Hot flashes and sleep: what the evidence supports and what is a myth

Declining estrogen disrupts thermoregulation in the hypothalamus: the range of “normal” body temperature narrows, and the slightest shift triggers heat release — heat, sweating, and palpitations. At night, this wakes you up. Hot flashes occur in 75-80% of women, lasting 4-7 years on average, and longer for some. Their intensity depends on weight, stress, alcohol, smoking, and what you eat in the evening.

One week of sleeping 5-6 hours reduces insulin sensitivity by 20-30% — in healthy young people. During perimenopause, when insulin already works less effectively, this is a direct path to belly fat. Cortisol is higher in the morning, appetite is higher during the day, and energy for a workout is lower. Therefore, in the method for women over 45, sleep takes priority over the fasting window: until you sleep seven hours, the window should be no longer than 14/10. How stress and cortisol do the same thing — separate article. General overview of sleep — sleep and weight.

Works: weight loss (every 5 kg noticeably reduces hot flashes), strength training and regular walking, cognitive behavioral therapy for insomnia, avoiding alcohol and evening coffee, and a cool bedroom. Hormone therapy is the most effective method for severe hot flashes, and this is a conversation with a gynecologist, not the internet. Works poorly or not at all: soy and phytoestrogens in supplements, “herbs for menopause,” melatonin for hot flashes (it helps you fall asleep but does not eliminate the heat). A low-carbohydrate diet eliminates nighttime blood sugar swings, and many women report that they wake up less often.