Sleep changes rarely have a single cause During perimenopause and menopause, hormonal changes may occur alongside hot flushes, night sweats, mood changes and sleep difficulties. Caring responsibilities, work stress, anxiety, chronic conditions or another sleep disorder may also affect sleep. Everyone’s experience is different, and not every change should automatically be attributed to menopause. Start with a simple one-week record Note your bedtime and waking time, how often you wake during the night, hot flushes or night sweats, caffeine and alcohol, and how you feel the next day. The aim is not “perfect sleep”. It is to help you and your healthcare professional see patterns. Begin with gentle everyday adjustments Try to keep a reasonably consistent sleep and wake time. Make space for a quiet wind-down routine. If you often feel hot at night, try a cooler bedroom and lighter bedding. Notice whether afternoon caffeine or evening alcohol affects your sleep. Australian guidance for adults aged 18 to 64 recommends 7–9 hours of good-quality sleep with consistent bed and wake times, while individual needs and circumstances vary. When to seek support If sleep problems persist, worsen, or clearly affect your work, mood or daily life, consider starting with your GP. They can help determine whether the changes may relate to perimenopause and consider other possibilities such as thyroid conditions, iron deficiency, sleep apnoea, mental health or medicines. If you are considering medicines, menopausal hormone therapy, melatonin or supplements, speak with a doctor or pharmacist about whether they are suitable for you.