3AM and Wide Awake: The Hormone-Sleep Connection

Waking up at 3AM? Tossing and turning? Hot? Anxious? Heart Racing? 

Feeling exhausted no matter how early you go to bed?

You’re not alone — and it’s not “just stress.”

In this episode of Shift Happens: Hormones Unfiltered, we’re breaking down the real connection between sleep, hormones, and midlife changes. If your sleep has suddenly shifted in perimenopause, there are physiological reasons behind it — and more importantly, there are ways to support your body.

Hosted by a Women’s Health Nurse Practitioner & Functional Medicine Provider, Johanna Lancaster and a National Board-Certified Health & Wellness Coach, Melissa Gaskin, this episode blends science with practical tools to help you finally understand what’s happening when your head hits the pillow.

We cover:
 • Why sleep disruption is so common in perimenopause
 • The role of cortisol and your nervous system in nighttime wake-ups
 • How declining estrogen and progesterone impact sleep quality
 • Blood sugar crashes and their link to 2–4AM wake-ups
 • Why “good sleep hygiene” isn’t always enough in midlife
 • Simple, realistic strategies to support deeper, more restorative sleep

If you’ve ever thought, “Why can’t I just sleep like I used to?” — this episode will connect the dots.

Because your body isn’t broken.

Shift happens — even in your sleep.

Key Takeaways

• Nighttime wake-ups are often hormonal + nervous system-driven, not random
 • Blood sugar instability can be a major trigger for middle-of-the-night waking
 • Progesterone and estrogen shifts directly impact sleep quality
 • Chronic stress and cortisol dysregulation keep your body in “alert mode”
 • Supporting sleep in midlife requires a whole-body approach, not just bedtime routines

Work With Us

If you’re navigating perimenopause, menopause, or unexplained hormone symptoms, we offer a unique approach that combines clinical hormone care with personalized health coaching.

Together we support women with:

✨ Functional medicine hormone insight
 ✨ Root-cause testing and individualized care
 ✨ Sustainable lifestyle and nervous system support
 ✨ Coaching for lasting health behavior change

👉 Learn more or book a consultation:
https://www.omniyou.me/

https://www.melissagaskin.com/

Connect With Us

Follow along for more conversations about hormone health, midlife wellness, and advocating for your body.

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Disclaimer

This podcast is for educational purposes only and does not replace personalized medical advice. Always consult your healthcare provider regarding your individual health needs.

Transcript

SPEAKER_00 0:06

Welcome to Skiff Happens Hormones and Filters. This goal where we decode a wild, wonderful, and occasionally WTF moments of perimetophons and menopause and everything in between. We're your host. I'm Johanna Lancaster, a women's health nurse practitioner and functional medicines provider at ONU Youth, specializing in empowering women to understand the root cause of fuel hormone imbalance and helping you feel like yourself again.

SPEAKER_01 0:34

And I'm Melissa Gaskin, a National Board Certified Health and Wellness Coach at Citrous End, supporting clients through sustainable lifestyle changes for root cause healing. Together we are your science meets goal, clinical material life, hormone dream team.

SPEAKER_00 0:50

A volunteer nothing is off limits. Hot glasses, mood swings, tweets that disappear like your favorite pair of beings. Yeah, we're talking about all of it.

SPEAKER_01 1:01

Our mission is simple cut through the noise, ditch the chains, and help you understand what's actually happening in your body with zero judgment and a lot of laughs.

SPEAKER_00 1:11

So whether you're shifting, pausing, or wondering why your hormones feel like they're on a boot text without you, you're in the right place.

SPEAKER_01 1:20

Grab your tea, your electrolytes, and your secret midlife snack, no judgment. And let's get into today's episode. Welcome back. We are diving into sleep today, and our focus is all about wide awake at 3 a.m., why this happens, what is this connection between our sleep, our cortisol, and even our nervous system. So we're gonna dive into that today.

SPEAKER_00 1:48

Yeah, huge topic. And sleep is so important. We know this, that it really is important for our gut. The microbiome resets at night, your brain kind of takes out the trash and resets your cellular health. The cells recycle all their trash overnight, you detoxify, um, genes replenish. So it's super important for longevity and overall health, um, and and just functioning, how you feel, your energy levels the next day. Big deal. Absolutely. How are you sleeping these days, Melissa?

