The Best Bedtime Routine to Consider for Better Sleep in Perimenopause

Perimenopause |
4 min read

Published

December 26, 2025

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

Trouble sleeping in midlife, more specifically during the menopause transition? More than half of women in perimenopause face the same issue.¹

Apart from hot flashes and irregular periods, difficulty sleeping is ranked as one of the most universally-shared symptoms of menopause.²

Fortunately, trying out a few science-backed sleep tips during perimenopause may help improve both the quality and quantity of the sleep you get at night.³ Let’s first take a look at why perimenopause sleep issues occur in midlife and how to establish a balanced perimenopause bedtime routine.

How Hormones Affect Sleep in Perimenopause

There are many reasons for perimenopause sleep disruptions. Hot flashes, for starters, affect more than 80% of women during menopause and, unfortunately, aren’t limited to the daytime. Night sweats—aka, nighttime hot flashes—may leave you uncomfortably warm and sweaty, dampening clothes or bedding in the process.⁴

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These symptoms experienced during menopause are primarily driven by drops in estrogen, a hormone that influences our body’s temperature regulation.⁵ In addition to night sweats, other factors that may negatively impact sleep during menopause include: ^6,7

Sleep apnea
High stress levels
Mood changes (including depression)
Urinary changes (frequency and urgency)

What Is a Good Bedtime Routine During Perimenopause?

Looking for calming bedtime routines for women over 40 and not sure where to begin? According to experts, a perimenopause bedtime routine may look different for everyone, but here are a few steps to get you started.

Perimenopause Bedtime Routine: Sleep Tips for Perimenopausal Women

Step 1: Spend your daytime hours wisely.

Research shows that simple and smart choices you make throughout the day may pay off when it comes time for rest at night.⁸ Experts recommend taking the following steps each day to improve your chances of falling and staying asleep at night.

● Light exposure. Get your daily sunlight exposure, either by going outdoors or by spending time near a window. Doing so helps to reset your circadian rhythm, keying your body into when it’s time to exert energy vs. when it’s time to wind down.⁹

● Exercise daily. Experts state that just 30 minutes of moderate exercise may improve sleep quality that same night.¹⁰ This includes brisk walking or jogging, swimming, strength training, yoga, gardening, and any other safe activity that gets your heart pumping.¹¹ (Don’t forget to clear any new exercise regime with a physician, especially if you have underlying health conditions.)

● Consume a balanced diet.¹² For food that supports sleep during menopause, try to consume a diet rich in lean protein, micronutrient-dense fruits and vegetables, and fiber-rich whole grains. Additionally, foods high in melatonin (tart cherries, pistachios, eggs), tryptophan (turkey, pumpkin seeds, fish), and magnesium (spinach, avocados, bananas) may help support sleep.¹³

Step 2: Power down before bedtime.

If you’re struggling to get the rest you need, consider starting a bedtime routine that begins before you lay your head down on your pillow.

An hour before you plan to go to sleep, wind down by focusing on calming activities only – such as a relaxing bath and other relaxing additions to your night time routine. Try eliminating stimulating activities that experts say can interfere with your ability to both fall and stay asleep, such as: ^14,15

Scrolling on your phone
Tackling work emails
Watching television
Intense exercise
Consuming caffeine or alcohol
Eating high-fat and/or spicy foods

Step 3: Create a cool, comfortable environment.

Science shows a cool bedroom can improve sleep quality.¹⁶ Cold temperatures at night help to stimulate the production of melatonin, a hormone that helps the body fall and remain asleep.^17,18

During midlife, do your best to take steps that go beyond simply turning down the thermostat. Consider the following tips for maintaining a cool environment and preparing for those potential night sweats during menopause:¹⁹

Keep cold water at your bedside.
Use an additional fan.
Try lightweight bed linens
Consider layers for pajamas (and strip layer by layer, if necessary).

Trouble Sleeping? Talking to a Healthcare Provider May Help

If establishing a new bedtime routine isn’t helping to improve your sleep, consider talking to your healthcare provider for guidance. A qualified professional can provide personalized advice on how to improve sleep or run tests to determine other potential causes for poor sleep.

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