Perimenopause doesn't just disrupt sleep — it restructures it. Declining progesterone removes a natural brain sedative called allopregnanolone. Erratic estrogen fragments deep sleep and triggers night sweats that cause micro-arousals you may not remember. A 2023 meta-analysis found insomnia is the most prevalent menopausal symptom globally. Cathy covers the science of what's happening to your sleep architecture, CBT-I evidence, magnesium, and what actually helps.

Up to 60% of women develop insomnia during perimenopause — not because they've become bad sleepers, but because four hormonal systems that quietly managed sleep for twenty years collapse simultaneously. Estrogen destabilises the circadian clock. Progesterone loss removes the brain's natural GABA sedative. Melatonin weakens. Cortisol spikes at 3am when it should be at its lowest. Standard sleep hygiene won't fix a hormonal problem. Here's the mechanism, the patterns evidence-b