How to Sleep Better at Midlife

4 Ways to Avoid Age-Related Circadian Rhythm Disruption

by Christiane Northrup, M.D.

Occasional problems with sleep are common at midlife, often secondary to hot flashes and night sweats, or anxiety and depression—which often occur together in midlife women. Between 20 and 40 percent of women have sleep disorders, and women in perimenopause often need more sleep and suffer from insomnia more often than do men of the same age.

When we don’t get sufficient sleep, we not only become tired and irritable, but we are more accident-prone and exhibit decreased concentration, efficiency, and work motivation. Inadequate sleep can cause errors in judgment. Plus, lack of sleep causes stress hormones to rise, which over time can disrupt hormonal balance and depress the immune system. Too little sleep over time can put you at greater risk for obesity, heart disease, and diabetes.

Sleep is also critical for consolidation of learning and memory, and it serves as a way to help us sort out in our minds and bodies the things we have learned and experienced during the day. In fact, studies have linked a nightly battle with insomnia to memory loss, dementia, and even Alzheimer’s, not to mention other brain disorders, including Parkinson’s.

Why You Can’t Sleep at Midlife

Hot flashes and night sweats are by far the most common reasons for sleep deprivation at midlife. In many women at menopause, the brain chemicals that are important for sleep undergo changes, making our bodies become less efficient at falling into a deep sleep – the sleep that is associated with the release of human growth hormone and memory consolidation, and that is essential for feeling rested in the morning — and more easily aroused by internal or external stimuli.

Your ability to sleep is also profoundly affected by your feelings. At midlife, many women experience increased demands at work and at home. Insomnia and hot flashes are exacerbated by underlying unresolved and unprocessed emotions, such as stress, anxiety, sadness, fear, and anger, and the unfinished business that fuels these symptoms, creating a perfect storm for poor sleep.

9 Natural Sleep Aids for Insomnia

Natural sleep aids can help with occasional midlife sleep problems. But, it’s important to remember that some natural sleep aids bind to the same place in the brain as prescription sleep drugs. And, like prescription drugs, natural sleep aids can lose their effectiveness over time. Be sure to consult your physician before taking any supplements.

2% progesterone cream. Try bioidentical progesterone cream. Use one-quarter to one-half teaspoon at bedtime on skin. Progesterone binds to the GABA receptors in the brain and has a calming effect.

Pueraria mirifica. This herb has been used in Thailand for over 700 years to help women quell perimenopausal symptoms. It’s ability to interact with the body’s own estrogen to help diminish hot flashes makes it excellent for calming the mind and body at night.

Amantilla and Babuna. These natural medicines originate from the valerian plant (Valeriana officinalis) and the flower of the manzanilla plant (Matricaria recutita, commonly known as chamomile), respectively. In a double-blind, randomized, placebo-controlled multicentered study, Amantilla was 82.5 percent effective in helping patients sleep, while Babuna was 68.8 percent effective. On nights when you’re keyed up, try 15 drops of Babuna thirty minutes before going to bed, followed by 15 drops of Amantilla at bedtime.

Valerian. Look for valerian (Valeriana officinalis) in capsule form, as it has a bad taste. The dosage is 150–300 mg of a product standardized to 0.8% valerenic acid. Use one hour before bedtime.

Melatonin. Melatonin is secreted by the brain’s pineal gland in response to cycles of light and darkness. It helps your body regulate its sleep-wake cycles, so it can be good for travel-related insomnia. Natural melatonin secretion is also affected by depression, shift work, and seasonal affective disorder (SAD). The usual dose is 0.5–3.0 mg, taken one hour before bedtime.

5–HTP. 5-HTP (5–hydroxytryptophan) increases serotonin, which is converted to melatonin. This is why 5-HTP may be helpful for sleep pattern disruption, as well as PMS and seasonal affective disorder (SAD). The starting dose is 100 mg, three times per day. Gradually increase over several months to 200 mg, three times per day.