SPEAKER_01 2:30

Well, I would say I'm 40, and so my sleep is off and on. I notice that if I eat too late or if I, you know, have a glass of wine or two glasses of wine, I will wake up in the middle of the night and feel alert. Then there's other times, most recently, where I woke up and it was before my alarm, but I was startled awake and my heart was racing, and I was kind of my nervous system, I could tell, was immediately disright dysregulated. And so I knew I didn't have enough sleep that night because I woke up in this kind of panic state, which I would call that like tired but yet wired feeling.

SPEAKER_00 3:10

Yeah.

SPEAKER_01 3:11

And um, so those things happen a little more often than they have. Thankfully, it's not every night.

SPEAKER_00 3:18

Um, but it is there's, you know, yeah, that's the down stages of of perimenopause. I'm a little bit further ahead in in menopause, and for me, it's the hot flashes that are just you know awful. You're you're just it's like a heat explosion that's taken over your body, and then you start sweating, and you're you're taking off the blanket and your drenched shirts, and then you get cold, and then you have to put that all back on. It's it's a constant battle. And also the the tiniest noise or any light will will immediately wake me up. My poor husband, he um cannot even roll around and change positions, and I will yell at him. So I have to have you know my super um ceiling, earplugs, the the face, eye mask, and sound machine and fan on, and we have the temperature set to 62, and my husband's freezing, and I'm still too hot. So it's a whole it's a whole jam.

SPEAKER_01 4:22

Yeah. So if you relate, hang in there with us today. So we're gonna talk about why that's happen why this is happening in this season of our lives, as well as what you can do about it during this time of adapting.

SPEAKER_00 4:38

Exactly. And uh yeah, do you do you want to tell us a few stats here about sleep?

SPEAKER_01 4:43

And yeah, so it's about 31 to 42 percent of women that experience insomnia symptoms um at any given year during perimenopause. And so these symptoms are falling asleep, staying asleep, waking up too early. And rates are higher in later menopause than in early menopause. So that's where you get that range of like 31 to 42 percent of people, which is nearly half, right, of women's population.

SPEAKER_00 5:08

Huge.

SPEAKER_01 5:09

Yeah, and then 40 to 60 percent of women report sleep difficulties, which is a broad generalization here. Um, but that also is something that it's it just shows how prevalent this is right now. Now, elevated chronic insomnia, which we'll we'll touch on here shortly, those chronic insomnia symptoms um are about 56% in perimenopausal women versus pre-menopausal women's that are like closer to the 36%. So it it is a concern that we are navigating right now as women in midlife, and it's prevalent, you're not alone, and so yeah, we're gonna dive in.

SPEAKER_00 5:56

Um, I think we have in an another stat in general, the American uh adult uh population, there's about a 50 to 20 percent occurrence of insomnia, so that's huge, and then of course, as we head into perimenopause and menopause, those numbers climb. Yeah, so let's talk about hormones.

SPEAKER_01 6:20

Tell us what is impacting our hormones and and like why is that impacting our impacting our sleep? What's what's the change here?

SPEAKER_00 6:27

Yeah, so so there are a few big ones, and and um in perimenopause, the first shift that usually happens is that we start losing progesterone or we're not making as much progesterone as we were before. Maybe we're not ovulating every month, maybe not at the same time. Um, and the main source of progesterone is your ovulated follicle. So progesterone is your, I call this the zen hormone, right? It's super important for our mood and keeping our mood stable and us away from an irritable hot mess to sleep and falling asleep, but especially staying asleep during this 3 to 4 a.m. kind of window or or even longer than that. But that's usually when we start waking up when progesterone declines. Um that's the big one in perimenopause. In menopause, then the added drop in estrogen happens when we just stop making hormones altogether, and estrogen, a lack of estrogen really messes up with your thermal regular regulation in the hypothalamus in the brain. So this really sends you into heart flashes and night sweats and um all the things that cause this waking up in the middle of the night and make this really hard, much harder to sleep through the night. Um so yeah, I think that was my part, and we probably have to cut that out.

