Sleep hygiene

Sleep hygiene is two things: knowing how sleep works, and the daily habits that support it. When you go to bed, what you eat and drink in the evening, how your bedroom feels at night.

The British Menopause Society calls it sensible advice for anyone sleeping badly. It also says, plainly, that sleep hygiene is not usually enough on its own to treat a sleep disorder. So if you have done everything on the list and still lie awake, you have not failed at it. That is a reason to see a doctor, not to try harder.

The NHS website says menopause and perimenopause can affect your ability to fall asleep and to stay asleep, and that night sweats can make it worse.

The BMS lists several reasons sleep breaks in these years, often more than one at once: hot flushes and night sweats, changes in mood, aches in the joints and muscles, and getting up in the night to pass urine. It also notes that some sleep disorders become more common around menopause, including breathing problems in sleep, restless legs and chronic insomnia. That is why the advice below has a limit.

The Pakistan Menopause Society

Section 4.2.3 of the 2026 recommendations covers restorative sleep:

• keep a regular sleep schedule
• avoid screens and heavy meals in the hours before bed
• limit caffeine and alcohol in the evening
• keep the bedroom cool, quiet and dimly lit.

For night sweats, it adds light, absorbent nightwear, cooling aids such as a facial spray or a cold pillow pad, avoiding sudden changes in temperature, and layers you can take off.

On chai, the same recommendations note that tea drinking is high in Pakistan and list excess caffeine as something that may break up sleep (Table 7). Our page on chai and caffeine has more.

The British Menopause Society

The BMS tool for clinicians covers much the same ground, and adds:

• avoid daytime naps
• limit nicotine as well as caffeine
• relaxation training, such as progressive muscle relaxation
• keep the bed for sleep, not for eating or watching TV
• exercise in the day, ideally not just before bed
• weight loss and stopping smoking, especially when a breathing problem in sleep is suspected.

The NHS Every Mind Matters page adds two small ones: give yourself time to relax before bed, and put your phone away. For night sweats, the NHS menopause pages list hot drinks among the possible triggers to avoid or cut down on.

NICE NG23 says doctors can consider menopause-specific CBT, a talking therapy, for sleep problems such as waking in the night that come with hot flushes and night sweats, alongside other options including HRT, or instead of them (1.5.24). The Pakistan Menopause Society also recommends CBT, face to face, in a group or remotely (4.2.4.1).

The BMS says HRT can improve sleep quality during menopause, partly by easing hot flushes. If sleep stays poor once menopause symptoms are treated, its tool asks doctors to check for chronic insomnia, and recommends CBT for insomnia (CBT-I) where it is diagnosed. Whether any of this suits you is your doctor's call.

The NHS website says to speak to a GP if changing your sleep habits has not helped, if you think you have insomnia, or if you think menopause symptoms are behind it.

Mention snoring, anyone noticing that you stop breathing in your sleep, or an urge to move your legs at night. The BMS asks doctors to screen for these, because they need their own treatment. The European Menopause and Andropause Society (EMAS) lists two more causes of poor sleep around menopause worth raising: low iron and acid reflux. Tell your doctor about your medicines too: the NHS notes that some can affect sleep. And the BMS tool says not to drive if you feel sleepy.

Ramadan changes the shape of the night: suhoor before dawn, taraweeh late, the last ten nights. Outside Ramadan, some women wake for tahajjud. Women ask how a regular sleep schedule fits around worship, and the guidelines above were not written with that in mind. Questions about worship belong with a qualified scholar; questions about medicine timing, with whoever prescribes it. See Ramadan and fasting.

At home, a cool, quiet room is not always yours to arrange. A shared bed, a fan someone else wants off, a child who still comes in at night. The Pakistan Menopause Society lists honest talk with your husband and family as part of care (4.2.6). Telling them why you are awake is a fair place to start.