MyMT™ Blog

Waking at 2am? The science of your menopause insomnia …. and why not sleeping may change your immune health

What do you think about when you are lying awake at 2am, or 3am or 4am? Do you plan your day ahead or are you just despairing because night after night you aren’t sleeping and you can feel your energy being sucked out of you?

You know that the day ahead is another busy one and your brain will be fuzzy and fatigued. You won’t be functioning at your best will you?

If you feel like this, then you aren’t alone. I was like that too, so please keep reading.

What you may not realise is that wakefulness, light sleeping and insomnia (not being able to get back to sleep), is linked to your changing reproductive hormones during menopause as well as a number of other factors, such as low Vitamin D, low iron, and even low calcium intake – yes, all of these factors affect your sleep patterns.

But perhaps of more concern, is that the longer you lie awake night after night, the more your symptoms and/or weight gain and immune health may become worse over time too.

For many women, as I found myself, the HRT kicks in for a while, but when we don’t change our lifestyle to allow our body to adapt to midlife hormonal changes, then sleep problems can stay around. 

Why your Sleep is Important to Conquer in Menopause

Scientists divide sleep into two major types: REM (rapid eye movement) sleep or dreaming sleep, and non-REM or quiet, healing sleep. Sleep specialists have called non-REM sleep “an idling brain in a movable body.”

During this phase, thinking and most bodily functions slow down, but movement can still occur, and a person often shifts position while sinking into deeper stages of sleep. When we go to bed and start to fall asleep, both phases last around 4 hours or more.

After your REM sleep, comes your deeper sleep, or your non-REM sleep. This is characterised by slow brain waves called delta waves. When your brain slows down, you allow your body to enter deep sleep. Breathing becomes more regular.

Blood pressure falls, and the pulse slows to about 20% to 30% below the waking rate. The brain is less responsive to external stimuli, making it difficult to wake up. But if blood pressure doesn’t fall, then many women may wake up to hot flashes/flushes at this time of night.

That’s why I have a focus on reducing blood pressure before bedtime. It helps you to fall into a deeper sleep and it’s this deep sleep that is really important for us to have during menopause because this is the time that your body heals, and cells and tissues both repair and renew. 

But there’s more to the sleep story during menopause. We need to have deep sleep in order to activate our immune system.

Hence, for those of you doing lots of higher intensity exercise or if you are following the advice about doing heavy weight training, then you have to be sleeping well. Menopause insomnia not only causes your performance to drop, but your muscles and joints may remain sore for longer and you don’t recover sufficiently before the next training session. 

Just as deep sleep restores your body, scientists also know that REM or dreaming sleep restores your mind, perhaps in part by helping clear out irrelevant information. A very important task for a generation of women with a lot going on in their lives still!

When we get this deep, restorative sleep (between 2-4am), blood flow is directed less toward your brain, which cools measurably. At the beginning of this stage, the pituitary gland releases a pulse of growth hormone that stimulates tissue growth and muscle repair.

But if we are lying awake between 2 and 4am, then this release of growth hormone does not reach the threshold it needs to for healing and repairing our body. 

As I mentioned above, this is why I hear from so many women who are avid exercisers and they don’t understand that their sore muscles and joints are due to not just low oestrogen, but also not sleeping!

A full night’s sleep helps you to build and retain muscle. It is also necessary for weight management too.

When we aren’t sleeping well and growth hormone is low, our blood sugar hormone called insulin remains high. So too, does our chronic stress hormone called cortisol.

This powerful combination of high insulin and high cortisol competes with your sleep hormone, called melatonin which is already low not only due to changing levels of oestrogen in menopause, but because we are ageing!

The lower that melatonin is before you go to bed and the lower it stays overnight, the more awake you feel. The more awake you feel, the busier your brain  and the more hot flushes you have …. night after night, it happens … and over time, your brain and your hormones are now reading this as your ‘new normal’.

