Why Early Morning Waking and Anxiety Happen in Menopause and How to Fix it.

Waking up between 3-5 AM and struggling to fall back asleep is one of the MOST common sleep issues in menopause. Often, this is accompanied by a racing mind, anxiety, or a sudden feeling of alertness that makes it difficult to drift back into sleep.  It’s very hard to switch your mind off. This can be one of the earliest signs on Peri-menopause.  I have personally been struggling with this for many years and it has taken a lot of trial and error, patience and calm to deal with.  It remains a work in progress.  A whole night’s sleep has become an Olympic sport for me!

This happens due to a combination of hormonal shifts, cortisol imbalances and blood sugar fluctuations but the good news is that targeted strategies CAN help.

Why You Wake Up Too Early & Feel Anxious

Declining Estrogen & Progesterone Disrupt Sleep Cycles

Estrogen supports deep sleep & melatonin production, so when it drops, sleep becomes lighter and more fragmented.

Progesterone has a calming, sedative effect, so declining levels can make you more prone to nighttime anxiety.

Solution: Support these hormones naturally with lifestyle changes and the right nutrients (see below).  Start here and then seek help for HRT if you still struggle.

Cortisol Spikes in the Early Morning

Cortisol (your stress hormone) follows a natural rhythm, rising in the morning to wake you up and decreasing at night to help you sleep.

In menopause, cortisol regulation becomes erratic, meaning it can spike too early (around 3-5 AM), waking you up.

If stress levels are high, this spike is even stronger, making you feel wired and anxious.

Solution: Manage stress and cortisol levels throughout the day, not just before bed (see strategies below).

Blood Sugar Dips Cause Adrenaline Surges

Overnight, your body relies on stored glucose (glycogen) to maintain stable blood sugar.

But, in peri/post-menopause, insulin sensitivity changes, and your blood sugar may drop too low overnight.

When this happens, your body releases cortisol & adrenaline to bring blood sugar back up, waking you up with a jolt.

Solution: Eat a protein-rich snack before bed to stabilise blood sugar.

Increased Anxiety & Overactive Mind

Many women report that even minor worries feel magnified at night.

This is because, when progesterone drops, GABA (a calming neurotransmitter) also decreases, making it harder to quiet the mind.

Solution: Use relaxation techniques and supplements to boost GABA levels.

How to Fix Early Waking & Sleep Anxiety

Evening Routine Adjustments

Eat a Sleep-Stabilising Snack Before Bed

To prevent blood sugar dips & adrenaline spikes, eat a protein + healthy fat snack 30-60 minutes before bed:

- ½ avocado with sea salt

- almond butter on a slice of banana

- handful of walnuts, pumpkin seeds or pistachios and almonds contain melatonin

- Greek yogurt with a sprinkle of cinnamon

Lower Cortisol in the Evening

High cortisol at bedtime makes you more likely to wake up at 3-5 AM.

Try one of these 30-60 minutes before bed:

Gentle stretching or restorative yoga (activates the parasympathetic nervous system).

4-7-8 breathing (inhale for 4 seconds, hold for 7, exhale for 8) Do this 5 times.

Magnesium glycinate (200-400mg) – calms the nervous system & helps muscle relaxation (seek advice from healthcare provider on supplements)

Keep Bedroom Temperature Cool (16-19°C / 60-67°F)

Overheating or night sweats can trigger wake-ups.

Use cotton sheets & wear breathable pajamas (cotton, bamboo or silk).

Invest in a ceiling fan or a fan, this can make a big difference.

Reduce Blue Light Exposure Before Bed

Blue light suppresses melatonin, the less melatonin, the more likely you are to wake up early.

Turn off screens 60 minutes before bed OR use blue-light-blocking glasses.

What to Do If You Wake Up Too Early

Don’t Check the Clock

Seeing the time increases stress (“Ugh, it’s 3:30 AM again!”), making it harder to fall back asleep.

Avoid Grabbing Your Phone or Overthinking

If your mind starts racing, use box breathing instead:  Inhale for 4 seconds → Hold for 4 → Exhale for 4 → Hold for 4.

Use a “Sleep Reset” if you can’t fall back to sleep (instead of lying there anxiously). If you’ve been awake for more than 20 minutes, get up and do a quiet, non-stimulating activity in dim lighting:

Read a calm, non-exciting book (nothing stressful) this can help distract your mind

Journal or write down your thoughts to “offload” your worries.

Listen to a low-volume, guided meditation.

Sip warm chamomile or passionflower tea.

Try Acupressure for Sleep

Press between your eyebrows (Yintang point) for 30 seconds to calm anxiety.

Gently massage the inside of your wrist, 2 finger-widths from the wrist crease between two tendons (Pericardium 6 point) to promote relaxation.

Use a Cold Compress If You Wake with Anxiety or Hot Flashes

Place a cool washcloth on your forehead or wrists to lower body temperature and reduce night sweats.

Daytime Fixes to Prevent Early Waking

Regulate Cortisol with Morning Light Exposure

Getting sunlight within 30 minutes of waking helps regulate melatonin & cortisol rhythms, making you less likely to wake too early the next day.  We need to pay attention to our Circadian rhythms (Read Blog: Why Breaks Matter - Understanding Circadian and Ultradian rhythms)

Eat Protein at Breakfast to Stabilise Blood Sugar for the Day

A breakfast high in protein & healthy fats helps prevent blood sugar crashes later at night.

Example: Scrambled eggs with avocado & flaxseeds or Greek yogurt with nuts & berries.

Reduce Afternoon Caffeine

Caffeine stays in your system for 6+ hours, even small amounts in green tea, chocolate, or soda can impact sleep. No caffeine after 1pm.

Switch to herbal teas (chamomile, lemon balm or rooibos) in the afternoon.

Move Your Body, But Avoid High-Intensity Workouts Late in the Day

Exercise helps regulate cortisol but intense workouts after 6 PM can spike cortisol too much before bed.

Best choices: Morning strength training, afternoon walking or gentle yoga in the evening.

Try Adaptogenic Herbs to Balance Cortisol & Anxiety

Ashwagandha or Rhodiola (taken in the morning) help stabilise cortisol levels.

Passionflower or valerian root (taken at night) promote relaxation.

(use on the advice of a healthcare practitioner)

Final Thoughts

Early waking and anxiety during peri & post menopause are fixable with the right routine. Since hormonal changes are at play, the key is to:

✔ Stabilise blood sugar before bed

✔ Lower evening cortisol levels

✔ Reduce stress/anxiety triggers

✔ Create a sleep-supportive environment

By making small, consistent adjustments, you can retrain your body to sleep through the night and wake up feeling refreshed.

After

all, sleep is SANITY!