Waking at 3 a.m., soaked or wide awake, is one of the most common complaints in perimenopause. In the SWAN study of 3,045 women, trouble falling asleep and staying asleep became more common through the transition. Here's why it happens (night sweats, hormones, mood and a learned wake-up habit) and what the research says helps you sleep again.

Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep03_3am

Chapters

0:00 Intro

0:19 What changes

0:44 Three reasons

1:27 When it counts as insomnia

1:42 What helps

3:16 At 3:07 itself

3:55 When it's something else

4:24 Why it matters

4:53 Wrap-up

Sources

• Sleep through the menopause transition, hot flashes, hormones and hormone use (SWAN, 3,045 women): PubMed 18652093

• CBT for insomnia by phone in women with hot flashes (insomnia score −9.9 vs −4.7 points; 84% vs 43% in the no-insomnia range at 6 months): MsFLASH trial, PubMed 27213646

• Menopause-specific CBT for sleep problems linked to hot flashes: NICE guideline NG23

• Hormone therapy and hot flashes (about 75% fewer): JAMA review 2023, PubMed 36749328

• Bedtime micronized progesterone in perimenopause (review, limited trial evidence): Prior 2011, PubMed 24753856

• Insomnia and fatigue among the top menopause symptoms in women 40–60: 2023 survey, PubMed 37667324

• Memory in SWAN: PubMed 19470968

• Sleep needs, long-term insomnia, sleep habits, sleeping pills: NHS, Insomnia

For information only, not a substitute for advice from your own doctor. Loud snoring with gasping or daytime sleepiness, or sleep problems with low mood, deserve a doctor's look.

A hot flash is a sudden wave of heat through the face, neck and chest. Between 50 and 75% of women get hot flashes or night sweats in the menopause transition, and in the SWAN study frequent hot flashes lasted a median of 7.4 years. Here's what's happening in your body, how long they last, and what the research says helps.

Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep02_hotflashes

Chapters

0:00 Intro

0:16 What a hot flash is

0:38 Why it happens

1:21 How common, and how long

1:59 At night

2:41 In the moment

3:09 Options that work

4:18 When it isn't menopause

4:46 Takeaways

Sources

• How common: PubMed 36749328; 2023 review, PubMed 37388717

• Why it happens (the brain's thermostat, neurokinin B): PubMed 37388717

• How long (SWAN, 3,302 women): PubMed 25686030

• Night sweats and sleep (SWAN): PubMed 18652093

• CBT for insomnia in women with hot flashes: PubMed 27213646

• Hormone therapy and non-hormonal options: PubMed 36749328; The Menopause Society 2022 position statement, PubMed 35797481; The Menopause Society 2023 nonhormone therapy statement, PubMed 37252752; NICE NG23

• Lifestyle and triggers: NHS, Hot flushes

For information only, not a substitute for advice from your own doctor. Sweats with a fever, cough or weight loss, or palpitations with chest pain, need medical attention.