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Cortisol and Sleep Connection in Menopause

By | Fact Checked By Andrea Donsky |

Cortisol and Sleep Connection in Menopause

When we talk about menopause, the hormones most often mentioned are estrogen and progesterone because of their impact on so many aspects of a woman’s physical, emotional, and mental state. Yet the stress hormone cortisol also plays a big role, especially when it comes to sleep.

What is cortisol?

Cortisol is a hormone produced by a complex network of players known as the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus in your brain releases a hormone called corticotropin-releasing hormone (CRH) to the pituitary gland, which is also in the brain. CRH stimulates the pituitary to release adrenocorticotropic hormone (ACTH), which makes its way through your bloodstream to the kidneys and signals the adrenal glands to make cortisol. After the adrenals have produced enough cortisol, the hypothalamus stops sending out CRH. 

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What does cortisol do in the body?

Cortisol plays a significant role in the body’s response to stress. When cortisol is released under stressful circumstances, the cortisol receptors throughout the body can respond in a variety of ways, such as rapid heart rate, rapid breathing, sweating, or a sharp rise in blood sugar levels. 

Cortisol also has an impact on mood, metabolism, digestion, and how your immune system responds to infection, trauma, or disease. Yet one more thing cortisol affects is sleep.

Cortisol and sleep

The stress response and sleep have something in common: they share the HPA axis, which means when the function of the HPA axis is disturbed, sleep can be disrupted as well. 

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The body produces cortisol in cycles: levels are lowest around midnight and highest about 60 minutes after you wake up. Along with the regular release of cortisol, smaller amounts are released throughout a 24-hour period, and some of these smaller amounts correspond to the time you are sleeping.

If your HPA axis is overly active, it can interfere with your sleep, causing insomnia, waking up often during the night, trouble falling back asleep, and overall not getting sufficient restful sleep. These sleep problems in turn can disrupt your normal production of cortisol. Research has shown, for example, that insomnia and other sleep problems can cause your body to send out more cortisol during the day, which contributes to a hormonal imbalance. 

Cortisol, sleep, and menopause

Although this relationship has not been studied extensively, a few studies give us an idea of what is going on. In one study of women older than 55, the authors reported that higher cortisol levels were associated with less rapid eye movement (REM) sleep (critical because it stimulates the brain areas involved with making memories and learning). These women also tended to wake up earlier than desired.

In addition, the investigators found that higher cortisol levels among stressed women were associated with reduced sleep time in stages 2, 3, and 4 (REM). During stage 2, heart rate slows, and body temperature drops. This stage usually lasts about 20 minutes. Stage 3 is when you get your deepest sleep, which is necessary to feel refreshed the next day. 

In the Seattle Midlife Women’s Health Study, the researchers evaluated cortisol levels in women during perimenopause and early postmenopause. None of the women were taking hormone replacement therapy. The experts reported that cortisol levels increase gradually with age beginning around the late 40’s. This increase has a “psychological impact in menopause and is linked to sleep-wake patterns.” 

Read about 9 ways to lower cortisol naturally and why you should

How to promote healthy cortisol levels

Several lifestyle modifications can help promote healthy cortisol levels.

  • Limit consumption of salt, unhealthy fats, refined sugars, alcohol, and animal protein, which can disrupt the normal production of cortisol.
  • Focus on fresh fruits and vegetables, which promote healthy production of cortisol and in turn help with sleep.
  • Take ashwagandha and fish oil supplements.
  • Engage in aerobic exercise at a moderate level for 150 minutes per week.
  • Practice stress reduction techniques such as meditation, yoga, visualization, deep breathing, volunteer work, or any activity that reduces tension and stress for you.

Bottom line

Keeping cortisol at healthy levels during the normal 24-hour cycle is important for getting restful sleep during menopause. Although cortisol disruptions are not the only thing that can disturb sleep during the menopause years, steps to balance this hormone, along with other healthy sleep strategies, can go a long way.

  • Nicolaides NC et al. HPA Axis and Sleep. 2020 Nov 24. In: Feingold KR et al. eds. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–.
  • Pistollato F et al. Associations between sleep, cortisol regulation, and diet: Possible implications for the risk of Alzheimer disease. Advances in Nutrition 2016 Jul 15; 7(4):679-89.
  • Prinz P et al. Urinary free cortisol and sleep under baseline and stressed conditions in healthy senior women: effects of estrogen replacement therapy. Journal of Sleep Research 2001; 10(1):19–26.
  • Stanborough RJ. How does cortisol affect your sleep? Healthline 2020 Jul 10
  • Woods NF et al. Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Menopause 2009 Jul-Aug; 16(4):708-18
Andrea is a Registered Holistic Nutritionist (RHN) & Menopause Expert. Andrea is in menopause & has been researching for the last 5 years science-based ingredients and methods to help women manage their symptoms. She’s the Founder of NaturallySavvy.com—a multiple award-winning website. Andrea co-authored the book “Unjunk Your Junk Food” published by Simon and Schuster, as well as “Label Lessons: Your Guide to a Healthy Shopping Cart,” and “Label Lessons: Unjunk Your Kid’s Lunch Box.” Andrea co-hosts the Morphus for Menopause podcast and appears as a Healthy Living Expert on TV across North America. Andrea has more than 20 years of experience in the health & wellness space and is a multiple award-winning Influencer.