Fatigue, Sleep & Energy

Common Issues

• Insomnia

  Insomnia in midlife often means trouble falling asleep, staying asleep, or waking up too early without being able to return to sleep, and it's more common during perimenopause and postmenopause due to hormonal changes and night sweats disrupting normal sleep patterns.

• Night waking

  Frequent night waking — especially waking multiple times per night — is a hallmark of sleep disturbance during menopause, linked to fluctuating estrogen levels, vasomotor symptoms like hot flashes, and changes in sleep architecture that make it harder to stay asleep.

• Daytime fatigue

  Poor quality sleep at night often leads to persistent tiredness and difficulty staying alert during the day; studies show many women report both fatigue and reduced daytime functioning in association with sleep disruption during menopause.

• Sleep apnea risk increases

  As estrogen and progesterone decline during menopause, airway muscles may relax more easily and breathing regulation can weaken, increasing the risk of obstructive sleep apnea — a condition where breathing repeatedly stops and starts during sleep.

Major Concerns

• Feeling constantly exhausted

  Persistent insomnia and fragmented sleep can leave women feeling chronically exhausted, even after "enough" hours of rest, because disrupted nighttime sleep doesn't provide restorative deep sleep stages important for energy and cognitive function.

• Work performance

  Menopause-related sleep problems (including night waking, poor sleep quality, and daytime fatigue) are associated with decreased concentration, memory challenges, and reduced productivity, and research shows these symptoms can meaningfully affect work performance and attendance.

• Mood instability

  Sleep disturbance and hormonal shifts are tightly interconnected with mood regulation; poor sleep frequently worsens irritability, anxiety, and depressive symptoms, creating a cycle where mood instability further disrupts sleep.

Topics We'll Explore

Our evidence-based articles and resources will explore these important topics to support your informed decision-making: