Why Perimenopause Can Disrupt Your Sleep (and a Surprisingly Simple Trick That Helps)
When Sleep Suddenly Stops Working
“No, I actually sleep really well.”
Wait… what?
Brain fog? Check. Irritability? Check. Mood swings? Check.
But sleep is fine??
As a psychiatrist and MSCP who specializes in women’s mental health, that is not the usual story I hear in perimenopause. So obviously, I needed to know more!
“It’s train stories,” she said. “My family makes fun of me, but I swear they work.”
Train stories?
A few years ago, she found sleep stories and just picked one… a train story… and listened to the same one every night when she got into bed.
At first, her brain paid attention. Followed the story and stayed engaged. But after about a week or so, she started drifting off before it even finished.
Now she’s asleep within the first few sentences!
Her brain learned: this is what we do before sleep. And honestly? That makes perfect sense.
Why Sleep Gets Worse in Perimenopause
One of the most frustrating parts of perimenopause is that sleep becomes less predictable.
Hormones that support sleep, especially progesterone, begin to fluctuate and decline. Estrogen changes too. The brain becomes more alert at night and more likely to wander.
Instead of drifting off, your brain is suddenly:
replaying conversations
planning tomorrow
questioning life choices
reorganizing the pantry at 2am
So instead of sleep, you get… thinking. And a lot of it. This isn’t a personality flaw or you not wanting to sleep enough.
It’s biology.
A Simple Trick That Actually Helps
This is where routines come in because your brain loves predictable patterns. It relaxes when it knows what’s coming next.
Giving it something consistent and mildly engaging, like a calm, slightly boring story, creates a track for your attention to follow instead of spiraling into everything else.
That’s why something as simple as a “train story” works. It’s actually not magic but it can feel that way! It’s just your brain learning a new pattern that includes falling asleep at the end.
What I Do Instead
I use a similar approach, just without an app. I have a short list of mantras I repeat in my head. I say each one a few times, then move to the next. If my mind wanders, I bring it back.
Sometimes I make it through the whole list and fall asleep right after. Other times I barely make it halfway before I’m out. And if I wake up in the middle of the night (for example after the 4th trip to the bathroom), I just start again and usually fall back asleep pretty quickly.
Another simple option? An eye mask. Even something as low-tech as a T-shirt over your eyes can become a cue. Put it on when you go to sleep, and if you wake up, putting it back on can help trigger your brain to settle down again.
Where to Start
You don’t need anything fancy.
Start with one small step:
a sleep story
a simple mantra
a consistent wind-down routine
There are plenty of free sleep stories on YouTube and podcasts like Get Sleepy or Nothing Much Happens that work just as well.
If sleep is a bigger or ongoing issue, cognitive behavioral therapy for insomnia (CBT-I) is one of the most effective, evidence-based treatments we have.
You can find more sleep resources here.
You’re Not Broken
If your sleep has changed, you’re not imagining it. Midlife sleep disruption is incredibly common, especially during the perimenopause transition.
The goal isn’t to force sleep.
It’s to give your brain a better path to follow.
Want More Support?
If you’re dealing with sleep issues along with mood changes, anxiety, or brain fog, it can help to look at the full picture.
This is the work I do every day with patients.
We look at:
medication options
therapy strategies
lifestyle factors
and when appropriate, hormone support
You don’t have to figure it all out on your own.
If you’re in Florida, Texas, New York, Ohio, or Indiana and would like help sorting this out, you can learn more about working with me here.
