and waking in the middle of the night with trouble returning to sleep may even become a nightly occurrence and can leave you feeling fatigued and hopeless. Sleep apnea, or interrupted breathing during sleep, can additionally show up in this stage of life, and can further your inability to get restful, restorative sleep.

Having a good sleep routine will be important in perimenopause (and beyond!) to help you get the best rest possible while aiming for at least 7 hours total. Here are some essential sleep to-do's to add to your routine:

• Maintain a regular sleep schedule - try to go to bed and get up in the morning at the same time each day. Keep it up even on the weekends to help set your circadian rhythm. Getting some sunlight each morning for 30 minutes is great for your circadian rhythm, as well.

• Exercise daily - studies show daily exercise can improve insomnia symptoms. Just don't exercise too close to bedtime or it may backfire on you, stick to walking or gently yoga as bedtime approaches.

• Avoid alcohol - alcohol and perimenopause just do not mix well and can lead to more difficulty sleeping and night waking.

• Avoid caffeine and tobacco - avoid consuming any stimulants for 6 hours prior to bedtime for a better chance of restful sleep.

• Avoid taking naps - if you have to take a nap try to keep it short at under half an hour and early in the day.

• Take time to unwind- for an hour prior to bedtime try to do something relaxing like reading a book, writing in your journal, meditating, deep breathing, practicing mindfulness, drinking some chamomile tea, or taking a warm bath. Utilize the Oura or Calm apps for guided, calming meditations to help you wind down.

• Avoid your cell phone - put away your phone an hour before bed and avoid all screens like TVs, computers, and tablets which have blue light that has been shown to disturb your natural melatonin production. 

• Create a restful environment - leave all screens in another room. Keep your bedroom dark using blackout curtains or sleep masks if needed. Keep your bedroom cool and consider using a fan to help keep cool and provide some white noise. If noise is an issue consider using ear plugs.

• Last but not least, discuss HRT with your practitioner - sometimes just taking some bioidentical progesterone prior to winding down for sleep nightly can make all of the difference in the world, due to its sedating effects. Others may need some estrogen replacement along with it to help balance their hormones further to relieve perimenopausal sleep disruptions.

Try these tips for better sleep - they sound simple, but they work... you may be sleeping soundly before you know it!