The 2-3am Wake-Up

You’re exhausted, you fall asleep, and then boom, you’re awake again at 2 or 3am like your body set an alarm. If you’ve been lying there with a racing mind, a hot flush, a pounding heart, or that strange “wired but tired” feeling, I want you to hear this clearly: you’re not broken, and you’re not weak. There are real physiological reasons perimenopause insomnia shows up so predictably, and once you understand the pattern you can start changing it.

Today I unpack the big three drivers behind middle-of-the-night waking in perimenopause and menopause: shifting hormones, cortisol rhythm disruption, and blood sugar instability. I explain how progesterone normally supports calm through GABA, why oestrogen fluctuations can trigger night sweats and circadian rhythm chaos, and how chronic stress can nudge cortisol to spike too early, jolting you into fight-or-flight at the exact time you’re desperate for deep sleep.

Then I get practical. I talk about stabilising blood sugar with balanced meals, why very low-carb or under-eating can backfire at night, and how alcohol can wreck sleep architecture even if it makes you feel sleepy at first. I also share simple nervous system support you can do after dinner (less phone scrolling, dim lights, magnesium glycinate, breathing, journalling, lavender) plus the underrated power of morning sunlight exposure to reset your sleep-wake cycle.

If your sleep disruption has been dragging on, I also flag when it’s worth looking deeper at thyroid function, iron, cortisol testing, gut health, and stress load so you can get personalised support. If this helped, subscribe or follow so you don’t miss next week, share it with a friend who’s awake at 3am too, and leave a review to help more women find the show.

Are you a woman feeling stressed, flat and experiencing the challenges of perimenopause or menopause?

It’s time to reclaim your youthful energy, radiance and self-assurance (and your ideal weight).

I’m here to help with my proven method.

Here's how I can support you -

1. Hit your health and wellbeing goals this year, balance your hormones and lose weight with your own personalised protocol, based on your body's biochemistry. Sounds awesome right!! Book a free 30 minute Peri Weight Loss Assessment with me so we can discuss your health and wellbeing goals and also see how I might be able to support you. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book your call here. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

2. Follow me on Instagram and Facebook - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@the.perimenopause.path

3. Join the waitlist for my innovative NEW 8 week group program, In Your Skin™️, for women in perimenopause and post-menopause who want effective  solutions to manage skin changes at this time of life.

