How Hormones Affect Sleep

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How Hormones Affect Sleep

Difficulty sleeping is one of the more common symptoms during the hormonal transition of peri-menopause and menopause. Here’s what the research has to say about how hormones affect sleep.

First off, progesterone. This hormone is responsible for our deepest sleep cycle, non-REM sleep, primarily by affecting GABA receptors.

Estrogen also plays a role. The hormone has been shown to decrease the amount of time it takes to fall asleep as well as the number of awakenings during the night to help with both sleep quality and latency. It does this by breaking down norepinephrine, serotonin and acetylcholine in the body. Estrogen also helps quell hot flashes, a common reason for sleep interruption during menopause.

The adrenal glands are responsible for cortisol regulation. Cortisol is a hormone that is released in response to stress. Normally its levels are high during the day and tapper off towards the night. With chronic stress however, cortisol release may be altered and higher levels detected at night. This in turn suppresses melatonin production making it difficult to fall asleep or stay asleep. Early morning 2-3am waking is a common pattern seen with high cortisol at night.

Melatonin levels naturally decrease with age, but this hormone is also suppressed by blue light from electronics and bright light generally. If melatonin levels are disrupted, so is sleep. This hormone is released by the pineal gland and it’s responsible for regulating sleep and wakefulness. It works inversely to cortisol with levels slowly increasing mid to late evening and remaining elevated throughout the night.

In addition to hormones, sleep can be affected by a number of external factors. It is important to maintain proper sleep hygiene as follows:

  • Avoid napping during the day.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime.
  • Exercise can promote good sleep, but avoid vigorous exercise too close to bedtime.
  • Food can be disruptive right before sleep.
  • Ensure adequate exposure to natural light during the day.
  • Establish a regular relaxing bedtime routine.
  • Associate your bed with sleep.
  • Make sure that the sleep environment is pleasant and relaxing and free from light pollution. E.g. Lighted alarm clock faces, street lights through open windows, cell phones/tablet devices.

If you’re seeking hormone support and reside in the Lower Mainland, as a certified Menopause clinician, I’m confident I can help. Give us a call!


  • Eichling, Philip S., M.D. Evaluating and Treating Menopausal Sleep Problems. Menopause Management. Sept/Oct 2002.