Sleep

Perimenopause, which is the transitional years leading up to menopause, can bring noticeable changes to your body and overall well-being. One of the most common and frustrating concerns during this time is disrupted sleep.

If you’re finding it harder to fall asleep, waking during the night, or rising earlier than usual and unable to return to sleep, you’re not alone. Sleep disturbances are a frequent symptom of perimenopause. Understanding why these changes happen can help you take steps to improve your rest.

erimenopause is the time when your body begins transitioning toward menopause. It can start several years before menopause, often in your 40s, but sometimes earlier. During this stage, estrogen and progesterone levels fluctuate unpredictably.

These hormonal shifts affect many systems in the body, including those that regulate sleep.

Sleep problems during perimenopause are usually caused by a combination of hormonal changes and related symptoms.

Hot Flashes and Night Sweats

Declining and fluctuating estrogen levels can affect the body’s temperature regulation. This may lead to hot flashes during the day and night sweats during sleep.

Night sweats can:

• Wake you suddenly

• Make it difficult to fall back asleep

• Leave you feeling unrested in the morning

Even mild temperature changes can fragment sleep without you fully realizing it.

Sleep plays an essential role in:

Chronic sleep disruption can worsen mood symptoms, increase fatigue, and affect overall quality of life.

3. Practice Relaxation Techniques

Stress and anxiety can worsen sleep problems. Techniques that may help include:

• Deep breathing exercises

• Progressive muscle relaxation

• Meditation

• Gentle stretching or yoga before bed

Establishing a calming bedtime routine can signal your body that it’s time to rest.

4. Limit Sleep Disruptors

To promote better sleep:

• Avoid caffeine in the afternoon and evening.

• Limit alcohol, which can disrupt sleep cycles.

• Reduce screen time at least an hour before bed.

• Keep lights dim in the evening.

5. Stay Physically Active

Regular physical activity can improve sleep quality and reduce stress. Aim for most exercise earlier in the day, as vigorous activity close to bedtime may interfere with sleep.

6. Talk With Your Health Care Professional

If sleep problems are persistent or affecting your daily life, consult your health care professional. They can evaluate for:

• Insomnia

• Sleep apnea

• Restless legs syndrome

• Depression or anxiety

Treatment options may include:

• Cognitive behavioral therapy for insomnia (CBT-I)

• Medications for sleep or mood symptoms

• Hormone therapy, when appropriate

• Nonhormonal therapies for hot flashes

Your care plan should be individualized based on your symptoms, medical history, and personal preferences.

Consider seeking medical guidance if you:

• Have trouble sleeping most nights

• Snore loudly or gasp during sleep

• Feel excessively sleepy during the day

• Experience mood changes that interfere with daily activities

Persistent sleep problems are not something you simply have to endure.

Perimenopause can significantly affect sleep due to hormonal fluctuations, night sweats, mood changes, and increased risk of sleep disorders. Although these changes are common, effective strategies and treatments are available.

With the right support and adjustments, restful sleep is possible during this transition.

If sleep concerns are affecting your health or quality of life, consider speaking with your health care professional about options that may help you feel more rested and balanced.

Sources: 

How perimenopause affects sleep. Lifestyle Medicine. (n.d.). https://lifestylemedicine.stanford.edu/sleep-perimenopause 

Prior JC;Cameron A;Fung M;Hitchcock CL;Janssen P;Lee T;Singer J; (n.d.). Oral micronized progesterone for perimenopausal night sweats and hot flushes a phase III Canada-wide randomized placebo-controlled 4 month trial. Scientific reports. https://pubmed.ncbi.nlm.nih.gov/37277418/ 

Troìa L;Garassino M;Volpicelli AI;Fornara A;Libretti A;Surico D;Remorgida V; (n.d.). Sleep disturbance and perimenopause: A narrative review. Journal of clinical medicine. https://pubmed.ncbi.nlm.nih.gov/40094961/ 

Struggling to sleep after night shifts or long-distance travel?
Shift work and jet lag can disrupt your body’s internal clock, making it hard to fall asleep, stay asleep, or feel alert when you need to be. The good news: with consistent habits and a structured plan, most people can reset their sleep schedule in about a week.

Your body follows a 24-hour internal clock, known as the circadian rhythm, which regulates sleep, hormones, digestion, and alertness. Light exposure, meal timing, activity, and sleep schedules all influence this rhythm.

• Shift work forces sleep and wake times that conflict with natural light–dark cycles.

• Jet lag occurs when rapid travel across time zones leaves your internal clock out of sync with local time.

