Perimenopause Sleep: A 15-Minute Bedtime Yoga Routine

If you've started sleeping badly in your forties, you're far from alone, and it isn't in your head. A cool bedroom, a short wind-down routine and a plan for 3 a.m. waking can help a lot. The routine below takes 15 minutes, is done in a cool room, and ends in bed. If poor sleep has lasted for months, pair it with CBT for insomnia, which has the strongest evidence of anything for menopause-related sleep problems.

Why sleep changes in perimenopause

Several things tend to stack up at once. Night sweats can wake you directly. Shifting hormone levels can make sleep lighter and more easily disturbed. Mood changes, anxiety, and a busy midlife, often caring for teenagers and aging parents at the same time, add to it. Snoring and sleep apnea also become more common in women after menopause. That's why no single fix works for everyone.

Set up the room first

• Cool it down. Many sleep experts suggest a bedroom around 60 to 67°F (about 15 to 19°C). A fan helps even if you have air conditioning.
• Layer your bedding so you can throw off a layer without waking fully.
• Keep a spare top and pillowcase by the bed for night sweats.
• Put iced water on the nightstand.
• Dark and quiet: blackout curtains or an eye mask, and earplugs or a fan if noise wakes you.

The 15-minute bedtime routine

Do this in your bedroom, lights low, with the fan on. Breathe through your nose and move slowly.

1. Seated forward rest (2 minutes). Sit on the edge of the bed, feet on the floor, and rest your forearms on your thighs. Let your head hang heavy. Breathe out slowly.
2. Cat-cow on the floor or bed (2 minutes). On hands and knees, move gently between arching and rounding with your breath. Skip the rounding if you have osteoporosis.
3. Supported child's pose (3 minutes). Knees wide, a pillow lengthwise under your chest, head turned to one side.
4. Reclined bound angle (3 minutes). Lie on your back, soles of the feet together, knees falling open onto pillows. One hand on your chest, one on your belly.
5. Legs on a pillow (3 minutes). Lie back with your calves resting on a firm pillow or folded blanket. Let the legs feel heavy.
6. Cooling exhales (2 minutes). Under a light sheet, breathe in through your nose for four, and out slowly through your mouth for six to eight. Then let your breathing return to normal and let yourself fall asleep.

When you wake at 3 a.m.

1. Don't check the time or your phone.
2. If you're sweaty, change your top and pillowcase quickly in dim light, and sip cold water.
3. Lie back and do a slow body scan: right hand, arm, shoulder, side, leg, foot, then the left side.
4. Count breaths backward from 27. Start again if you lose count.
5. If you're still wide awake and frustrated after about 20 minutes, get up, sit somewhere dim with a dull book, and go back to bed when sleepy.

Our full guide to waking at 3 a.m. in perimenopause has more on this pattern.

What the evidence says

Common mistakes

• Going to bed very early to "catch up." More time lying awake tends to make insomnia worse.
• Long daytime naps. If you nap, keep it under 30 minutes and before mid-afternoon.
• Wine to fall asleep. Alcohol may help you drift off but often causes waking and night sweats later.
• Screens in bed. Bright light and scrolling keep the brain alert.

Common questions

Can yoga fix perimenopause insomnia?

It can help, and one well-run trial showed improved insomnia symptoms. For chronic insomnia, combine it with CBT-I, which has the strongest evidence.

Is it okay to do this routine in bed?

Yes. Everything except cat-cow works on a firm mattress, and you can skip cat-cow if getting on the floor is difficult.

How long until I sleep better?

Some women notice a difference within a week or two. Give the routine at least two weeks of nightly practice.

Related guides

• Perimenopause and menopause yoga: the symptom-by-symptom guide
• Yoga for hot flashes: what works and what doesn't
• A cooling bedtime routine for night sweats
• A 20-minute yoga nidra script for sleep

Sources

1. Ciano C et al. Longitudinal study of insomnia symptoms among women during perimenopause (SWAN). JOGNN, 2017 — insomnia symptoms in 31–42% of perimenopausal women each year
2. Newton KM et al. Efficacy of yoga for vasomotor symptoms: a randomized controlled trial (MsFLASH). Menopause, 2014 — yoga improved insomnia symptoms
3. McCurry SM et al. Telephone-based cognitive behavioral therapy for insomnia in perimenopausal and postmenopausal women with vasomotor symptoms (MsFLASH). JAMA Internal Medicine, 2016 — CBT-I improved insomnia
4. American Academy of Sleep Medicine: Behavioral and psychological treatments for chronic insomnia disorder in adults, 2021 — CBT-I as first-line treatment