As many of you already know – the result is daily fatigue, exhaustion, irritability and with  your insulin levels all mixed up overnight, the weight starts to increase around our belly too.

That’s why in the MyMT ‘Transform Me’ weight loss programme and the MyMT Circuit Breaker symptom-reduction programme, the first module you listen to is simply called ‘Sleep All Night’. Without this precious sleep, your body doesn’t burn fat. 

One of the strategies that women on my programmes discover is the importance of our Circadian Rhythms and how to adjust these to specifically match their changing hormonal levels during menopause.

The term ‘Circadian’ means “about a day” so our circadian rhythms  are daily fluctuations in our biology that can become messed up as we transition through menopause. This internal clock, which gradually becomes established during the first months of life, controls the daily ups and downs of biological patterns, including body temperature, blood pressure, and the release of hormones.

Circadian rhythms make people’s desire for sleep strongest between midnight and dawn, and to a lesser extent in mid-afternoon.

But our changing menopause hormones cause disruption to our normal circadian rhythms, so as we transition into or through menopause, then it’s really important to restore this biological rhythm and make adjustments to get us back sleeping all night. If we don’t, then over time, our brain and body start to read this 2-3am ‘awake’ period as ‘normal’.

But here’s the thing – because hormones in the body all work in harmony with each other, when your reproductive hormones change as you go into menopause, your other hormones start to adjust to re-balance the body. Especially hormones that control your blood pressure, heat regulation, stress levels and moods.

When I began to look into our menopause symptoms as part of my women’s healthy ageing studies, I began to understand that our menopause transition is a natural transition that all women go through.

But for millions of women, this stage of their lives can result in all sorts of mayhem, and it all starts with not sleeping well. 

Hundreds of women are experiencing the excitement and renewed energy from sleeping all night and getting rid of their hot flushes and night sweats without resorting to hormonal medications.

And if you need to lose weight, then you must get your sleep sorted.

Menopause is the transition into the next phase of our lives – our ageing. As oestrogen levels naturally decline, there are numerous changes that occur in our body, from our pituitary hormones which control sleep, to our muscles to our blood sugar regulation. I’ve pulled all the scientifically-evidenced solutions together in one fabulous programme which not only helped me,  but is now ‘life-changing’ for other women too. 

If you would like to join me on either of my 12 week online programmes then come on board when you can. If you are thinner you might like to look at the Circuit-Breaker’ programme and if you are overweight, then look at the ‘Transform Me’ programme.

Both programmes are $99NZ a month for 3 months, which includes my private coaching as well (if you are a newsletter member, then also check your emails for any promotions).  

You can also start with my 2 hr Masterclass on Menopause which is updated and revised and is now in 2 parts. I have a brief video for you below as I explain why you need to watch it! I would love you to discover how to sleep all night, reduce your symptoms in menopause and get back to feeling like the ‘old-you’ again.

Dr Wendy Sweet (PhD)/ MyMT™ Founder & Member: Australasian Society of Lifestyle Medicine 


Davis, S., Castelo-Branco, C. (2012). Understanding weight gain at menopause. Climacteric, 15: 419–429.

Harvard Health Report (2017). Improving Sleep. Harvard Health Publication

Geddes, L. (2019). Chasing the Sun: The new science of sunlight and how it shapes our bodies and minds. London: Profile Books.

Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006 Nov 15;164(10):947-54. 

Reinke H. & Asher G. (2017). Circadian clock control of liver metabolic functions. Gastroenterology, 150: 574–580.

Rizzi, M. et al. (2016). Sleep Disorders in Fibromyalgia Syndrome.  Journal of Pain Relief, 5:2, 1-5

Sharma, S. & Kavuru, M. (2010). Sleep and Metabolism: An Overview. Int. Journal of Endocrinology, Article ID 270832, 1-12.

Woods, N. et al. (2009). Cortisol Levels during the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study. Menopause, 16(4): 708–718.

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