Common symptoms include:

• Difficulty falling or staying asleep

• Daytime sleepiness or fatigue

• Poor concentration or mood changes

• Digestive discomfort

Day 3: Time Your Sleep Window

Gradually shift your bedtime closer to your target sleep time. Aim for a sleep window that allows 7 to 9 hours of rest.

If you can’t fall asleep after about 20–30 minutes, get out of bed and do something quiet in low light until you feel sleepy.

Day 4: Align Meals and Caffeine

Meal timing also influences your body clock.

• Eat meals at consistent times aligned with your new schedule.

• Avoid heavy meals within 2–3 hours of sleep.

• Limit caffeine to the first half of your waking period.

Day 5: Optimize Your Sleep Environment

Create a sleep setting that supports rest, especially if sleeping during the day:

• Use blackout curtains or an eye mask

• Keep the room cool, quiet, and comfortable

• Consider white noise to reduce disruptions

Day 6: Be Physically Active at the Right Time

Regular physical activity supports sleep quality and alertness.

• Exercise earlier in your waking period when possible.

• Avoid vigorous activity within a few hours of bedtime.

Day 7: Evaluate and Adjust

By the end of the week, many people notice improved sleep timing and daytime alertness. Continue reinforcing the habits that work best for you.

If sleep remains disrupted, additional evaluation may be helpful.

Seek medical advice if you experience:

• Ongoing insomnia despite schedule adjustments

• Excessive sleepiness that interferes with work or safety

• Snoring, breathing pauses, or restless sleep

• Symptoms lasting longer than several weeks

A clinician can assess for conditions such as shift work sleep disorder, insomnia, or sleep apnea and recommend appropriate treatment.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Sources: 

Centers for Disease Control and Prevention. (n.d.-b). Jet lag disorder. Centers for Disease Control and Prevention. https://www.cdc.gov/yellow-book/hcp/travel-air-sea/jet-lag-disorder.html 

Mayo Foundation for Medical Education and Research. (2022, November 19). Jet lag disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/jet-lag/symptoms-causes/syc-20374027 

Mayo Foundation for Medical Education and Research. (2025e, December 16). Pros and cons of Melatonin. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/melatonin-side-effects/faq-20057874 

RR;, K. B. (n.d.). Jet lag and shift work sleep disorders: How to help reset the internal clock. Cleveland Clinic journal of medicine. https://pubmed.ncbi.nlm.nih.gov/21968474/ 

Shift work. Sleep Education. (2021, May 6). https://sleepeducation.org/sleep-disorders/shift-work 

U.S. Department of Health and Human Services. (n.d.). Causes and risk factors. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/circadian-rhythm-disorders/causes 

Circadian rhythms are natural, internal processes that regulate the sleep-wake cycle and repeat approximately every 24 hours. These rhythms play a critical role in maintaining overall health by influencing various biological processes, including hormone release, metabolism, and body temperature. When circadian rhythms are disrupted, they can impact your physical and mental well-being.

Circadian rhythms are driven by a biological clock located in the brain’s hypothalamus. This internal clock responds to environmental cues, primarily light and darkness, to synchronize bodily functions with the day-night cycle.

For instance, when light enters eyes in the morning, it signals the brain to reduce melatonin production—a hormone that helps promotes sleep—while increasing alertness. In contrast, darkness triggers the release of melatonin, preparing the body for rest.

While the sleep-wake cycle is a recognized circadian rhythm, other systems, such as digestion and immune response, also follow these patterns.

If experiecing persistent sleep problems or suspect a circadian rhythm disorder, consult a healthcare provider. A thorough evaluation, which can include a sleep study, can help diagnose any issue present and serve as a guide for appropriate treatment. 

While occasional disruptions are common, prolonged issues may impact quality of life. By understanding the body's natural rhythms and adopting strategies to help maintain their balance, improved sleep and enhanced physical and mental health is possible. 

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Sources: 

Circadian rhythm sleep disorders: Types and treatments. Sleep Foundation. (2024a, March 15). https://www.sleepfoundation.org/circadian-rhythm-sleep-disorders 

Circadian rhythm. Sleep Foundation. (2024, March 15). https://www.sleepfoundation.org/circadian-rhythm 

U.S. Department of Health and Human Services. (n.d.). Causes and risk factors. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/circadian-rhythm-disorders/causes 

U.S. Department of Health and Human Services. (n.d.). Circadian rhythms. National Institute of General Medical Sciences. https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx 

U.S. Department of Health and Human Services. (n.d.-b). Treatment. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/circadian-rhythm-disorders/treatment 

Related articles: 

Healthy Sleep: A Guide to Restful Nights

Sleeping and Aging Well

A good night's sleep is vital for overall well-being, and snoring can often disrupt this restful experience. While occasional snoring is common, persistent snoring may be indicative of an underlying issue that could impact your sleep health. Learning about nasal breathing versus mouth breathing may help with snoring and getting a restful night’s sleep.

