Helping You Understand Sleep in Perimenopause with Traditional Chinese Medicine
You used to be someone who could fall asleep anywhere. Now you’re lying awake at 3 AM, mind racing, wondering when your body betrayed you. Tonight, last night, and most nights.
If you’re in your 40s and suddenly struggling with sleep for the first time in your life, you’re not alone. What you’re experiencing isn’t “just getting older”, and it is not something you should ignore. Changes in sleep – even as early as your late 30s – are likely your body navigating the perimenopause transition.
As you probably already know, getting good quality healing sleep is a foundation of maintaining good health – and key to dealing with many of the other concerns that may come up during perimenopause.
As a Registered Acupuncturist here in Niagara, I see women every week who are frustrated and exhausted from new sleep challenges. They’ve tried melatonin, sleep hygiene apps, and cutting out caffeine, but nothing seems to work the way it used to. Most are just pushing through, hoping it will get better soon. Because life is busy – and you just have to get on with it, right?
Here’s what I want you to know: this is a common issue in perimenopause – and sleep medication is not necessarily the first answer. From a Traditional Chinese Medicine (TCM) perspective, there are clear patterns happening in your body during this transition – and there are gentle, effective ways to support yourself through it.
Why Perimenopause Disrupts Sleep
In TCM, we understand that perimenopause represents a natural shift in your body’s energy systems. Think of it like a river changing course – it’s not broken, but it needs new pathways to flow smoothly.
During perimenopause, three main patterns tend to emerge that directly impact sleep:
1. Liver Qi Stagnation: When Stress Gets Stuck
What it may look like:
- Your mind won’t “turn off” at bedtime
- It is hard to fall asleep, and perhaps you resist going to bed until later for this reason
- Or, you fall asleep fine but wake up between 1-3 AM with racing thoughts
- Feeling irritable or frustrated during the day, especially when your routine gets disrupted
- Sighing frequently without realizing it
- Tension in your jaw, shoulders, or neck
- A tendency to migraines in the past – or more frequent migraines now
- New or worsening digestive problems such as bloating or constipation
- PMS symptoms that seem worse than they used to be
Why it happens in your 40s: By midlife, many women are carrying years of accumulated stress. A build up of daily stressors from careers, parenting, relationships, and the mental load of managing households. Add hormonal fluctuations into the mix, and your Liver system (which governs the smooth flow of emotions and energy) can become overwhelmed. Feelings of restlessness, frustration, anger – even rage? This is what can happen if the smooth flow of emotions becomes blocked and stagnant.
In TCM, the Liver is responsible for planning and vision – making plans for both your day and your life. If the Liver energy is healthy, it feels like everything is moving smoothly as per plan. Healthy Liver Qi feels like resilience: you are able to calmly carry through with daily life no matter what is happening around you. When Liver Qi stagnates, it’s like having a traffic jam in your energy system right when you need rest the most.
Smooth flowing Liver Qi is also a factor in digestive health. Left unchecked, Liver Qi Stagnation can start to affect digestive patterns and contribute to abdominal stagnation in the form of bloating or constipation.
2. Kidney Yin Deficiency: When Your Inner Cooling System Falters
What it may look like:
- Night sweats or feeling too warm at night
- Difficulty staying asleep, especially in the second half of the night
- Waking up feeling unrefreshed, even after 7-8 hours
- Afternoon energy crashes, perhaps with a feeling of heat
- Dry skin, eyes, or mouth
- Lower back soreness or stiffness
- Feeling “wired but tired”
- New dizziness or tinnitus
Why it happens in your 40s: In TCM, your Kidney system stores your body’s essential energy reserves – think of it as your internal battery. Kidney Yin specifically provides the cooling and nourishing aspects of this energy. The Kidney organ system has both Yin and Yang aspects, they cooperate and need to be balanced for optimal health. But specifically Kidney Yin is about moistness and calming energy, in contrast to Kidney Yang which is fire and active energy.
During perimenopause, declining estrogen affects your body’s ability to maintain this cooling, nourishing quality. Without sufficient Kidney Yin, you can’t properly “downshift” into cooling rest mode, leaving you feeling restless and overheated when you should be sleeping peacefully. Other common reasons for Kidney Yin deficiency may be overwork and/or staying up late (including shift work).
