Sleep and mood in perimenopause

Disrupted sleep, low mood and anxiety are some of the most common, and least talked about, perimenopause symptoms. They also feed each other: poor sleep makes mood worse, and worry makes sleep worse.

Helping your sleep

• Keep a regular bedtime and wake time, even at weekends
• Keep your bedroom cool, dark and quiet, especially if you get night sweats
• Try to avoid alcohol and nicotine for 1 to 2 hours before bed. Caffeine can keep you awake, so try a warm milky drink or herbal tea instead later in the day.
• Try to avoid screens for an hour before bed
• If you are awake after around 20 minutes, get up, do something calm, and go back to bed when sleepy
• Get daylight and be active during the day

Looking after your mood

• Talk to people you trust about how you are feeling
• Regular exercise can help mood
• Try relaxation, mindfulness or yoga
• NICE says to consider CBT designed for menopause, for low mood and anxiety linked to hot flushes, and for sleep problems that go with them
• NICE also says to consider HRT for low mood that starts around the same time as other menopause symptoms
• If you have depression, treatment follows the usual depression guidance and can be given alongside menopause care. You can refer yourself to NHS talking therapies in England.