For individuals who struggle with mouth breathing during sleep, chin straps may be a valuable tool. These straps are designed to help keep the mouth closed during sleep and encourage nasal breathing. By promoting proper airflow through the nose, chin straps may reduce the vibrations in the throat that lead to snoring. It is important to note that while chin straps can be effective for some individuals, they may not be suitable for everyone.

Before incorporating any sleep aid, including chin straps, into a sleeping or nighttime routine, it is important to consult with your treating provider. Snoring can be a symptom of a more serious condition, such as sleep apnea, a disorder characterized by pauses in breathing during sleep. A healthcare professional can conduct a thorough evaluation to determine the underlying cause of snoring and recommend appropriate interventions and treatments.

In the pursuit of optimal sleep health, understanding the significance of nasal breathing versus mouth breathing is crucial. For those struggling with snoring due to mouth breathing, chin straps can offer a potential solution. However, it is imperative to prioritize consultation with a treating provider to rule out underlying sleep disorders and ensure the most effective and personalized approach to improving sleep quality.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Related articles: 

Healthy Sleep: A Guide to Restful Nights

Sleeping and Aging Well: Choosing the Right Pillows for Neck, Back, and Knees

Sources:

Bhat, S., Gushway-Henry, N., Polos, P. G., DeBari, V. A., Riar, S., Gupta, D., Lysenko, L., Patel, D., Pi, J., & Chokroverty, S. (2014, August 15). The efficacy of a chinstrap in treating sleep disordered breathing and snoring. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106943/ 

Mouth Breathing - Mankato. Mayo Clinic Health System. (n.d.). https://www.mayoclinichealthsystem.org/locations/mankato/services-and-treatments/otorhinolaryngology/pediatric-ent-conditions/mouth-breathing#:~:text=Benefits%20of%20nasal%20breathing&text=Taking%20air%20in%20through%20the,by%20breathing%20through%20the%20nose. 

Rausch-Phung, E., & Singh, A. (2023, December 7). How to stop sleeping with Mouth Open. Sleep Foundation. https://www.sleepfoundation.org/snoring/sleeping-with-mouth-open 

CPAP or Continuous Positive Airway Pressure is a therapy prescribed to treat breathing problems experienced while someone is sleeping. This type of therapy helps treat sleep apnea and other respiratory disorders.

There are different modes and devices providers prescribe based on individual needs. While each device or CPAP machine may work differently, it is important to keep the products clean. It is best to refer to the instruction manual that comes with your equipment for specific manufacturer recommendations; however, below is a general guide for cleaning your PAP equipment and supplies.

Supplies needed:

• Mild liquid dish detergent
• Sink or basin
• Clean hand towel
• Device to hang tubing (ie. drying rack, shower bar or towel rack)

View How to Clean:

How To Clean Your CPAP Mask

Wash daily. Natural body oils on your face can wear down the mask, which can cause a poor mask-to-face seal.

1. Remove the headgear from the mask.
2. Wash the mask in warm, soapy water.
3. Rinse the mask under running water.
4. Shake off excess water.
5. Place the mask on a clean hand towel to dry the mask

In lieu of steps 1-5, use an approved mask cleaning wipe and allow to air-dry.

How to Clean Your Nasal Pillow

Wash daily.

1. Remove the nasal pillows from the frame.
2. Wash the nasal pillows in warm, soapy water.
3. Rinse the nasal pillows under running water.
4. Shake off excess water.
5. Place the nasal pillows on a clean hand towel to air-dry or use the hand towel to dry the nasal pillows.

In lieu of steps 1-5, use an approved mask cleaning wipe and allow to air-dry.

How to Clean Your CPAP Humidifier

Water or moisture that sits in the water chamber when not in use readily begins to grow mold and fungal material. When these are blown with pressure through your nose, it can trigger allergies, rhinitis (clear, runny nose) and congestion. This makes tolerating PAP difficult.

1. Daily empty the humidifier tub and wipe it thoroughly with a clean cloth. Allow it to dry out of direct sunlight.
2. Weekly wash water chamber reservoir in the dishwasher if the water chamber instruction manual says it is safe to do so and you have a dishwasher. Otherwise, follow steps 3-6.
3. Wash the inside of the water chamber with warm, soapy water or a solution with a ratio of 1 part vinegar and 9 parts water at room temperature.
4. Rinse the inside of the water chamber thoroughly.
5. Pour out excess water.
6. Use a clean hand towel to wipe the outside of the water chamber and allow the inside of the water chamber to air-dry.

