Hormonal Insomnia: 5 Expert Tips for Reclaiming Your Sleep

Understanding the impact of hormonal imbalances on sleep can help you pinpoint potential reasons for experiencing insomnia

Tania Sultana
By Tania Sultana
Jovan Mijailovic
Edited by Jovan Mijailovic

Published March 6, 2024.

A woman lying in bed, unable to sleep.

Sleep issues affect people differently. 35% of adults experience some insomnia symptoms, with 20% having short-term insomnia lasting less than three months. [1]

Hormonal insomnia is relatively common. In premenopausal ages, sleep disorders affect about 42% of women. [2] But how can a hormone imbalance contribute to insomnia, and can hormones even cause it? We've created a list of tips to answer these questions and help you regulate your sleep.

Understanding hormonal insomnia

Hormonal insomnia is a sleep disorder caused by disruptions in hormone levels. Many of these hormones are associated with the circadian rhythm (the sleep-wake cycle), sexual development, and stress regulation.

Most people have a sleep-wake cycle roughly synchronized with nighttime and daytime, depending on their sleeping patterns. It occurs every 24 hours.

Five major hormones play a crucial role in regulating our sleep-wake cycles:

  • Melatonin
  • Cortisol
  • Estrogen
  • Progesterone
  • Testosterone

Can hormones cause insomnia?

Imbalances can disrupt normal sleep patterns and lead to insomnia. If you have low melatonin levels, it might be harder for you to fall asleep. Imbalances in estrogen and progesterone can also lead to nighttime awakenings. However, there's no sufficient proof of whether hormones cause this directly.

Which hormone levels peak during sleep?

Melatonin and testosterone levels peak at night. The female sex hormones, estrogen and progesterone, don't have a pronounced peak during sleep.

Hormones that make you sleep

Five major hormones play a crucial role in regulating our sleep-wake cycles:

  • Melatonin: This essential hormone rises in your blood in the evening, signaling your body that it's time to sleep. Melatonin production declines with age, causing sleeplessness in older people.
  • Cortisol: When stressed, your brain releases this neurotransmitter to keep your brain alert, resulting in short sleep cycles and shallow sleep. Cortisol production drops to its lowest point around midnight and peaks about an hour after you wake up.
  • Estrogen and progesterone: These neurotransmitters regulate body temperature and promote relaxation at night. During menopause or the menstrual cycle, their low levels can lead to sleep disturbances. Some frequent symptoms I see are hot flashes, night sweats, and increased anxiety.
  • Testosterone: Testosterone forms part of your natural circadian rhythm. It rises during sleep. Men with lower levels of it experience shorter sleep. As the level drops, the amount of cortisol circulating in the body increases, causing sleeplessness.


Does melatonin cause sleep paralysis?

Sleep paralysis is when you wake up but can't move your muscles, even though your mind is active. This can happen in the rapid eye movement (REM) stage of sleep when dreams happen. High melatonin level increases REM sleep. Although it makes sense that taking melatonin supplements to treat insomnia may lead to more sleep paralysis, no direct link is known yet.

How does progesterone and waking up at night correlate?

When you have a high progesterone level, you also have a high GABA level, a relaxing chemical that reduces anxiety. When progesterone levels drop, especially during the menstrual cycle's luteal phase and perimenopausal changes, it can increase wakefulness during the night.

What female hormone makes you tired?

Progesterone levels in women are highest in the menstrual cycle's third week. This can make you feel more tired around that time, which may help you fall asleep. However, by the fourth week, progesterone levels plummet, causing trouble sleeping, tiredness, and low energy.

How are REM and testosterone connected?

Testosterone levels rise when you first fall asleep and reach their peak during the first REM cycle., which gets longer as the night progresses. So, when you don’t get enough sleep or wake up frequently, your body does not get enough REM sleep and cannot make enough testosterone.

Additionally, a man’s testosterone level naturally begins declining around age 40. So, a middle-aged man who doesn’t sleep well can experience a significant drop in testosterone production.

5 Strategies for reclaiming sleep

If you're struggling with hormonal insomnia, these strategies can help improve your sleep quality:

1. Adopt a healthy lifestyle

A healthy lifestyle can support your sleep-time routine. To regulate your hormones related to the sleep-wake cycle, you can:

  • Cut down your coffee consumption
  • Eat easy-to-digest snacks
  • Exercise during the day

2. Build a healthy sleep-wake cycle

To set up a sleep-wake cycle that encourages enough rest, you can:

  • Maintain a consistent sleep routine
  • Create an optimal bedroom environment
  • Avoid any stimulus (coffee, screen time, alcohol, and exercise) a few hours before bedtime

3. Natural supplements

Some people find relief with natural supplements that support hormone balance, such as black cohosh or chaste berry for menopausal symptoms.

Your healthcare provider may also recommend over-the-counter melatonin supplements to help regulate your sleep-wake cycle.

4. Cognitive-behavioral therapy for insomnia (CBT-I)

If hormonal insomnia leads to chronic sleep problems, CBT-I can help you change behaviors and thought patterns related to sleep, improving its quality. It can also help you manage stress better, lower cortisol levels in the blood, and improve your sleep quality.

Note: Some apps can help you condition your mind for better sleep.

5. Hormone replacement therapy

If hormonal imbalance is the reason for your insomnia, your doctor will advise you on the treatment.

They might prescribe hormone replacement therapy to restore levels to a more balanced state. Doctors usually use it for conditions like menopause-related hormonal imbalances, where estrogen and progesterone levels decrease.

Work toward better sleep

Understanding how imbalances in your hormones can lead to insomnia can help you identify potential causes of sleep problems. Addressing those causes through intervention can improve your sleep quality and overall well-being.

InsideTracker offers actionable and personalized wellness recommendations backed by science. Using your biomarkers and bloodwork, it can help monitor and optimize your well-being so you can live healthier longer.

If you have any concerns, please consult a qualified professional, as InsideTracker doesn't diagnose or treat medical conditions.


[1] https://sleepeducation.org/insomnia-awareness-day-facts-stats/

[2] https://sleepeducation.org/insomnia-awareness-day-facts-stats/