Sleep and Perimenopause  
The Sleep Hygiene Checklist 
As we turn the clocks back for daylight savings, it’s a reminder of how closely our well-being is tied to nature’s rhythms. Just as ecosystems depend on balance, so do our bodies, especially when it comes to rest and recovery.
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Adults typically need at least seven hours of uninterrupted sleep each night. In midlife, achieving this can become increasingly difficult. Many environmental factors get in the way, like caring for children or family members, stressful times, or demanding work schedules.
 
Perimenopausal symptoms can play a role, with hot flashes and temperature changes interrupting sleep. Lower levels of progesterone can contribute to insomnia and anxiety.
 
Medical conditions such as sleep apnea, anxiety, overactive bladder, and restless leg syndrome can also negatively impact sleep. This is known as secondary insomnia. Some medications and supplements can interfere with sleep duration and quality as well. 
What are the Consequences of Inadequate Sleep? 
  • Worsening brain fog
  • Weight gain
  • Increased stress hormone production
  • Accelerated skin aging
  • Difficulties with memory and attention
  • Depression
  • Accidents
  • Increased use of sleep aids and supplements
  • Higher risk of heart disease, diabetes, cancer, and dementia
Protect Your Sleep
 
Sleep hygiene refers to regular habits that improve sleep quality and quantity. If sleep has recently become a challenge—or if it’s something you’ve been putting off—now’s the time to put your health first.
Think of each item below as a tool in your sleep-repair toolbox:
  • Set a consistent bedtime and wake-up time
  • Consolidate sleep: Avoid naps and get out of bed when you’re not sleeping
  • Have caffeine before noon (not in the afternoon or evening)
  • Limit alcohol (it disrupts sleep cycles and can worsen hot flashes)
  • Limit or quit nicotine (reach out for support if trying to quit!)
  • Exercise during the day - try taking a walk in natural sunlight
  • Avoid large meals right before bedtime
  • Keep your bedroom quiet, dark, and cool
  • Consider blackout curtains
  • Refresh your bedding and consider a mattress cooling system like a Chilipad
  • Keep screens outside of your bedroom
  • Reserve your bed for sleep and sex only - avoid working or watching television in bed.
  • Practice mindfulness: try meditation, guided breathing, or apps like Calm or Headspace
  • Wind down with gentle stretching in the evening (free options: Yoga with Adriene on YouTube; paid: Peloton’s 10-minute stretch classes)
  • Build a bedtime routine or sleep ritual—washing up, brushing your teeth, and changing into pajamas. Other soothing additions:
    • Aromatherapy (lavender)
    • A small cup of chamomile tea (just small enough to avoid a late-night bathroom trip!)
When to Seek Help: 
  • If a medical condition is disrupting your sleep, work with your healthcare team. Sleep hygiene is valuable, but sometimes additional treatment is needed.
  • If these measures aren’t helping or feel out of reach, consider cognitive behavioral therapy for insomnia (CBTi), or reach out to your primary care doctor for support.
  • The CBTi Coach App (from the VA) is a free, helpful tool for tracking sleep patterns. You can find it here: CBTi
Rest is a renewable resource, and one worth protecting. Here’s to nurturing both your sleep and the world we share,
Dr. Sam Mekrut
Samantha Mekrut, MD FAAFP MSCP 
Physician and founder of Meristem Family Medicine
Interested in learning more about Meristem and Direct Primary Care?
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This newsletter is intended for informational purposes only and does not constitute individualized medical advice or instruction from Dr. Mekrut. Nothing herein is intended to be used for medical diagnosis or treatment.  The information in this newsletter should not be considered complete, nor should it be relied on to suggest a course of treatment for a particular individual.  Always consult with a qualified healthcare professional regarding any questions or concerns you may have about your health. Do not disregard professional medical advice or delay seeking treatment based on the information presented here. If you are a Meristem Family Medicine patient, please schedule an appointment to discuss any questions regarding your personal health. 
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Medfield, MA 02052, United States

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