Sleep, Recovery & Menopause

Sleep is when your body repairs from training, and menopause makes it harder to get enough. Aim for 7 to 9 hours a night.

Key takeaways

  • Short sleep blocks recovery. Your body produces less growth hormone, cortisol stays high for longer, appetite increases and blood sugar control gets worse.
  • Falling hormones disturb sleep. Lower progesterone, estrogen and melatonin can make it harder to fall asleep and stay asleep, while hormonal changes can also contribute to night sweats.
  • Habits come first. Keep the bedroom cool and dark, keep regular hours, eat dinner earlier, and cut back on alcohol and on caffeine after midday.
  • Calm the nervous system before bed. Slow belly breathing, yoga and meditation all help.
  • Supplements are optional. Some have modest evidence, and some interact with medication, so ask your doctor first.
  • See your doctor if poor sleep lasts more than 3 months. CBT-I and menopause treatment both work.

Why sleep matters for training and recovery

Adults need 7 to 9 hours of sleep. With less than that, five things go wrong:

What happens Effect on you Evidence
Less growth hormone Growth hormone peaks in deep sleep, soon after you fall asleep. It repairs tissue, builds muscle and helps burn fat. Short or broken sleep cuts that peak, and production also falls with age. Kim et al., 2015
Cortisol stays high The stress hormone normally falls in the evening. After a week of 4-hour nights, it fell about 6 times more slowly. That slows repair and makes belly fat, injury and overtraining more likely. Spiegel et al., 1999
More hunger After 2 nights of 4-hour sleep, leptin (the "full" hormone) fell 18%, ghrelin (the "hungry" hormone) rose 24%, and appetite rose 23%. That is why you want late-night snacks. Spiegel et al., 2004
Poorer blood sugar control One night of about 4 hours' sleep cut insulin sensitivity by about 20 to 25%. Your muscles then refill their energy stores (glycogen) less well. Donga et al., 2010
Tiredness builds up Hard sessions burn a lot of energy (ATP). This leaves adenosine, which builds up in the brain and makes you drowsy. Only sleep clears it. W. Chris Winter, The Sleep Solution

How menopause changes sleep

Three hormones that support sleep fall during menopause.

  • Progesterone has a calming and mildly sedating effect. With less of it, falling asleep and staying asleep get harder.
  • Estrogen helps you fall asleep faster and wake less often. It also helps control cortisol and body temperature. As it falls, the body copes with a narrower range of temperatures, which brings hot flushes and night sweats. Noise, light or minor stress may then wake you more easily.
  • Melatonin, the hormone that cues sleep and cools the body, is also produced in smaller amounts.

The numbers back this up:

Women aged 40 to 59 (US, 2015) Sleep less than 7 h Trouble staying asleep 4+ nights a week
Before menopause 32.5% 23.7%
Around menopause (perimenopause) 56.0% 30.8%
After menopause 40.5% 35.9%

Source: CDC, NCHS Data Brief 286 (2017). In one study, up to 64% of postmenopausal women reported poor sleep (Sleep Foundation).

The stages of sleep

A good night is 4 to 6 cycles of about 90 minutes each. Each cycle goes through four stages:

  1. N1, falling asleep (1 to 7 min): you drift out of conscious thought.
  2. N2, light sleep (10 to 25 min): heart rate and body temperature drop.
  3. N3, deep sleep (20 to 40 min): the most restorative stage, when most growth hormone is released.
  4. REM, dream sleep (10 to 60 min): the muscles go limp and the brain is very active. REM is about 25% of the night.

Deep sleep happens mostly in the first half of the night and REM in the second half. Going to bed late or waking early therefore reduces one of the two. Source: Sleep Foundation.

Sleep habits checklist

These habits do the most to protect deep sleep and REM. Tick the ones you already do.

