The hot flashes, night sweats, and anxiety experienced by many women with menopause are bad enough on their own, but when they start affecting your sleep, they can feel even worse. In a frustrating cycle, the stress and tiredness caused by another restless night can sometimes just make the symptoms, and your sleep problems, worse.

Keep reading to learn eight strategies you can use to improve your sleep during menopause. Lifestyle changes can help you reduce the frequency of your hot flashes or make it easier to sleep through them. In some cases, your doctor may also prescribe hormone replacement therapy (HRT) or other treatments.

As you near menopause, your ovaries stop producing the hormones estrogen and progesterone. The decrease in these hormones can cause hot flashes and night sweats. As your body’s temperature begins to rise during sleep, you may wake up. By the time your hot flash has passed, you may have been awake for several uncomfortable minutes. Many women find it hard to fall back asleep afterward.

In addition to hot flashes and sweating, you may experience sleep problems as a result of depression, anxiety, or mood disorders during perimenopause or menopause. If you’re facing extra emotional stress, the mental toll may prevent you from sleeping. If your mind can’t free itself from the worries and anxieties you face during the day, you may find it hard to fall and stay asleep. On top of that, lack of sleep can lead to other problems, including daytime drowsiness, fatigue, and mood swings.

Other health conditions, such as sleep apnea, restless leg syndrome, and insomnia, can also contribute to sleep problems during menopause.

1. Eat well and get plenty of exercise

It’s important to eat regular, well-balanced meals that aren’t high in fat or sugar and exercise daily to help prevent hot flashes.

The timing of these activities also matters. Eating or exercising too close to bedtime for some people can interrupt the body’s natural clock and may inhibit their sleep. Some people find they can sleep better if they exercise in the evening. Experiment and see what works best for you.

2. Wear loose-fitting clothing to bed

Sleep in clothes made from natural fibers, such as cotton. This allows your skin to “breathe” more easily. The fabric helps wick moisture away from your skin.

3. Use cotton sheets

Compared to some other fabrics, cotton stays cooler against your skin. It helps keep heat from building up around you. This can help prevent sweating.

4. Keep your bedroom cool

A cool room is more conducive to sleep than a warm one. Consider lowering the temperature in your home at night. Ceiling fans or standing fans also help circulate air and keep your bedroom cool.

5. Avoid spicy foods

Foods that cause you to sweat may lead to sleep disturbances if you eat them too soon before bedtime. Spicy foods are a common culprit.

6. Avoid nicotine, caffeine, and alcohol

If you drink soda or coffee or smoke too close to bedtime, your body may struggle to counteract the natural boost of energy that caffeine and nicotine give it. A glass of wine before bed may help you fall asleep, but it can interfere with your natural sleep cycle. In other words, you may fall asleep more easily after drinking it, but you’re more likely to wake up earlier and feel less rested.

7. Manage your stress

Emotional stress can heighten your sensitivity to temperature changes. This may bring on hot flashes and sweating. Try relaxation techniques such as yoga, exercise, and massage to help manage stress or anxiety that you’re facing.

If you feel chronically stressed, anxious, or depressed, speak with your doctor. They may be able to recommend strategies to manage your stress and improve your mood. In some cases, they may prescribe lifestyle changes, medications, or therapy.

8. Take medications as prescribed

If lifestyle treatments aren’t effective, your doctor may suggest HRT to help manage your menopause symptoms. Estrogen replacement therapy is most commonly administered through a pill, patch, or vaginal cream. In some cases, the estrogen is combined with progesterone.

HRT was once routinely prescribed for hot flashes and other menopause symptoms. However, research now suggests that HRT can raise your risk of certain health conditions, such as:

  • blood clots
  • stroke
  • heart disease
  • breast cancer

Ask your doctor about the potential benefits and risks of HRT and other options. There are medications that are not hormones that have been shown to help women with the symptoms of menopause. Your doctor can help you learn which treatment choices may be best for you.

Loss of sleep can leave you feeling tired, confused, and irritable during the day. It can also raise your risk of accidental injuries and certain health conditions. If hot flashes or other menopause-related symptoms are keeping you awake, speak with your doctor.

Your doctor will probably recommend lifestyle changes to help improve the quality of your sleep. For example, they may encourage you to exercise regularly, adjust your diet, or avoid stimulants before bed. They may also recommend changes to your bedroom environment or sleep routine. In some cases, they may recommend medications, including hormone replacement therapy.