Magnesium. Magnesium deficiency is associated with insomnia. Most people, especially women, have less-than-optimal magnesium levels. If you experience restless sleep or wake up frequently during the night, adding magnesium may help you sleep more soundly.

Magnolia bark. In Traditional Chinese Medicine, magnolia bark is used to promote relaxation and sleep, as well as to ease anxiety and stress by lowering adrenaline. Research shows that magnolia bark can reduce the time it takes you to fall asleep and can increase the amount of time you spend in both REM sleep and NREM sleep. For people with anxiety, magnolia bark can be as effective as the drug diazepam without the risks of dependency or side effects. The standard dosage is around 250 – 500 mg daily with a higher dosage recommended for improving sleep.

L-Theanine. This amino acid found in tea leaves increases the levels of GABA, serotonin, and dopamine – calming neurotransmitters in the brain that regulate emotions, mood, concentration, alertness, sleep, and energy. Increased levels of these chemicals help with sleep, as well as menopause-related mood swings, difficulty concentrating and changes to appetite during menopause.

Be sure to avoid prescription and over-the-counter sleep medications. They are habit-forming and lose their effectiveness over time as the brain builds up a tolerance so that you need more and more to get the same effect. If you do use them, make sure you use it for no longer than 7 to 10 consecutive days. Over-the-counter sleep remedies are troublesome, too, because they interfere with the production of the brain chemical acetylcholine, which is very important for memory. The use of these drugs over time can cause serious memory problems and confusion

15 Ways to Get a Good Night’s Sleep

  1. Take a good multivitamin/mineral daily.Taking nutritional supplements can contribute greatly to your overall health. When you are in good health, you have a better likelihood of sleeping without disturbances, including those caused by medications and pain. In addition to a multivitamin and mineral supplement, you may want to take an antioxidant supplement daily.
  2. Avoid alcohol.While you may fall asleep quickly after drinking, alcohol can interrupt your circadian rhythm. Another reason you don’t sleep well when you drink alcohol is because alcohol blocks REM sleep, the most restorative type of sleep, so you wake up feeling groggy. Finally, alcohol reduces anti-diuretic hormone (ADH) so you may have to get up to urinate during the night.
  3. Limit caffeine. Women metabolize caffeine much more slowly than men. Even one cup of coffee in the morning can affect your sleep quality later if you are sensitive.
  4. Get regular exercise. Regular exercise can improve the quality and quantity of sleep. Being physically active can make you feel more tired at bedtime. In addition, exercise can reduce stress levels, making it easier to fall and stay asleep. Mind-body exercises such as gentle yoga can help quiet the parasympathetic nervous system, which can help you relax before bed. Just don’t exercise vigorously within three to six hours of bedtime.
  5. Get a good quality mattress. Be sure your mattress supports you and does not cause any stress on your joints. A good mattress is worth the investment—you spend a third of your life asleep!
  6. Sleep in a dark room. Excess light in your bedroom – such as the artificial light emitted from streetlights, televisions, or smartphones and other devices – can disrupt your circadian rhythm by suppressing the production of melatonin.
  7. Follow a low-glycemic diet. High blood sugar and insulin are often associated with poor sleep because they are associated with high cortisol levels at night. When cortisol is high at night, your rapid eye movement (REM) sleep is disrupted. This can leave you feeling unrefreshed, no matter how many hours of sleep you get.
  8. Don’t eat before bed. There are a number of reasons why eating a large meal before bed isn’t the best idea, including the possibility of weight gain if you do this regularly. In addition, your body digests food better when you are upright. So, lying down to sleep after a heavy meal may cause you to experience heartburn or acid reflux. Since it takes about 3 hours for your stomach to empty after a meal, a good rule of thumb is to stop eating at least 3 hours before bed. However, a light snack (one high in protein and low in refined carbohydrates) is okay and may even help some people sleep better.
  9. Stop Drinking Water. While you want to be optimally hydrated at all times, drinking a lot of water before bed may cause you to wake up in the middle of the night to go to the bathroom, which causes a big disruption to your sleep cycles. Try to drink (and eat) more water during the day and less late at night. If you do need some water, take small sips rather than big gulps.
  10. Tidy Up. I’m not suggesting that you clean your entire house top to bottom. But, straightening up, washing the dinner dishes, preparing your kitchen for your morning routine, or putting away your clothes can be great ways to bring your attention to the moment. Plus, having a tidy house can reduce cortisol levels, helping you to feel more relaxed.
  11. Make a to-do list. If you tend to worry about things you need to do tomorrow while lying in bed, it helps to write them down before going to sleep. You may also want to leave a pen and a piece of paper next to your bed so if you wake up and think of something you forgot, you can jot it down. (You can also write down your dreams.)
  12. Stay calm. Don’t watch the news (or disturbing movies) before bed—it activates the sympathetic nervous system. For the same reason, try not to have emotionally distressing conversations near bedtime, and try not to stew over things. (If you find you are turning things over and over in your mind, get out of bed and do something else relaxing, such as taking a bath or reading a good book for a while).
  13. Wind down: Establishing a ritual that helps you wind down before bed can help to signal your mind and body that it’s time for sleep. Change into your PJs and get completely ready for bed at least half an hour before you climb between the sheets.
  14. Shut off all electronics. The blue light that comes off screens mimics the light of full daylight, which can affect melatonin production and disrupt your sleep patterns. Plus, checking email and social media before bed can cause overthinking and increase stress and worry when you are trying to go to sleep.
  15. Practice mindfulness. Mindfulness helps to decrease stress levels and increase relaxation, which can help you fall asleep faster and stay asleep. You can practice mindfulness by sitting quietly, stretching, or gently practicing yoga, or reciting affirmations before bed.

