Why do I keep waking at 3am?

Waking in the small hours is one of the most common things women tell me about in perimenopause. Falling progesterone can take away some of its calming effect, night sweats can wake you without you noticing why, and dips in blood sugar or a stress response can nudge you awake and keep your mind busy.

The basics make more difference than people expect: a cooler bedroom, a steady evening meal, less caffeine after lunch and less alcohol in the evening. If you do wake, slow breathing with a longer out-breath helps your body settle rather than getting up and scrolling.

If poor sleep has gone on for weeks and is affecting your days, talk to your GP. HRT and other options can help, and you deserve a proper conversation about them.