Hormonal Insomnia: Symptoms, Causes, And Treatment

Even though I have insomnia, I didn’t recognise that I had a problem for years.

That’s because I thought the condition only meant struggling to fall asleep. But I have sleep maintenance insomnia, which means I wake up in the middle of the night and then struggle to return to the land of nod.

I heard the phrase for the first time last year. But I only read the words “hormonal insomnia” this week.

Speaking to HuffPost UK, Dr Giuseppe Aragona, GP and medical adviser for Prescription Doctor, explained that those with the condition “often have trouble falling asleep initially, wake during the night and struggle to return to sleep, or wake too early in the morning”.

But what does the term mean, why does it happen, and what can you do if you have it?

The term “refers to difficulty sleeping that arises as a result of changes or imbalances in the body’s hormone levels,” Dr Aragona explained.

“Several hormones play a key role in regulating sleep, including melatonin, which signals to the brain that it is time to sleep, and cortisol, which promotes alertness and can interfere with sleep if elevated at night.”

Reproductive hormones, like oestrogen and progesterone, can also lead to the condition because they, too, affect our sleep patterns.

So perhaps it’s not surprising that the GP said: “Hormonal insomnia is most commonly observed during life stages when hormone levels are changing significantly, such as during the menstrual cycle, pregnancy, perimenopause, or menopause, and may also occur in thyroid disorders or other endocrine conditions.

“These hormonal shifts can disrupt the body’s temperature regulation, circadian rhythm, and mood, all of which contribute to sleep disturbance.”

They’re quite like those of “regular” insomnia, Dr Aragona said.

“People experiencing hormonal insomnia often have trouble falling asleep initially, wake during the night and struggle to return to sleep, or wake too early in the morning.

“Sleep may feel fragmented and of poor quality, leading to daytime fatigue, irritability, poor concentration, and low mood.”

If your hormonal insomnia is linked to hormonal changes like menopause, you might notice other symptoms keeping you awake, like hot flushes and night sweats.

If a GP were to check for hormonal, rather than general, insomnia, the doctor tolf HuffPost UK, they “would typically explore a person’s life stage, hormonal history, and the timing and pattern of symptoms.

“It is also important to consider associated symptoms such as mood changes, night sweats, or bladder issues, and to rule out other causes of insomnia such as stress, poor sleep hygiene, sleep apnoea, or pain.”

Blood tests can help to rule out thyroid issues or hormonal imbalances, too.

Dr Aragona recommends a blend of different strategies.

“Maintaining a consistent sleep routine, avoiding stimulants and screens in the evening, and keeping the bedroom cool, dark, and quiet can help,” he advised, while “Relaxation techniques such as mindfulness or breathing exercises can reduce stress and cortisol levels, making it easier to fall asleep.

“Addressing underlying hormonal symptoms, for example, through lifestyle strategies or, where appropriate, medical treatments for menopause-related symptoms, may also improve sleep.”

If your insomnia lasts for a long time ― some doctors put it at more than three nights a week, for three months or longer ― see a GP, said the expert.

Lastly, “General health measures, including regular exercise, a balanced diet, and avoiding excessive alcohol or nicotine, also support better sleep,” said Dr Aragona.

“Hormonal insomnia is usually multifactorial, so addressing lifestyle, behavioural, and medical factors together tends to be the most effective approach.”