4 Ways to Avoid Age-Related Circadian Rhythm Disruption

Your circadian rhythm is your 24-hour internal clock. It helps to determine your sleep-wake patterns, as well as physical, mental and behavioral differences throughout the day. You’re your circadian rhythm even affects your metabolism.

As you grow older, your circadian rhythm changes so many people experience a decrease in the length and quality of sleep. This may result in feeling tired and even experiencing cognitive decline later in the day. And studies show that disruption of the circadian rhythm is linked to obesity, mood disorders, cardiovascular disease, and even cancer.

Fortunately, you can overcome age-related circadian rhythm changes with a few simple strategies. Here are 4 ways you can reset your circadian rhythm and keep it on track so you experience better sleep:

  1. Spend time in nature. The primary external influence on your circadian rhythm is light. Most people have limited light exposure during the day and an increased amount of artificial light during the evening, which can contribute to disruption of your circadian rhythm. Spending more time outdoors can help restore your natural sleep-wake cycle. One good option is to go camping for a few days where you have no (or very little) artificial light. This will help set your body to “solar” time. (Be sure to leave your smart phone turned off completely, unless it’s an urgent matter.) If camping is not an option, you can try going outside more frequently during the day, especially if you feel tired. The sunlight can help your body feel awake and help get you through the rest of the day and evening until it’s time to sleep.
  2. Change your schedule. Making gradual changes to your sleep schedule over time can help reset your circadian rhythm. For example, if your current pattern is to go to bed at 12 AM, try going to bed 15 or 30 minutes earlier each week. After a month or two you will have reset your sleep clock to go to bed by 10 PM. If you normally wake up at 6 AM, you will be getting fully 8 hours of sleep. You can also change your schedule to go to bed later and waking later by using the same strategy. Also, shifting when you eat by 15-30 minutes (earlier or later) will also help reset your circadian rhythm.
  3. Try a sleep deprivation challenge. If you’ve even been on an overnight flight and unable to sleep, then stayed up all day once you reached your destination, you have essentially done a sleep deprivation challenge. Sleep deprivation is used in clinical settings as part of chronotherapy and depression treatment. You simply stay up for 24 hours then go to sleep at your regular time the following day. The idea is that depriving yourself of sleep for a day, will help reset your internal clock and overcome sleep problems. However, this is not for everyone. It’s best to work with your healthcare provider. And you should not drive or plan any activities while sleep-deprived.
  4. Get your vitamin D levels checked. If you have low levels of vitamin D, you may have a more difficult time falling and staying asleep. Vitamin D receptors are found in the several areas of the brain involved in sleep regulation. Research shows a direct correlation between low vitamin D levels and poor sleep quality. Studies also show that vitamin D plays a role in the synthesis of melatonin, the hormone that regulates your circadian rhythm and sleep. Finally, interventional studies show that patients with low levels of vitamin D experience higher levels of pain associated with some conditions, and are more likely to suffer from sleep apnea and restless leg syndrome—all of which can affect sleep quality. Supplementing with vitamin D if your levels are below 30 nmol/L could help improve you sleep.