Transcript

Welcome And Podcast Mission

SPEAKER_00 0:00

Hi, I'm Susie Garden and this is the Ageless and Autumn Podcast. I'm an age-defying naturopath and clinical nutritionist and I'm here to bust myths around women's health and ageing so that you can be ageless and autumn in your 40s, 50s, and beyond. The Ageless and Autumn Podcast is dedicated to helping women through perimenopause and menopause with great health, a positive mindset, and outrageous confidence. Hit subscribe or follow now and let's get started. Hello, gorgeous one, and welcome to this week's episode of the Ageless and Autumn Podcast. I'm Susie Garden, Perimenopause naturopath, weight loss nutritionist, and proud perimenopause survivor. Today we're talking about one of the most frustrating and exhausting symptoms women experience in their 40s and absolutely 50s and beyond even. And that is waking up in the middle of the night. That is something, if you've a longtime listener, you know I've talked a lot about my own battle with sleep and insomnia. And so I absolutely identify with women that are going through this. And the thing is with waking up in the middle of the night, it's often at exactly the same time or near enough. And it's like, what the hell? And then sometimes you can go for weeks where it's actually changed that time, like gone from maybe between two and three to perhaps midnight or one o'clock. And you know, you wake, sometimes your mind can be racing. Sometimes you just get up to go to the toilet and go back to bed and just lie there. And you're not particularly thinking about anything, you're not particularly feeling stressed, but there it is, you can't go to sleep. Um, you may feel wired, you may feel alert, sometimes it's hot, sometimes you wake up in a pool of sweat, um, and falling back to sleep feels almost impossible. And if that sounds familiar, please know you are really not alone in this. Um, this is really common. Probably one of the most common symptoms, actually, during perimenopause. And again, not necessarily recognized as a symptom of perimenopause. Often, when you go and speak to your doctor about it, you may get offered sleep support, but not necessarily looking at the underlying causes of this. So, today we're going to talk about what's actually happening inside your body and how you can begin to fix it. So, before we zoom into that 2 to 3 a.m. wake up specifically, let's talk about the bigger picture. Sleep changes during perimenopause for a few reasons. Firstly, estrogen and progesterone both influence sleep architecture, and they both change a lot during perimenopause. So, progesterone has a calming effect on the brain. It enhances a particular neurotransmitter called GABA, and GABA helps your nervous system relax. As progesterone declines during perimenopause, that calming effect weakens because our progesterone tends to decline. It's one of the sort of first things we notice in terms of symptoms is that sleep disruption. And often we don't think about it being part of perimenopause because often even our cycle may not have changed. And but it's declining, and that calming effect on the brain can weaken, and so sleep becomes a bit lighter, maybe, you wake more easily, your nervous system can become more reactive. And then, of course, you've got the estrogen. So estrogen plays a role in, as we know, regulating body temperature and our circadian rhythms. Um, and when estrogen fluctuates, so it spikes and then it drops, our temperature regulation becomes unstable. We already know that. That's why we get the night sweats, that's why we get the hot flushes, and they often appear during sleep. And so that hormonal foundation of sleep is already shifting. And then you add in the stress of life, you add in blood sugar changes. So we know we come a little less insulin sensitive during this time, and then you add in cortisol rhythms, and suddenly that middle of the night wake up starts to make a lot more sense when you can understand these other drivers behind it. So, first I want to talk about this 2 to 3 a.m. wake up, um, it which can often be a cortisol search. So your body naturally releases cortisol during the night. During the day, we have a like a circadian rhythm with our cortisol picture. That's often when you get cortisol testing through a naturopath or nutritionist. We'll do salivary cortisol testing, which is done at four different time points during the day. So we can look at that circadian rhythm and see if cortisol is higher when it should be and lower when it should be. And cortisol, you know, it is a stress hormone, but it has other roles as well. Um and normally cortisol is relatively low during deep sleep and gradually rises in the early morning to help you wake up. Uh, but during perimenopause, cortisol patterns can become a bit dysregulated. And particularly if you've been under a lot of stress for a long period of time, which many midlife women are, cortisol uh can become more reactive. There is a relationship between estrogen and cortisol as well. So if estrogen's not happy on spiking and dipping, then cortisol will also be influenced by that. And possibly, if we're talking about the uh relationship with cortisol and sleep, so sometimes if you've been under a stress, your body may release the cortisol during the night too early because you've got a dysregulated pattern. And so instead of this nice gradual rise towards morning to help you get up, the cortisol spikes between two and three. And that spike wakes your brain. Because remember, cortisol is there to help you with your fight or flight response. And you know, suddenly you're gonna be alert because that's the response that's been activated by that cortisol jumping. Your thoughts can