Between 30-60% of women suffer symptoms of insomnia during the menopause transition. This is, in part, caused by fluctuations in oestrogen levels which affects the production of the essential sleep hormone, melatonin. Furthermore, developing unhelpful habits around our bedtime routines such as working late, using electronic devices, and by having inconsistent bed / wake times, drastically impact our ability fall asleep or stay asleep during the night.

If it was not hard enough to get to sleep, hot flushes and night sweats usually disturb the sleep cycle and wake women up.


The consequences of insomnia during the menopause lead to a range of physical and psychological problems that include – but are not exclusive to – anxiety, depression, poor concentration, increase risk of diabetes, cardiovascular disease, and weight gain. Interventions that deal with the psychological component of insomnia can improve quality and quantity of sleep.

Six Tips to Improve Insomnia

  1. Reset Your Circadian Cycle

Reset your circadian cycle by waking up consistently at the same time and exposing your eyes to sunlight. Take a 15min walk in the morning, no sunglasses. This will help reset your body clock.

  1. Mental Download

Do a ‘mental download’ 2-3 hours before going to bed. Allow for 10-15 min every day to think about all the things that usually come up at night. This could include worries, things you need to do, or anything else that usually concerns you before bed. Go back to this list the next day and check if these things are resolved, or if they need your attention. If they do not, they are no longer important.

  1. Avoid Alcohol

Avoid alcohol at night – alcohol disrupts your overall quality of sleep as it interferes with your brains ability to recharge.

  1. Set an Alarm

Set an alarm to go to bed – this will help establish a healthy routine around bedtime.

  1. Stop checking the Time

Resist the urge to check the clock if you wake up at night. Rather than checking the time, all you can tell yourself if you wake up is: ‘it’s sleep time.’ Then turn your attention to your breath and try to relax every part of your body from the top of your head, face, arms, and body to the tips of your toes.

  1. Acceptance

If you wake up at night for more than 15 minutes, focus on resting and enjoying the comfort of your bed. Even if you are not asleep, drop the struggle and ‘stand back’ to notice your experience. Think and feel without becoming overly critical and judgemental, shifting towards an attitude of acceptance could be a way to disrupt the vicious cycle of insomnia.

Cognitive Behavioural Therapy for Insomnia

Cognitive Behavioural Therapy has a good track record in helping to improve sleep. There are two forms of CBT that are recognised as valid treatment. These are CBTi (Cognitive Behavioural Therapy for Insomnia) and ACTi – (Acceptance and Commitment Therapy for Insomnia).

CBTi – focused on symptom reduction by addressing the cognitive and behavioural elements associated with insomnia.

ACTi – focused on supporting a change in attitude towards sleep difficulties. This is accomplished by adopting an acceptance-based attitude towards sleeping difficulties. Although it sounds paradoxical, the less we struggle with the fact we have difficulty sleeping the more likely we are to fall asleep.

As in menopause the sleep difficulties are often caused by the hormonal changes, hot-flushes, and night sweats, learning an ACTi approach could work better.

Simon Stokes Counselling Psychologist


Best wishes,

Simona Stokes

Counselling Psychologist

Menopause CBT Clinic








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