How to Clean Your CPAP Tubing

Wash weekly.

If using heated tubing, assure that electronic contacts are dry before reconnecting to your PAP device.

1. Separate tubing from the PAP unit and mask or nasal pillows.
2. Wash the tubing in warm, soapy water.
3. Rinse the tubing under running water.
4. Shake off excess water.
5. Allow tubing to air-dry by hanging it so that water will drain out. Tubing also can be dried by reattaching it to the PAP unit and turning the unit on for several minutes.

If using heated tubing, assure that electronic contacts are dry before reconnecting to your PAP device.

How to Clean Your CPAP Headgear

Wash weekly.

1. Close the Velcro tabs so they do not accumulate lint from the drying towel.
2. Hand wash the headgear in warm, soapy water. Do not wash the headgear in the clothes washer.
3. Rinse headgear thoroughly.

Place the headgear on a clean hand towel to air-dry or use the hand towel to dry the headgear. Do not dry the headgear in the clothes dryer.

How to Clean Your Washable CPAP Machine Filters*

Wash weekly when cleaning tubing.

1. Remove the filter from the PAP unit.
2. Wash the filter in warm, soapy water.
3. Rinse the filter under running water.
4. Squeeze out excess water or press filter in a clean hand towel.
5. Allow the filter to air-dry. Keep filter out of direct sunlight.
6. Do not reinstall filter until it is completely dry.

*not applicable to most PAP devices

How to Clean Your PAP Unit

1. Remove household dust from the PAP unit by wiping it with a damp cloth.
2. Do not place liquids on the top of the PAP unit.

You can travel with your PAP equipment. When traveling, PAP cleaning wipes can be used to clean your mask. PAP manufacturers normally recommend only distilled water is used with humidification due to potential mineral deposits in the system, hose or mask. In rare circumstances where distilled or purified water is not available, bottled water should be used in place of distilled water.

It is important to not use cleaning supplies that are expired and to follow the manufacturer’s instructions on when to replace equipment and/or supplies. Do not put solutions in the water chamber that may be harmful to you, such as bleach and other cleaning products with similar, strong chemicals.

The Mayo Clinic Store offers a wide selection of CPAP supplies online, and several of our store locations throughout Minnesota and Wisconsin have CPAP machines and supplies available as well.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

A Guide To Using And Caring For CPAP Equipment And Supplies

How to Obtain Replacement CPAP or Sleep Apnea Supplies

To obtain new or replacement continuous positive airway pressure (CPAP) supplies, you may contact the Mayo Clinic Store where you obtained your device or through our mail order department.

Medicare or your insurance company may require documentation demonstrating compliance for replacement sleep apnea supplies. You can call your insurance provider regarding your specific coverage criteria.

A Guide To Using And Caring For CPAP Equipment And Supplies
How to Clean CPAP Supplies

A good night's sleep is often considered the cornerstone of a healthy lifestyle, and as we age, its significance becomes even more pronounced. Quality sleep plays a fundamental role in supporting overall well-being, cognitive function, and emotional balance. One often overlooked aspect of achieving restorative sleep is the choice of pillows, specifically designed to provide optimal support for the neck, back, and knees.

As people age, our bodies undergo various changes that can impact the quality of our sleep. From a natural decline in melatonin production to changes in sleep architecture, aging introduces unique challenges that may lead to difficulty falling asleep, staying asleep, or experiencing restorative sleep. Inadequate sleep has been linked to a myriad of health issues, including cardiovascular problems, weakened immune function, and cognitive decline.

One often underestimated solution to promote better sleep is investing in supportive pillows that cater to specific needs. The alignment of the spine and proper support for the neck, back, and knees can significantly enhance sleep quality, alleviate discomfort, and contribute to overall well-being.

*This article is intended for informational purposes only and should not substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Related Articles: 

Snoring and Sleep Health - Nasal Breathing, Mouth Breathing, and Chin Straps

Healthy Sleep: A Guide to Restful Nights

Sources: 

New evidence on sleep’s role in aging and chronic disease. PRB. (n.d.). https://www.prb.org/resources/new-evidence-on-sleeps-role-in-aging-and-chronic-disease/ 

Sleeping with a pillow between your knees. Sleep Foundation. (2023, February 17). https://www.sleepfoundation.org/best-pillows/sleeping-with-a-pillow-between-your-knees 

U;, P. L. (n.d.). Neck support pillows: A comparative study. Journal of manipulative and physiological therapeutics. https://pubmed.ncbi.nlm.nih.gov/9608378/