maybe can begin racing. You might feel a little anxious or restless for no clear sort of reason. It's not your imagination. There is a physiological stress response happening during sleep, and that's gonna wake you up because it's obviously preparing you to run away or to fight. So we've got that aspect of it. So let's go next to blood sugar because this is one of the most overlooked drivers of night waking blood sugar. Estrogen helps to regulate insulin sensitivity, which is why we get a little bit of a reduction in insulin sensitivity in perimenopause and postmenopause. And insulin and glucose metabolism obviously very closely linked. So as estrogen fluctuates, blood sugar becomes less stable. And during the night, your body continues to use glucose for energy, like there's a lot of stuff going on in your body when you're asleep. The whole body is not at rest, you're doing repair work, you are building new hormones, there's a lot going on. So your body continues to lose, sorry, use glucose for energy during the night, particularly your brain. And if the blood sugar drops too low overnight, your body will see this as a threat. And it'll respond really quickly because it's really important. So your adrenal glands will release adrenaline and cortisol to raise that blood sugar back up. And insulin is a stimulating hormone. It increases your heart rate, it heightens your alertness, wakes you up. So, what feels like to you anxiety or overthinking, ruminating, worrying about what you've done the day before, worrying about what you've got to do the next day, all of that happening at around 2, 2 to 3 a.m. is often a blood sugar crash, triggering an adrenaline surge and a cortisol surge. And several things can make this more likely to happen. So if you've skipped meals during the day, very low carb diets, and a lot of women are doing very low carb diets for weight loss, um, that's not necessarily going to serve your whole body. Alcohol in the evening absolutely can mess with your blood sugar. Eating too little overall. So I've talked about this before. I see this a lot with PTs, putting you on very low calorie uh consumption, like 1200 calories a day, that kind of thing. So eating too little overall can trigger this off. High sugar dinners followed by a crash. So, you know, we've all done it. You know, you have a nice celebratory dinner and have a nice big dessert. Maybe you've had some alcohol, um, maybe having some then chocolates. Um, high sugar dinners absolutely can trigger off a crash, uh, a blood sugar crash, that is, in the middle of the night. And if you have long gaps between dinner and bedtime, that can also happen. So when you can stabilize your blood sugar, these wakeups often improve dramatically. So that's really important. Another important piece of the puzzle is progesterone. Progesterone interacts with GABA receptors in the brain, which I mentioned before, and these promote relaxation and sleepiness. And as progesterone declines during perimenopause, many women experience lighter sleep, increased anxiety, greater stress sensitivity, and reduced stress resilience, and difficulty falling back to sleep once they're awake. And that's why many women say, I just wake up, my mind just goes 100 miles an hour, and I just might as well just get up. Um I've got one client who, when she first started singing, said she gets up at 3 a.m. and she starts doing housework because she said she just knows she's not going to get back to sleep. Um, it's not necessarily because something's wrong in your life, uh, it's because your brain's natural calming signal is reduced. And again, this is physiology. This is not a personal weakness. This is not something that we should feel shame over. This is not something that we feel that we should be feeling we can just control. Things are changing internally. And even though you may feel like you're the same person, uh, when you're in perimenopause and postmenopause, these hormonal shifts need to be addressed. So let's look at some practical ways to improve this nighttime waking. Let's talk about what actually helps. And sure, reading a book may help, but let's let's let's kind of you know, we want to try and avoid it happening in the first place. So, number one, stabilizing blood sugar during the day. I think I said this last week as well with the brain fog. Stabilizing blood sugar. So this means having regular meals, ideally, three, good, well-balanced protein in every meal, three meals a day, no snacks if possible. Three meals a day, no snacks, about five to six hours between meals is ideal. Um, if you skip meals or you under-eat during the day, it's one of the fastest ways to trigger night waking. Always include protein and complex carbohydrates at dinner. So that can just be a protein with vegetables, um, a moderate amount of slow carbs, things like you know, quinoa is a really good one. Um, if you want to have like a grain, but a lot of just your standard veggies are going to be relatively slow carbs. That will help stabilize your glucose overnight. I would avoid things like packaged sauces. Have a look if you do have packaged sauces in your cupboard. Have a look at the sugar content. Often that can be something that can really impact your sleep and preservatives as well can often impact your sleep. Um, so yeah, as I mentioned, quinoa, lentils, brown rice, brown pasta, lentil pasta, all of those things can be really good for helping stabilize blood sugar. Reducing alcohol. So this is the thing. I'm sorry, ladies, because I know we all many of us like to have a wine with dinner, but alcohol, it really will impact your sleep. And look, it may make you feel more sleepy initially, it might relax you, but we know it disrupts sleep