Remember, persistent sleep problems are often messages from your inner guidance system that something is off balance in your life. You need to address the imbalance directly before you can truly have quality sleep

Are you getting quality sleep? What are some of the things you do when you have trouble sleeping? Please let me know your ideas in the Comments below.


Last Updated: July 26, 2022

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


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  1. Diane Lindenberger
    5 months ago

    since my Mother died 3 years ago I cannot sleep naturally…..of course the doctor put me on klonopin 1.5 mg and now after 3 years it is not working……these doctors do not know what the heck they are doing….all they can do is stick you on meds…..I am also taking Visteral (spelling)…..but that makes me fall asleep during the afternoon…..I HATE THIS….I will be 80 next month and I am also giving up all sugar as I think that raises cortisol……and not looking at the computer before bed……it seems that my GRIEF is causing anxiety and depression and cannot sleep but about 5 hours…..I wish to God I could sleep naturally again…..I would give my left arm to be able to just sleep….without taking any medications……Help!!!!

  2. Ann Oberling
    4 years ago

    Dr Christiane,
    I just listened your wonderful tapping video with Jessica Ortner, it is wonderful! It gives me so much hope, as I felt better after doing the tapping session. My sleep problem is rocking my world, and I’m sure(self diagnosis) that my problem is hypoglycemia, which doesn’t show up in bloodwork(reactive hypoglycemia?) I go immediately to sleep every night, sleep for 2-3-4 hrs, go back to sleep several times, but by morning I’m totally exhausted, anxious, weepy, depressed. If only I could know what to do to eliminate this problem and get good sleep, it would change my life. I’m 80 yrs old, I am active( on good days), but after bad nights I’m a wreck! If possible, please recommend something, I would be eternally grateful.

  3. Terri
    4 years ago

    Hi I have been having anxiety because of my mom being ill. I have tried honey infused with Marijuana and just taking 1/2 teaspoon but it has really worked. Do you know of any reason this could be a problem? I take it about 1/2 hour before bed and it has worked to get me to sleep fast.

  4. G
    4 years ago

    I’m in peri, and getting a handle on my excess estrogen, particularly in the later half of my cycle, has helped tremendously. I was having what I call “night flashes” where I’d keep waking up hot even in my cold bedroom, but no sweating. Just a feeling that I was burning up from the inside out. A small daily dose of calcium-d glucarate has cut the night flashes way down.

    Also, I was recently diagnosed with adenomyosis, and, long story short, I figured out that my frequent trips to the bathroom that got to be practically unbearable right before I started (at my worst I lost count around 5 trips one night) were due to my abnormally swollen uterus pressing on my bladder. I suspected something hormonal because it worsened during PMS, but adeno explained things in a way that just hormones couldn’t. But adeno needs estrogen, and depriving it of that estrogen has gotten me some symptom relief and led to less bathroom trips, especially during PMS.

    I also find a high-potency CBD oil under my tongue every night helps me sleep just a little deeper and makes me less susceptible to be awakened by my bladder.

