Struggling to sleep during menopause? Know the signs of chronic insomnia

Sleep problems can be one of the first symptoms of perimenopause that many women notice. Thanks to the hormonal fluctuations in this life stage, a good night's rest can become harder to come by - and its impact is very difficult to ignore.

A reported 40 to 60% of women experience issues with sleep in menopause. Whether it's struggling to fall asleep, stay asleep, or waking up too early in the morning, a series of poor nights' sleep can have a serious impact on mental and physical wellbeing.

A quarter of women going through perimenopause and menopause experience chronic insomnia that affects their daily activities.

What is chronic insomnia?

Insomnia is considered chronic when you struggle to sleep at least three times a week for at least three months. It is a persistent medical condition that can have a significant impact on day-to-day functioning.

Along with poor sleep, many women experience mood changes, increased anxiety, brain fog, and find it difficult to concentrate when they are dealing with chronic insomnia. This isn't just a symptom of menopause. It can have a serious impact on everyday life at home or at work.

Menopause can trigger insomnia due to the hormonal changes women experience, says Dr Zoe Schaedel, NHS GP with a special interest in sleep and menopause, the Co-Director of Myla Health and Co-founder of The Good Sleep Clinic. "Oestrogen and progesterone [our reproductive hormones] start to vary and fall once perimenopause begins. Length of sleep also tends to be shorter. We wake up more often and more easily," she says.

Other symptoms of menopause, like night sweats, can make the issue worse as well.

Chronic insomnia vs poor sleep

There's a big difference between chronic insomnia and an occasional night of poor sleep, which can happen to everyone. A key symptom of chronic insomnia is the effect it can have during the day. Poor quality sleep can affect concentration, mood, and energy levels. It can also impact work productivity.

“It is important to recognise when insomnia is chronic, as this may be more than just a ‘symptom’ of menopause. It requires a professional diagnosis and should be managed appropriately," says Dr Schaedel.

What to do about chronic insomnia

Many women experiencing menopause feel they must cope with sleep issues on their own, says Dr Schaedel, but it's important to know that support is available. You can learn more about chronic insomnia by visiting Rethink Insomnia.

"If persistent sleep issues are affecting daily life, speak to your GP," says Dr Schaedel. "They can guide you towards different treatment options - whether that be hormone replacement therapy (HRT), cognitive behavioural therapy for insomnia (CBT-I) or other non-hormonal options."

Article initiated by Idorsia Pharmaceuticals UK Ltd, who paid Future for its publication. Idorsia had no editorial control and reviewed article for ABPI Code compliance only. UK-DSA-00108. Date of preparation: September 2026