It is the most frustrating and destabilizing experience for a high-performer: lying awake at 3 AM, your mind racing, knowing that the next day's performance depends on a sleep that will not come.
If this is your reality, you are not alone, and you are not broken. This specific type of sleep disruption is one of the hallmark symptoms of perimenopause, and it has a clear, biological cause. More importantly, it has a clear, systematic solution.
For years, we've been told to fix sleep by focusing on our evenings—warm baths, no screens, meditation. While these things can help, they are often not enough during this physiological shift. Why? Because perimenopause insomnia isn't just a "bad habit"; it's a hormonal and metabolic problem.
The solution requires a more comprehensive, 24-hour approach. This is the 5-part protocol I developed to address the root causes of my own debilitating insomnia and reclaim my sleep.
Part 1: Understanding the "Why" - The Cortisol & Progesterone Problem
Two key hormonal shifts are working against your sleep during perimenopause:
Declining Progesterone: Progesterone is a calming, "pro-sleep" hormone. As its levels decline and fluctuate, we lose that natural sedative effect, making it harder to fall and stay asleep.
Dysregulated Cortisol: Cortisol, our stress hormone, is meant to be high in the morning (to wake us up) and very low at night (to allow us to sleep). Due to hormonal fluctuations and chronic stress, this rhythm often gets flipped. Many women experience a cortisol spike in the middle of the night (around 3 AM), which is what causes that classic, jarring wake-up.
Our goal is not just to feel sleepy at night, but to support our hormones and regulate our cortisol rhythm throughout the entire day.
Part 2: The Protocol - A 5-Pillar System for Restorative Sleep
Pillar 1: The HRT Conversation For many women, addressing the root hormonal issue is the most powerful first step. Hormone Replacement Therapy (HRT), specifically the addition of progesterone, can have a profound, direct impact on sleep quality. It is crucial to have an informed, data-driven conversation with a knowledgeable medical professional about whether this is the right and safe option for you.
Pillar 2: The Morning "Anchor" This is the most counter-intuitive but critical part of the system. To fix your nights, you must first fix your mornings. A high-protein breakfast (30+ grams) within 30-60 minutes of waking helps to anchor your cortisol rhythm for the day. It provides a strong "start" signal to your metabolism, which helps ensure it "winds down" correctly at night.
Pillar 3: The Movement Signal Strategic movement is a powerful tool for regulating cortisol.
Morning Movement: A short walk to get sunlight in your eyes or a strength training session in the morning reinforces a healthy cortisol spike at the correct time of day.
Avoid Intense Evening Exercise: A high-intensity workout in the evening can raise cortisol too close to bedtime, disrupting your ability to fall asleep. Gentle stretching or a slow walk is fine.
Pillar 4: The Evening "Wind-Down" This is where the traditional advice comes in, but with a strategic focus. The goal is to lower cortisol and signal to your brain that it's time to produce melatonin.
Light Management: Dim the lights in your home in the hour before bed. Crucially, eliminate screen time (phones, tablets, TV). The blue light from these devices directly inhibits melatonin production.
Create a Ritual: A consistent pre-sleep ritual—like reading a physical book, taking a warm shower, or listening to calming music—creates a powerful psychological cue for sleep.
Pillar 5: The Sleep Sabotage Audit You must identify and eliminate the variables that are actively working against your sleep. The two biggest culprits are:
Alcohol: While it may feel like it helps you fall asleep, alcohol fragments sleep in the second half of the night, often contributing to those 3 AM wake-ups.
Caffeine: Be mindful of your caffeine cut-off time. For many women in perimenopause, sensitivity to caffeine increases. A noon cut-off time is a good starting point.
Your First Step
Overwhelm is the enemy of progress. Do not try to implement all of this at once.
Choose one single pillar to focus on for the next week. Perhaps it's simply committing to a high-protein breakfast every single day. Or maybe it's creating a non-negotiable "no screens after 9 PM" rule.
Track your results. See how you feel. By taking a systematic, one-step-at-a-time approach, you can turn the tide on perimenopause insomnia and reclaim the restorative sleep you need to perform at your best.
All the best,
Sonja Rincón
Founder & CEO, Menotracker