3. Heart Yin Deficiency: When Your Inner Calm Goes Missing
What it may look like:
- Difficulty falling asleep despite feeling tired
- Vivid dreams or restless dreaming
- Waking up with anxiety or a racing heart
- Feeling emotionally sensitive or “raw”
- Heart palpitations
- Memory issues or difficulty concentrating
- Hot flashes, especially around your chest and face
Why it happens in your 40s: In TCM, the Heart houses your “Shen” – your spirit or emotional center. The Shen is the mind and consciousness, so in this way the Heart is seen to influence mental and emotional functions. Heart Yin provides the calm, grounded energy that allows your mind to settle into peaceful sleep. This yin is a nourishing fluid and related to blood that nourishes the Heart organ.
Heart Yin can be affected over a period of time when you may be overworked, or have gone through a longer period of stress or grief. It can also become deficient as a result of long periods of lack of sleep.
When Heart Yin becomes deficient (often alongside the hormonal changes of perimenopause), your Shen becomes “unsettled.” It’s like trying to sleep in a house where all the lights keep flickering – your nervous system can’t find the steady, calm state it needs for restorative rest. Since yin is always a cooling factor, lack of it can show up as heat – especially around the chest.
Supporting Yourself: Simple Self-Care for Better Sleep
While acupuncture treatment provides the most comprehensive support for these patterns, there are gentle self-care practices you can start tonight:
Acupressure Points for Better Sleep
Shenmen (Spirit Gate) – Heart 7 Location: On your wrist crease, in the small depression on the pinky side of your wrist, just below your palm How to use: Gently press and hold for 30 seconds while taking deep breaths. Perfect for calming racing thoughts before bed.
Yintang (Extra Point) Location: Right between your eyebrows, in the center of your forehead How to use: Use your middle finger to apply gentle pressure in small circles for 1-2 minutes. This helps settle your Shen and prepare your mind for rest.
Kidney 3 – Taixi (Supreme Stream) Location: On the inside of your ankle, in the depression between your ankle bone and Achilles tendon How to use: Press gently while sitting on the edge of your bed. Hold for 30 seconds on each side. This nourishes Kidney Yin and helps your body’s natural cooling and calming systems.
Evening Ritual for Liver Qi Stagnation
If your mind races at bedtime, try this 5-minute routine:
- Place both hands on your ribs and take 5 deep breaths, imagining your breath creating space between your ribs
- Gently massage your temples in circles
- Write down 3 things you’re grateful for and 3 things you’ll handle tomorrow (getting them out of your head and onto paper)
Cooling Evening Practice for Yin Deficiency
If you tend to overheat or feel “wired but tired”:
- Keep your bedroom cool (around 18-20°C)
- Try a warm (not hot) foot bath with Epsom salts 30 minutes before bed
- Avoid screens for at least 30 minutes before sleep
- Keep a glass of room-temperature water by your bed
You Don’t Have to DIY Your Sleep Health
What I want every woman in perimenopause to understand is this: your sleep challenges are not a personal failing. They’re your body’s way of asking for support during a major life transition.
Acupuncture and Traditional Chinese Medicine offer a gentle, holistic approach that doesn’t just mask symptoms – it helps restore the underlying balance your body is seeking. While self-care practices can provide meaningful relief, working with a qualified Registered Acupuncturist can help identify your specific pattern and create a personalized treatment plan.
We’ll talk about a treatment approach that includes sleep-focused acupuncture and how to plan out your sessions to get the best results. We’ll also discuss lifestyle recommendations to support your individualized case based on TCM’s view of perimenopause patterns and evidence based research.
If you’re in the Niagara region and tired of lying awake wondering when you’ll feel like yourself again, I’d love to support you. Your sleep matters. Your perimenopause health matters. And most importantly, you matter too.
Ready to explore how acupuncture can support your sleep and overall well-being during perimenopause? Book a free 15-minute consultation to discuss your specific concerns and learn how Traditional Chinese Medicine can help you reclaim your rest.