  • ☐ Get up at the same time every day, weekends included, and get daylight early in the morning. Light sets your body clock. (Sleep Foundation)
  • ☐ Stop caffeine by early afternoon. In one study, 400 mg of caffeine 6 hours before bed cut sleep by more than an hour, and people did not notice. (Drake et al., 2013)
  • ☐ Cut back on alcohol, especially late in the evening. It helps you fall asleep and deepens sleep at first, but cuts REM and breaks up the second half of the night. It can also bring on hot flushes. (Ebrahim et al., 2013)
  • ☐ Finish your last meal 2 to 3 hours before bed. Digestion keeps the body alert. If you train in the evening, eat a light dinner around 16:00 to 16:30, train at 18:00, then have a protein snack straight after.
  • ☐ Turn off screens 30 to 60 minutes before bed. Screens stimulate the brain, and their light delays melatonin. (Sleep Foundation)
  • ☐ Keep the bedroom at about 18 °C (65 to 68 °F). Cooling sheets or a cool shower before bed also help with night sweats. (Sleep Foundation)
  • ☐ Keep the room dark and quiet. Use blackout blinds or curtains, an eye mask, earplugs or white noise.
  • ☐ Keep a pen and paper by the bed to write down thoughts that keep you awake.
  • ☐ Train in the evening if that suits you. A review of 23 studies found evening exercise does not harm sleep. The one exception is a hard session that ends less than an hour before bed. (Stutz et al., 2019)

Managing stress for better sleep

Slow breathing shifts the body from "fight or flight" into "rest and digest" by activating the vagus nerve. Do this a few times a day and before bed:

  1. Sit upright, feet flat on the floor, hands resting on your belly.
  2. Breathe in through your nose for a count of 4, feeling your belly rise.
  3. Hold for 1 second.
  4. Breathe out through your mouth for a count of 4, letting your belly fall.
  5. Repeat 10 times.

Yoga. In a 12-week trial of 249 women in midlife, yoga improved insomnia, but it did not reduce hot flushes (Newton et al., Menopause, 2014).

Meditation. Guided apps take you through short mindfulness, relaxation or sleep sessions, which help stop racing thoughts at bedtime.

Sleep supplements

Supplements come after your habits, not instead of them. Check with your doctor before starting any, especially if you take medication.

Supplement What the evidence shows Cautions
Ashwagandha Some preparations may help with insomnia and stress. Short-term use (up to 3 months) seems relatively safe. Rare cases of liver injury. Avoid with thyroid or autoimmune conditions, and during pregnancy or breastfeeding. Interacts with thyroid, diabetes, blood pressure and sedative medication. (NCCIH)
Holy basil (tulsi) Traditionally used against stress. Studied much less than ashwagandha. Same caution with thyroid conditions and medication.
Tart cherry juice Naturally contains melatonin. Older adults with insomnia slept about 30 minutes longer after 2 weeks. The studies used one glass in the morning and one 1 to 2 hours before bed. About 30 g of sugar per cup. Large amounts can upset the stomach. (GoodRx summary of the studies)
Magnesium May help some people fall asleep a little faster, particularly older adults, but studies are small and results are mixed. High supplemental doses can cause diarrhoea, nausea and stomach cramps. Check with your doctor if you take medication or have kidney problems.

Gut health and sleep

The bacteria in your gut seem to affect sleep, and poor sleep affects the gut in turn. Research here is still early (Frontiers in Microbiology, 2024). It is a good reason to eat plenty of fibre, fruit and vegetables, and fermented foods such as yogurt, kefir and sauerkraut.

When to see a doctor

See your doctor if you sleep poorly three or more nights a week for more than three months. Treatments that work:

  • CBT-I (cognitive behavioural therapy for insomnia) is the recommended first treatment for insomnia, including insomnia linked to menopause.
  • Menopausal hormone therapy (MHT/HRT) can reduce night sweats and sleep problems. Discuss with your doctor whether it is suitable for you.
  • Sleep apnoea. After menopause, more than a third of women have it. Signs: loud snoring, gasping at night, morning headaches, sleepiness during the day. Ask for a sleep study.

Source: Sleep Foundation, Menopause and Sleep.

This guide provides general information and is not a substitute for medical advice. Talk to a healthcare professional about your individual circumstances.

Sources