SPEAKER_01 8:03

Okay, so why do these mostly occur at night? I mean, we know that we have hot flashes that occur during the day. Maybe you know, you're excessively sweaty even during the day during these hot flashes, but it does seem that there's this commonality about many are waking up in the middle of the night, really drenched, really hot. Why does it occur then?

SPEAKER_00 8:27

Yes. So there obviously are these external factors, you know, the temperature of the room, the fact that you are under a blanket and you're not moving, you don't have any kind of airflow that gets to your body to cool you off. So simple things. But then there's also this um hypothalamic temperature regulation. So in menopause, in general, this this regulatory uh window is narrowed. And when we try to fall asleep, um, whether we're perimenopause or menopausal or before, your body has to slow down its temperature to be able to fall asleep. So as the body senses the temperature gets lowered, in menopause we have this narrowed window of temperature regulation. We then sense wait, we're getting too cold, and your body kind of tries to regulate and it over-regulates with a hot flash, and then we're too hot. And and so it's it's really messed up, and and what it just means is that this trigger point for getting hot is much lower than in a person who is pre-menopausal. Um, and so what I always um find funny and talk about a lot with my clients is that um we all have this this technique of hanging the foot out of the bed, which um we talked about this how how feet are a huge um heat release, and when you hang one foot out of your bed, um it can help uh keep your body temperature lower, and it's like our own self-regulating hack. And no, definitely no socks, and and yeah, you you want to keep those feet cool. Yeah.

SPEAKER_01 10:16

So we briefly briefly talked a little bit about sleep disturbances that happen during this perimenopausal menopausal shift, but also insomnia. So maybe give us a little bit of explanation of what's the difference between these two.

SPEAKER_00 10:33

Yeah. So uh the sleep disturbances um can be due to any any kind of external factors. It can be your adrenals, your hormones, your sleep routine is off, um, stress, all the different factors, but it can turn into something more serious as a true insomnia when you're basically having this chronically, you're having this for at least three months, at least three episodes a week of either not sleeping or not falling, uh not not falling asleep or or not staying asleep, um, you notice daytime impairment, you know, fatigue, low energy, mood changes, difficulty functioning and focusing. But the biggest piece is that the sleep difficulties become self-perpetuating. And what that means is that when you're going to bed, you're already dreading that you won't be able to fall asleep or stay asleep, which then will keep you awake. So it's a behavioral cognitive thing that is happening, and then it becomes a insomnia diagnosis, and then we have to really use different techniques than just helping you with diet and lifestyle and hormones, then we probably will need some added cognitive behavioral therapy. We might need to use some medications um short term to help you regain um normal sleeping patterns.

SPEAKER_01 12:06

So if you feel like you have a chronic sleep disorder, definitely, you know, contact your primary care and really dig into what that is and what your next best next steps can be. Absolutely for evaluation, yeah.

SPEAKER_00 12:21

Yeah. And I I did want to throw in just a little bit of a different perspective. There is a uh traditional Chinese medicine view on insomnia, and and you might have heard of this, but it's really um uh based on your energy uh meridians, and there is a liver meridian that is um supposedly most active between that 1 to 3 a.m. window, and this this liver meridian is associated with unresolved emotions. So grief, anger, frustration, um, all of those can, when they're unresolved, can cause this waking up between 1 to 3 a.m. So just as a perspective to say it's never just the hormones, you know, it's it's always a compound of are you drinking too much alcohol? Are you eating late at night? Are you working out late at night? You know, what are these things that are, or do you have unresolved emotions that are impacting sleep as well?

SPEAKER_01 13:28

Yeah, it's kind of this perfect storm between emotions, cortisol, hormones, lifestyle factors, right? Like and that all impacts the the sleep. But yeah, I did not know about the liver meridian impacting sleep during that 1 to 3 a.m. hour. So that's fascinating and makes, you know, makes me think even more about okay, what is it that I could unpack that might be something I'm holding on to as far as a past emotion.

SPEAKER_00 13:59

So yeah, and we talked about how you know our age group, we definitely uh all have aging parents and that emotional burden of that, of knowing, or or they've already passed away, you know, we're grieving over the parents' loss, but we're also in this caregiver role and worrying about parents, you know, it's a huge emotional burden that I think uh happens around this time of menopause, unfortunately, and and can impact sleep significantly.

