6 Ways to Deal With Night Sweats During Menopause

Even small changes to your routine can help if you’re waking up drenched.

By Kelly ConaboyMedically reviewed by Alexis P. Melnick, MD

December 13, 2023

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If you’re going through menopause, you may be familiar with the following experience: You wake up throughout the night, drenched in sweat for no discernable reason. You toss and turn, clammy and cold. You feel anxious and exhausted, and you’re painfully aware that the lack of sleep you’re currently experiencing will perpetuate both of those feelings.

Unfortunately, vasomotor symptoms—which include hot flashes and night sweats—are a common symptom of menopause, affecting approximately 50-75% of those going through it.¹ They’re not just a nuisance; they can have real health consequences. “Women who have bad hot flashes and sleep disruptions are also at higher risk for cardiovascular disease and dementia in their lifetimes,” Melanie Marin, MD, director of the menopause program in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai, tells SELF. Fortunately, experts say, there are actionable things you can do to improve sleep when night sweats are getting in the way.

1. Schedule a menopause consultation.

Make a visit to your doctor to specifically go over your menopausal symptoms, their frequency, and their severity. “It’s really important for it to be separated from an annual GYN visit or any other kind of visit, because there is a lot to go through,” Laurie Jeffers, NP, DNP, co-director of the Center for Midlife Health and Menopause at NYU Langone Health, told SELF. In this consult, your doctor or nurse practitioner will parse out which symptoms are related to menopause and provide knowledge about treatment options. “Typically we go through the data, and we give women education regarding the actual risks, benefits, and potential side effects for either the hormonal options that are available or nonhormonal options,” Dr. Jeffers says.

2. Speak with your doctor about whether hormone replacement therapy might be the right choice for you.

Hormone replacement therapy is a treatment used to address the hormonal imbalances one goes through during menopause by replacing (or supplementing) estrogen that the body produces far less of during, and following, menopause. “I think women suffer a lot thinking that hormone replacement therapy should be the last choice, instead of the first choice,” says Dr. Marin. (There’s enough popular confusion about this point that the North American Menopause Society, the American Society for Reproductive Medicine, and the Endocrine Society have gone so far as to put out a joint statement that “medical organizations devoted to the care of menopausal women agree that there is no question that hormone therapy has an important role in managing symptoms for healthy women during the menopause transition and in early menopause.”) While there are risks and side effects with any medication, Dr. Marin explains that estrogen is “the most effective method for alleviating hot flashes and night sweats.” It can also help prevent bone loss and vaginal dryness, according to the FDA.

If you’re suffering from night sweats, and you haven’t been able to find relief in the oft-stated (but perhaps not particularly helpful) suggestions of dressing in light layers and using a fan, it’s worth speaking to your doctor about whether hormone replacement therapy would help. “I would truly encourage anyone who's really suffering and not able to get significant relief to speak to their doctor,” Dr. Marin says, “whether you're in perimenopause [the transitional phase into menopause], and low-dose birth control pills are the right way to go, or whether you're in menopause and hormone replacement therapy is the right way to go.”

Dr. Jeffers agrees. “if you’re an appropriate candidate for hormone therapy,” she says, “then that's going to be the most effective relief from night sweats.”

3. If hormonal options aren’t right for you, consider non-hormonal treatment.

If you aren’t an appropriate candidate for hormonal therapy, Dr. Jeffers says, “there are very good, very effective, and very safe non-hormonal options available.” These options might include SSRI or SNRI antidepressants alone or combined with clinical hypnosis, which is totally real—it’s a “state of deep relaxation and focused concentration” that you’re guided to “with verbal cues, repetition and imagery” by a trained therapist, according to the Cleveland Clinic.^2,3

Another route is cognitive behavioral therapy for insomnia (CBT-i). “It's not just for insomnia,” Dr. Jeffers says, “it's for sleep in general.” CBT-i is a structured program done with a specialized specialist; it might last for a single session or span several.⁴ It’s designed to address and alleviate sleep difficulties by targeting the thoughts, behaviors, and patterns contributing to them. “That's usually my go-to for significant night sweats that are interrupting sleep,” Dr. Jeffers says, “a hormonal or a non-hormonal, plus CBT-i.”

4. Try to get in 30 minutes of exercise a day.

In general, daily exercise is one of the most important things you can do for your health, according to the CDC. It can also be helpful in managing hot flashes and night sweats. “Daily exercise smooths out hormonal fluctuations and helps decrease inflammation,” Dr. Marin says.

Beyond that, if you’re having trouble sleeping, exercise can potentially help in and of itself.⁵ While it’s somewhat unclear how, precisely, sleep and exercise are physiologically connected, one review of existing research notes that multiple studies have found that middle age and older adults with sleep issues reported better sleep after starting an exercise program.^6,7 Dr. Marin tells patients to aim for 30 minutes of exercise every day, and to try to accomplish that goal at least five days a week.

5. Decrease your intake of alcohol, caffeine, and spicy foods.

“We don't have well-controlled trials that have actually been able to show that there is a significant difference if women are consuming caffeine, or alcohol, or spicy foods,” Dr. Jeffers says. “So that's from the scientific side. However, if you talk to women, as I do all day long, most of them, if not all of them, will note that there are certain things that increase their hot flashes.” Alcohol, caffeine, and spicy foods all fall under that category, she says. If you think there might be a connection between your consumption of these things and your inability to get a restful night of sleep, it might be helpful to moderate your use of them (or cut them out altogether).

6. Start a meditation practice.

“A behavioral thing that people, if they're not already doing this, should really start to practice as they enter midlife and menopause, is meditation,” Dr. Marin says. “We know it changes the structure of the brain. So I like to describe it to people like if you do push-ups, your muscles get bigger; if you practice calming practices for the brain like meditation, those pathways get bigger and stronger.” When you build up these calm pathways through a regular meditation practice, it's easier for your brain to follow them, rather than the pathways of agitation and anxiety that can arise when one is experiencing night sweats.⁸ This can contribute to a better night’s sleep.

But, of course, everyone’s busy—how do you make time for meditation? “Meditate for a minute,” Dr. Marin says. Just start there, and keep practicing. “Because it will make it easier.”

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