  5. pei
    4 years ago

    sometimes sleep problems can be related to depression, feeling of sadness, not been able to express them out so it can be numbing. when you are able to get those negativity out of the system, feeling sleepy will return to normal bed time. in the past, I experienced insomnia which found out later I was depressed. after when I was able to cry out my sadness that I regained my normal sleeping patterns. it is brave to show some tears of sadness as it is natural process of getting rid of bad energy and so it can then be turned to good energy.

  6. Ella Lauren
    5 years ago

    Thank you for sharing these amazing tips. I have read many posts on insomnia and sleeping disorders. but I did not find any genuine information or tips which really can implement.

    Thank you so much again for sharing it!

    1. Patrice
      4 years ago

      Christiane, I can’t believe this blog post was delivered to my e-mail box this morning! I’m an older woman (70 this year) who has been experience sleep deprivation due to insomnia for several years. Last night was extremely difficult. My body was tired, but I felt wide awake so I didn’t get to sleep until around 6 am (went to bed at 12:30 am) and only slept for a couple of hours. On a good night, I get 6 – 7 hours. I tried L-theanine, but did’t like the way it made me feel. Could be because I need a smaller dose – 200 mg may have been too much.

      Anyway, all this to say, thank you for this blog post. I know that I need to be more active during the day and I definitely need a better mattress. I’m going to bookmark this post for future reference as a reminder of the things I can do to improve my sleep when I’m not getting enough.

  7. Laura
    5 years ago

    The only thing that works for me to help going to sleep as well as if I wake during the night and can’t get back to sleep, and I have tried many, many things-probably about 15 to 20 herbal, amino acids, minerals, vitamins, melatonin, 5 htp – you name it I have tried it for long lengths of time and spent LOTs of money – is pregnenolone, 30 mgs. and 1/2 that during the night. From what I have read pregnenolone can counter excess cortisol during the night when it should be at its lowest. I open a capsule and put it under my tongue. In the night, if it is apparent I won’t get back to sleep, I use 1/2 a capsule or three 5 mg. sublingual tablets and soon I drift off and sleep soundly. It is the ONLY thing that is predictably effective for me.

    1. GG
      2 years ago

      Is Pregnenelone just for women or for men as well? Amazon has capsules by Life Extension but they’re 100mg. Too much? Open the capsule and take half the powder, perhaps??

  8. Jean
    6 years ago

    Hi Dr. Northrup, I too would like to know how you got your smart meter removed. I called my power company & they said the most they would do it move it to another location on my property at my expense. Please respond as many people want these removed & are getting nowhere. Thank you for the great article on sleep!

  9. Emilie
    6 years ago

    Dr. Northrup, Thank you for the article. I was wondering how you got your smart meter removed? Did you get the electric company to replace it with a different meter? Is there a legal way to do this?

  10. pei
    6 years ago

    thank you for the helpful tips. i am going through the perimenopause which causes fatigue even though getting enough sleep does not help on its own. now i take a regular supplement for women at that stage of time plus lavender tea and vitamin k for extra support on the bones.

  11. Nicole
    6 years ago

    I juice some celery and listen to smooth jazz hits from the 70s and early 80s. Works like a charm!

  12. bn
    7 years ago

    does only having 6 hours sleep each night negatively affect a woman’s hormones and how?


  13. Nicole Plume
    7 years ago

    Hey Christiane,

    Thanks for sharing these helpful tips and remedies on how to overcome insomnia and sleep-related problems! Just want to add another remedy that worked well for me:

    Fill your pillow with basil, horse chestnut (blossom), male fern (Aspidum filix mas) hop cones – 100 g each, geranium (leaves and blossom), melilot (Melilotus officinalis), camomile, lavender, marjoram (Origanum marjorana), melissa and stinky woodruff (Asperula odorata) – 50 g each. Source at

    Works wonders, and not only I have a good sleep, but I’m not tired in the morning (like I used to) anymore.

    Thanks again for putting this article together and publishing it!



  14. Jeannette Hinke
    8 years ago

    Hi there, I want to share this Light therapy tool with you. It realy helpt me a lot with my sleep problems. Have a look:

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