SPEAKER_01 14:33

Yeah. So let's dive a little bit more into I guess the the nervous system impact with sleep. And one big thing is that that you just mentioned there that really impacts the nervous system is is these out outside stressors. And when you're constantly in a state of chronic stress, it impacts our um sympathetic nervous system. And so we become dominant in that fight or flight or freeze situation. And so our bodies are just stuck. It's kind of like being on this hamster wheel of sympathetic nervous system stressors, and so that impacts, of course, our cortisol. Um, and this is this is common with high-achieving women that are, you know, constantly, you know, thinking of next steps and where we're where we're going. And and just very driven women living within this more masculine energy of go, go, go. It can impact our cortisol. And so great reminder of some of these lifestyle tips of really having grounding practices and rooting into more feminine and more receiving and calming the body in various modalities, which we'll talk about a few of our favorites here in a little bit. Um, but that that to me is the great definition of this like tired but wired when you feel your body is drained, but yet there's kind of like this internal buzzing of you can't sit still, you you're not right, you're you can't um, or you feel restless, I guess. Um, I've even had clients that are like, it's really hard for me to meditate or kind of bring my mind into presence because I just feel I'm going, going, going. And that's a sign right there of dysregulation with the nervous system of inability to just be and like be able to focus the mind and be fully present where you are. Um, so yeah, we have this mental overload, midlife, navigating all the things, empty nesting, as well as kids getting older and life choices that they're making, as well as aging parents, all of that really just um really impacts our nervous system. But our sleep is always improved when our body feels safe. Yeah. And I think that's our biggest takeaway here is the body must feel safe, not just tired, so that the body can actually do all these processes of restoration that it needs to do overnight.

SPEAKER_00 17:08

Yeah, and I think uh this is such an um extensive topic that we're probably gonna cover in another podcast episode, you know, nervous system dysregulation. Definitely. And I love how you talk about women who especially suffer from this because I don't know a single woman, our woman our age who does not struggle with that. It's because our society really expects us to be these crazy robot superwomen that do it all, right? We are supposed to be the super mom throwing the household, the kids' activities, we're managing everybody's calendar, but we're also working because if you're not working, you're lazy and what's wrong with you? Um, so we have these huge expectations for women, and we're supposed to be successful and doing it all with a big old smile on our face and not faltering at all, you know, and it's like, where did that come from? You know, don't know.

SPEAKER_01 18:06

Absolutely. Well, that could be a whole podcast talk there, too, because just these outside sources that tell women how you quote unquote should be and how it really impacts our nervous systems and being able to create some healthy boundaries around the shoulds and to what is the truth in our bodies, um, and what what our bodies are really meant to do to. Um, because a women's body, you know, our cycles we're very cyclical and it's not a 24-hour cycle, right? Yes. And so there's seasons and there's every phase of our our cycle is has a different need in our body. And so, you know, we we definitely could dive into another episode. All of that. So what to do? Yeah. Let's start with what not to do, because honestly, I feel like I hear, oh, well, I try to go to bed later and then I don't wake up at 2 a.m., 3 a.m. And that does not work. You go to bed later, you're still gonna probably wake up in the middle of the night. And so you're then just getting more, like less, less and less sleep, right? Um, taking every supplement in the world and just kind of throwing, throwing darts at a wall, trying to hope that something works. It really needs to be specific to what your body needs and what's going on in your specific situation. And if this is like we talked about, if it's a long-term more chronic insomnia versus is this hormonal changes, is this, you know, additional stressors during the season, etc. You mentioned earlier working out late at night, that's one of my biggest no-nos, because that is impacting your your dopamine and and just your adrenaline, and you are you're you're feeling good. And so it's better to do that earlier in the day, kind of like drinking coffee. It's it's a similar response in the body there of you're getting this these hits. And so you want to do exercise earlier in the in the day, absolutely.

SPEAKER_00 20:07

No afternoon coffee, exactly.

SPEAKER_01 20:10

Coffee in the morning, workout in the morning, um, always if if possible, or at least before dinner is for workouts. Um, and then scrolling. This is something in our society, right? It's oftentimes I hear it helps me calm my mind, but in reality, it's doing the opposite. It's giving you these false sense of like dopamine hits, and they're quick and short, and that's why it works, and that's why it's hard to stop scrolling once you start. Um, it's this similar to watching a late night show or watching, you know, TV before bed, etc. All of that is doing is just creating your brain, making your brain more alert when the goal for optimal sleep is to ground and calm the brain, not wire the brain. And so these are things that do not work. So if that is something you find yourself doing, let's talk about what you can do instead.