architecture, it increases night waking, and many women notice an immediate improvement in sleep when alcohol is reduced. Another factor with this is it can also increase your heart rate. A lot of women find probably because of the lower estrogen that the heart can get a little bit twitchy. You can wake up in the middle of the night with heart racing. Now, it can be that cortisol and adrenaline, but it also could be alcohol interfering there as well. So reducing alcohol is one of probably the key things that you can do to really improve many aspects of your health, particularly in perimenopause. Supporting your nervous system before bedtime. I am a massive advocate, as you probably know, of getting that phone out of your life after dinner. For me personally, I try at about 6 p.m. to just put the phone in another room and you know, it obviously there are things in your life if you if you need your phone near you for your kids, for that kind of thing. Absolutely, of course. But avoid scrolling. Avoid scrolling, avoid answering emails, avoid looking at your emails. If you're just using it as a phone, fine, but it's more the scroll, the death scroll, we've all the doom scroll, we've all been there, all of us. Um, and the thing is that requires a real discipline. I was really good for it with that for quite some period of time, and then I started getting into a habit of having the phone next to me, watching TV or whatever at night, and then of course you just pick it up to answer a text or whatever, and then I'll just quickly have a check, and then you're in the into the emails or into the scroll. So that usage of your phone other than as a phone from about 6, 7 p.m. can really impact your sleep because there is the blue light aspect, um, of course. So if you've got prescription glasses, I highly recommend that you get blue light blocker put into them with your prescription. So there is that, but there's also just the stimulation to the brain as well. Um, so supporting a nervous system before bed can look like reading, um, having a stretching routine, having magnesium glycinate, which is really nice for sleep, deep breathing, journaling, um, having a lavender bath or putting some lavender drops in the bottom of your shower. Your nervous system needs signals that it's safe to power down. Remember, our nervous system is pretty uh hasn't uh evolved a lot since we were cave people. And it used to be when the sun went down, we would pretty much be asleep, wouldn't be doing very much at all. So now we need to teach our nervous system that it's safe to power down because we've got all this stimulation going on, uh, all this bright light, because that's another thing, actually, is to support your nervous system before bed is dim lighting. Dim lighting from after from when you stop tasks that need light, turn all of those lights down. Uh and the next tip I have is morning sunlight exposure. As I've mentioned in last week's podcast about brain fog, morning light anchors your circadian rhythm and helps regulate cortisol patterns. So even 10 minutes outside within the first hour of waking can help reset sleep. The really great tip, actually, when you're traveling and going across time zones is to get up in the morning, get exposure to light, natural light that is. Um, but yeah, instead of grabbing your phone first thing in the morning, if you go outside, if you've got a dog that needs to be walked, or other people in the house that want to go for a walk with you, that's even better. Or meet a friend. So if having that accountability, if you know you've got to meet your friend at like 6 or 6:30 in the morning to go for a walk, you're way more likely to go. It's way so easy just to turn off the alarm. I have dogs. I don't get to say no because they just jump on me until I get up. Um, all right. So if if your sleep disruption is persistent, it is worth looking deeper because sleep issues during perimetopause can also be influenced by your thyroid function. So that may need to be tested. Iron levels can be tested, cortisol dysregulation, this can be tested, but your gut health, this can be assessed, and chronic stress, that also is a problem. And it could be other things. So this is where personalized support can really make a difference. And you know, when sleep improves, everything becomes easier, whether that's managing your mood, your motivation, your cognitive clarity, even weight loss becomes easier when your sleep is improved. So if you've been waking at 2 to 3 a.m. or at a different regular time every night, or almost every night, and wondering what is wrong with you, what is going on, why am I waking at the same time? I hope today's episode has provided some answers or some reassurance for you. Your body isn't malfunctioning, it's responding to hormonal shifts, to stress patterns and metabolic signals. And the good news is that these patterns can improve. So if you'd like support, understanding your sleep, your hormones, your metabolism, book in a free period loss assessment with me using the link in the show notes and we can have a chat about it. So until next week when we talk about hot flushes, anxiety, and low mood, take care of yourself. Um, take care of your sleep. Thanks so much for joining me on the Ageless and Awesome Podcast. If you would like this episode, please make sure you click the little plus button if you're on Apple Podcasts, or the follow button if you're on Spotify so that you get each new episode delivered to you every single week. If you feel like writing me a five star review, you would absolutely make my day. If you found this episode resonating with you, head over to my Instagram and DM me at the Perimetopause Park. I would love to connect with you.