7 Lifestyle Changes to Improve Sleep in Perimenopause and Beyond

Sleep issues are incredibly common—40–60% of women in the menopause transition experience them. Many of my patients struggle with this, and it's one of the most frequent concerns I hear.

As an integrative practitioner, I regularly recommend lifestyle changes, nutrition, and supplements when indicated. But when it comes to sleep, the data on supplements just isn’t that strong. It’s not as simple as “just take magnesium.” 

When it comes to magnesium, social media often overhypes its sleep benefits. That doesn’t mean I don’t recommend it—but it does mean we need to be realistic about what it can actually do.

Same goes for melatonin: research shows it can reduce sleep onset by an average of about 7 minutes. This is a small effect for most people that is not meaningful. Its best evidence is for jet lag and time zone adjustment (yes, I travel with it myself!).

But supplements aren’t today’s focus. In this newsletter, I want to share the lifestyle strategies that are effective for improving sleep, and these can truly be a game changer. 

Before we dive in, I want to share a quick reminder:

 You may have heard some of these tips before—but I invite you to ask yourself, “Have I truly given this a real try?” So often, we know what supports our health, but life gets in the way and we don’t follow through. And that’s completely normal, no judgment here. I’ve been there too.

The good news? You can always start again. This blog post is here to gently guide you back into a routine that supports better sleep, and maybe even helps you feel more like yourself again.

Tip #1: Establish a consistent bedtime (even on weekends). 

• This creates predictability and stability, which can support better sleep. I encourage my patients to aim for bedtime consistency within about 30 minutes of their usual time, even on weekends. Life happens, and perfect consistency isn’t always possible—but doing this more often than not can make a real difference in how rested you feel.

Tip #2: Try to avoid caffeine after 12pm.

• The effects of caffeine on sleep can persist for a considerable time after consumption. Caffeine levels in the body peak about 30 minutes after ingestion, and the average half-life is 5 to 7 hours. Notably, 90% of caffeine is metabolized in about 3.3 hours, which means its effects can last for almost an entire day.

• Even in individuals who report being normal, healthy sleepers, caffeine can alter sleep architecture as observed in polysomnography studies. This means that even if a person feels they can consume caffeine and still sleep well, the quality and structure of their sleep may be compromised.

Tip #3: Set a bedtime alarm to ensure you have time to wind down before sleep.

• We often set alarms to wake up, but few of us set one to remind us to start slowing down. A bedtime alarm acts as a gentle cue to step away from stimulating activities, like work, screens, or errands, and begin your wind-down routine.

• Think of it as a signal to transition into rest mode, allowing time for activities that calm your nervous system: dimming the lights, reading, light stretching, journaling, or any ritual that helps you disconnect from the day.

• Ideally, set this alarm about 30–60 minutes before your target bedtime. That buffer helps your body and mind shift gears, making it easier to fall asleep, and stay asleep, once your head hits the pillow. This is a great time to put all electronics away, including all screens and phones.

Tip #4: Be aware if you are intermittent fasting.

• If you're intermittent fasting and tend to eat dinner earlier in the evening (for example at 5:30pm), it can sometimes lead to dips in blood sugar (hypoglycemia) overnight. This drop in blood sugar may cause your body to release stress hormones like cortisol, prompting you to wake up prematurely or experience restless sleep.

• If you notice consistent early awakenings or disrupted sleep, consider adjusting your fasting window slightly or having a small, balanced snack closer to bedtime. This can help stabilize blood sugar levels throughout the night. You can experiment with the following:

  • A slightly later dinner

  • A small, balanced snack before bed (e.g., a bit of protein + complex carb)

  • Or adjusting your fasting window to better support your sleep needs

Tip #5: Sleeping separately may improve your sleep.

• Let’s get honest for a moment—there’s something that can seriously affect your sleep, and it might be lying right next to you. If your partner snores loudly, it might be time to consider sleeping in separate areas of the house (and gently suggest they get evaluated for sleep apnea—because that’s a real health issue).

• My friend and colleague, Dr. Woganee Filate, MD, a sleep specialist, shares an idea I love: instead of calling it a sleep divorce, think of it as a shared sleep action plan. It sounds more collaborative, and that’s exactly what it should be.

• Here’s the key point: sleeping in separate bedrooms is not a sign of relationship failure. In fact, it’s a science-backed strategy for improving your health, sleep quality, and yes, even your intimacy.

• Creating a plan together that prioritizes deep, restorative sleep can actually lead to greater relationship satisfaction. And it doesn’t have to be all or nothing—many couples start by sleeping apart on weekdays and co-sleeping on weekends. Flexibility is part of what makes it work.

Tip #6: Consider breaking up with alcohol.

• Alcohol might initially make you feel relaxed and sleepy, but it will actually sabotage the quality of your rest later in the night. Alcohol disrupts your sleep cycle by preventing you from entering deeper, restorative stages of sleep, causing frequent awakenings and a fragmented night of rest.

• Additionally, alcohol can worsen other sleep issues, like snoring and sleep apnea. It may also lead to increased bathroom visits during the night due to its diuretic effects.

Tip #7: Are you urinating multiple times a night?

• Many people assume waking up multiple times a night to pee is just a normal part of aging or menopause, but it actually isn't. Frequent nighttime urination (more than once per night, consistently) is known as nocturia and can significantly disrupt your sleep quality, leading to fatigue and reduced daytime functioning.

• Several factors can contribute to nocturia, including:

  • Drinking fluids too close to bedtime: Try reducing your fluid intake two hours before sleep.

  • Alcohol and caffeine: Both substances can increase urine production and irritate the bladder. Limiting their consumption, especially later in the day, can help reduce nighttime waking.

  • Hormonal changes: Menopausal changes, including lower estrogen levels, can influence bladder function.

  • Pelvic floor dysfunction: Seeing a pelvic floor physiotherapist to assess your pelvic floor is one of my number one recommendations for my patients!

BONUS TIP

If you frequently find yourself waking up frustrated in the middle of the night, consider doing some meditations, specifically Yoga Nidra meditations, which can be easily found on the Insight Timer app. Yoga Nidra involves gentle guidance through deep relaxation and breathing techniques, helping quiet the mind and ease back into restful sleep.

Additionally, addressing racing thoughts proactively can be a game-changer. A simple yet powerful practice I've personally found helpful is writing out my to-do list the night before in a journal. This strategy helps reassure my mind if I wake up during the night. I remind myself that everything is already captured and organized, which significantly reduces anxiety and allows me to drift back to sleep more easily.

Did these tips resonate with you or help improve your sleep? I'd genuinely love to hear your experience!

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