SPEAKER_00 21:05

Yes, so some evidence strategies for um regulating sleep and and helping you sleep better. You want to get started.

SPEAKER_01 21:14

Yeah, well, one of the things with just lifestyle is circadian listening to the circadian rhythm, right? Our bodies are in tune with when it becomes dark. It our bodies naturally are like, okay, calm, rest, it should be quiet. That should be a clue for us to turn off the electronics and really become, you know, play soft, gentle music or read from an actual book or just various activities like that. Um, versus and then in the morning, having sun first thing in the morning really helps our body just remind itself like, okay, we're awake instead of staying inside, keeping all windows closed, etc. Um, that circadian rhythm is a powerful tool. And then also having some rituals. I, you know, I often ask clients, like, what Is your sleep routine. And oftentimes I hear, well, around you know nine o'clock, I turn everything off, I go brush my teeth, and then I just go try to lay down and go to sleep. And some people that can work, but if sleep is a struggle, there you probably need about an hour before to really prepare your body. And this is where I love utilizing aromatherapy, having aromas that are calming, grounding that's a lot of your like wood essential oils or your lavender, et cetera, to just really tell the brain and body with, you know, there it tells your limbic system to calm with those rooted and grounding aromas. Um, another is make sure your room is dark, right? Make sure your temperature is no higher than 67, 68 degrees in your house so that you are in a cool environment and even cooler as you go through menopause because you do want to mitigate as much of that hot flash waking that you can. Um, food, stopping food by seven at the latest, and not eating after seven if at all possible, just so that gives your body plenty of time for digestion processes. So when you're sleeping, you're not working on digestion still, your body is able to do all these other processes that we mentioned at the beginning of this episode. Um, so those are some great things, even writing in a gratitude journal, or you know, spending some time in in just like thought or reflection of the day, or like the you know, the the wins from the day, those are great end cap to your your day that can really help ground and and calm the brain um with intentionality there.

SPEAKER_00 23:46

Yes, for sure. And I I think little things like even a really short meditation of five minutes when done regularly can have such a huge impact on how you're able to sleep. Um, and and we're we're also, you know, we're experts in this, but we're definitely not perfect. I mean, I scroll, I sit in bed and order groceries because I didn't have time during the day. And sometimes I get stuck on Instagram, and you know, I definitely do it, but it's a you I definitely notice that I it takes me much longer to go to sleep when I do that, or when I skip my meditation, I really love um meditation lying down with some red light therapy. That's that's my favorite evening ritual where I just you know everything is grounding and I do a uh a total body relaxation, muscle relaxation, and then my body is ready for sleep. Um hormones, of course, play a huge role, and this is something that I discuss with each client individually. You know, we can in perimenopause and and before, we can certainly do a lot of things to help your hormones regulate naturally. We don't need hormone replacement necessarily, but at some point that might really become a very important tool of helping you sleep and therefore you know feeling energetic during your day and feeling your best and being able to function properly and and do all the things you want to do. So it's an individual approach, but I I certainly use bioidentical hormones to help women through perimenopause and menopause um sleep better. Absolutely. Yeah.

SPEAKER_01 25:37

And like you shared, like I'm not perfect. I don't know how often we have watched a late night movie that's like a suspense, and then my brain is reeling, or I lay in bed and I go through my checklist and did I do all the things? And if I didn't, I might do it there on my phone, just like your example. Um, and so it's it definitely is it's a daily challenge. And I think the key here is that when you know and have the tools and you create a routine for a period of time, your body is more self-aware. You're more aware of okay, this was a poor night's sleep. And so I really need to get back on track my next night of prioritizing this quality of sleep, putting my phone in a different room or you know, in my bathroom instead of next to my bed type situations. Um, so yeah, what specifically is your night routine? Like what works the best for you?

