It’s 2 o’clock in the morning. Once again, you are lying awake in bed, staring at the time on your alarm clock. Twenty minutes pass. Then another 30 minutes creep by, and still sleep does not come. Why is this happening?

Causes of Midlife Insomnia

If you are a woman approaching menopause, hormones may play a role in this nightmare of a problem. Estrogen and progesterone levels begin to decline long before a woman actually enters menopause. Even 10 years before true menopause (known as perimenopause) begins, estrogen levels start to drop and can cause periodic hot flashes and emotional swings. Hot flashes can happen suddenly and cause a rush of adrenaline that can jolt you awake. The change in temperature and increased heart rate that occur during a hot flash are often uncomfortable and may even cause some women to wake up on multiple occasions throughout the night. Combined with declining progesterone, a hormone that boosts sleep, this often leads to many restless nights for women whose child-bearing years are behind them. The drop in estrogen may also be linked to depression and even make you feel higher levels of stress. Stress and feelings of worry or anxiety are other reasons you may not be able to sleep soundly at night.

Importance of Estrogen

It is commonly known that estrogen is critical to maintain a normal menstrual cycle and for giving birth to children, but it has other functions too. Estrogen has been known to help control cholesterol, promote strong bones, and impact your mood. The drop in estrogen that occurs as women begin perimenopause can also lead to insomnia.

Discover Good Sleep Routines

“Here are my recommendations for actionable tips for helping people sleep better,” says Dr. Neil Kline, D.O., DABSM, an internist, sleep disorder physician, and representative of American Sleep Association.

  • Maintain a regular sleep routine.

Go to bed at the same time every night and wake up at the same time in the morning. It is best if you stick to a regular sleeping schedule all week long.

  • Don’t take naps.

Sometimes napping ends up leaving you with too much sleep, which ultimately can make it difficult to fall asleep at night. People only need a specific amount of sleep each night—not more, and not less. Taking naps may interfere with sleeping normally at night, and cause insomnia.

  • Don’t stay awake in bed for more than 5-10 minutes.

If you find yourself lying awake at night, get out of bed and sit in a chair in the dark. Don’t go back to bed until you start to feel drowsy. Also, do not watch TV or use the internet. That will just stimulate you more than desired.

  • Avoid watching TV or reading in bed.

Watching TV or reading in bed teaches your body that it is okay to be awake in bed. Only use your bed for two important tasks—sleep and sex.

  • Do not drink caffeine inappropriately.

Caffeine can stay in your system even hours after ingestion. Caffeine can fragment sleep, and cause difficulty initiating sleep. If you drink caffeine, do so only before lunch. Remember that soda and tea also contain caffeine.

  • Avoid sleep-preventing substances

Smoking, drinking, and over-the-counter medications may cause fragmented sleep.

  • Exercise on a daily basis.

Exercise promotes continuous sleep, but it is best to do it during the early part of the day. Avoid exercising in the evening, because it can raise your heart rate and stimulate your brain, which can make it difficult to fall asleep.

  • Create a soothing, calm bedroom.

Set your bedroom temperature so that it is slightly cool, as opposed to slightly warm or hot. Eliminate extraneous noise, like a TV, that may disrupt sleep. Background white noise, such as a fan, is fine. If your pets awaken you, do not allow them in your bedroom. Keep your bedroom dark and be sure to turn off the lights.

Consult Your Doctor

If you’ve been struggling to sleep well at night, it is important to let your doctor know. First of all, your doctor may discover that your insomnia is caused by something other than a midlife drop in hormones. However, if that is the most likely culprit, there are estrogen therapies known as Hormone Replacement Therapy (HRT) or even low-dose birth control pills that have been shown to solve sleeping issues. The supplement melatonin is a natural option that can also sometimes help with sleep.

Sleeping Again

Once you find a way to treat the problem that is causing your insomnia, falling asleep night after night may feel like a gift. Getting enough shut-eye and being well-rested are critical for your body to perform all of its many functions. Sufficient sleep can make you look better, feel more energetic, and give you the strength you need to tackle the day. It can also help you interact more functionally with others, feel less depressed, and become motivated to eat healthier and get more exercise.