SPEAKER_00 26:30

Yeah, I think um the red light therapy meditation is is probably my personal favorite that I is easy to do. You know, I have this little red light panel I bought off Amazon, nothing fancy, it just calms me and and grounds me. And often my dog lies down with me and does the meditation with me, and that's kind of like an extra bonus, you know, your emotional support dog and um a sauna to me is extremely good for helping me sleep. I don't always get to do that at night, but when I do, I notice a huge improvement in sleep. Um, and then I really like uh binaural beats for when I wake up in the middle of the night and I have one of those um, you know, your mind spinning, you're going through your to-do list for the next day episodes. That's when I use binaural beats, and it's basically a sound frequency that has slightly different frequencies from one ear to the other. So you have to listen with headphones. Um, and because those frequencies are just slightly different, your brain works on equalizing them, and it's like a reset button for your brain, so it overrides all this uh monkey brain and talking in your head, it just um simmers it down and it's extremely calming. And usually I can go back to sleep in five minutes of that.

SPEAKER_01 28:00

Yeah, and binary beads are there's specific ones with frequencies for sleep, for anxiety, for various things. So that would be one to investigate too if if you're needing a solution for a reset. Absolutely.

SPEAKER_00 28:14

How about you? What's your favorite routine?

SPEAKER_01 28:16

Yeah, so I notice a difference taking magnesium glycinate that helps me immensely. I have to have a pitch black room. There cannot be any light down the hall, anything. And then I also really need white, white noise. Um, that just basic sound machine background noise inhibits me from awaking if my dog is walking down the hall in the middle of the night or my husband is moving around or snoring a little bit. There's, you know, I sleep better. I also find a correlation in exercise. So if I am not exercising or I have several days off, or I just is something traveling, things like that, then I notice my sleep is not as good. So it's there definitely is a correlation between the exertion as well as you know, perspiring during the day and my quality of sleep at night. So those I would say are my non-negotiables there. Um, and one other thing that I find if I wake up in the middle of the night, I will do a body scan where I'll imagine like a light going and warmth going, you know, or cool, whatever I need in the moment, going up one leg, up through my chest, my body, down an arm, up an arm, down the other side of the body, etc. That really does help because it brings my brain instead of thinking, why am I not sleeping? What am I, you know? Oh, I've got all these things on my plate tomorrow. Like those thoughts, it brings to okay, my body, like I'm comfortable, I'm safe. Busy doing an activity. Exactly. So then it I just repeat it, and usually I'm out and I'm like, oh, I guess I fell asleep doing that, you know.

SPEAKER_00 29:54

I love that.

SPEAKER_01 29:55

Yeah.

SPEAKER_00 29:57

Yeah. So so key takeaways for this episode as we're wrapping this up. I think sleep changes are so common, and I'm sure we're gonna have another episode on this because we can talk on forever and really take uh multiple deep rabbit holes here. But it is multifactorial, but it is mostly treatable, so that's the good news. Um, menopausal sleep disruption, especially, is super common and it affects a huge proportion of women during perimonopause and beyond, and it's tied to both hormonal changes and to symptoms those changes trigger, so hot flashes, mood shifts, and so forth.

SPEAKER_01 30:41

Yeah, so if you have a topic or you have questions that you would like us to cover in a future episode, we um would love to hear those. So please contact us using the details in the show notes, and we will consider that on our future episodes. But next up, we are diving into what is health coaching? That is a common question we both receive, and there's a lot of misconceptions out there. So we'll see you next time as we dig into health coaching.

SPEAKER_00 31:12

All right, friends, that's a wrap for today's episode of Shift Happens, Hormones Unfiltered. If your hormones are shifting and you want actual support instead of late-night googling, we've got you.

SPEAKER_01 31:25

Together we offer a blend of clinical care and coaching that helps you understand your body, regulate your nervous system, and actually feel like yourself identified.

SPEAKER_00 31:35

If you're looking for personalized hormone testing, functional medicine guidance, or support navigating parameters, mental policy, and new on accountability, have expanded health and minds of go with it.

SPEAKER_01 31:50

We work with women who are ready for root-cause answers and sustainable lifestyle shifts.

SPEAKER_00 31:55

You can learn how to work with us by clicking in the links in the show notes.

SPEAKER_01 32:00

Thanks for hanging out with us today. Your body isn't broken, it's shifting. And we're here to help you shift with it. See you next time.