Why Women Sleep Worse in Perimenopause with Eight Sleep's Alexandra Zatarain

Why does sleep suddenly become so much harder for so many women in their 30s, 40s and 50s?

Eight Sleep cofounder Alexandra Zatarain joins SheMD to explore how hormones, temperature and the brain’s natural circadian rhythm affect the way women sleep throughout different stages of life.

Dr. Thaïs Aliabadi explains why fluctuations in estrogen and progesterone during perimenopause can contribute to night sweats, temperature changes, anxiety, racing thoughts and middle-of-the-night wake-ups.

Alexandra shares what years of sleep research and data have taught the Eight Sleep team about deep sleep, REM sleep, temperature regulation, pregnancy, menopause and recovery.

We also break down how much sleep adults actually need, why consistency matters and why alcohol, caffeine and late-night exercise may interfere with recovery even when you are technically getting enough hours.

Plus, Alexandra shares five practical habits she recommends for better sleep and helps us tackle common sleep myths, including whether you can really catch up on lost sleep over the weekend and whether a nightcap actually helps you sleep.

If your sleep has changed and you cannot figure out why, this episode is for you.

Sponsors

Eight Sleep is featured in this episode through a conversation with co-founder Alexandra Zatarain about sleep science and the company’s sleep technology. No formal sponsorship or promotional offer is mentioned.

What You’ll Learn

• How Alexandra Zatarain's personal experiences inspired the creation of Eight Sleep and its approach to improving sleep through technology.
• Why perimenopause and menopause can disrupt sleep, including the roles of fluctuating estrogen, declining progesterone, night sweats, and anxiety.
• How body temperature and circadian rhythms influence when we fall asleep, stay asleep, and wake up.
• Why pregnancy and postpartum hormonal changes can affect temperature regulation, snoring, and sleep quality.
• The differences between deep sleep and REM sleep, and why both are essential for physical recovery, memory, and emotional processing.
• How much sleep adults generally need, why individual sleep requirements vary, and how to recognize whether you're getting enough rest.
• Why alcohol may make it easier to fall asleep while negatively affecting overnight recovery.
• Why catching up on sleep over the weekend cannot fully compensate for consistently getting too little sleep during the week.
• How sleep-tracking technology can help monitor sleep patterns, recovery, temperature preferences, and potential signs of sleep apnea.
• Five practical ways to improve sleep, including prioritizing sufficient rest, maintaining a consistent schedule, optimizing your sleep environment, adjusting daily habits, and working with your partner.
• Why women experiencing persistent sleep disruptions should consider underlying factors, including hormonal changes and other health conditions, with guidance from a healthcare provider.

Key Takeaways

• Sleep is a foundational pillar of health. Prioritizing exercise and nutrition while consistently sacrificing sleep can undermine overall well-being. Making enough time for rest is an essential part of supporting long-term health.
• Hormonal changes can significantly disrupt women's sleep. Fluctuating estrogen and progesterone levels during perimenopause and menopause may contribute to temperature sensitivity, night sweats, anxiety, and nighttime awakenings. Persistent sleep difficulties deserve attention rather than being dismissed as an inevitable part of aging.
• Temperature plays an important role in sleep. Core body temperature naturally declines as we approach sleep and rises toward morning. A comfortable, cool sleeping environment can support this process, although individual temperature preferences vary.
• Deep sleep and REM sleep serve different but complementary functions. Deep sleep is associated with physical restoration, while REM sleep supports processes involving memory, learning, and emotional processing. Getting sufficient sleep allows the body to cycle through both.
• Alcohol can interfere with overnight recovery. Although alcohol may help someone fall asleep more quickly, it can affect recovery metrics, including resting heart rate and heart rate variability. Falling asleep faster does not necessarily mean sleeping well.
• Consistency matters as much as duration. Maintaining relatively consistent bedtimes and wake-up times can support the body's circadian rhythm. Alexandra recommends aiming for seven to nine hours of sleep for most adults while paying attention to individual needs.
• Sleep quality can be affected by more than personal habits. Snoring, possible sleep apnea, hormonal changes, stress, and a partner's sleep patterns can all contribute to disrupted rest. Persistent symptoms may warrant evaluation by a healthcare professional.
• Small, sustainable changes can improve sleep habits. Gradually extending sleep time, keeping the bedroom cool, dark, and quiet, limiting late-day caffeine and alcohol, and avoiding heavy meals close to bedtime are practical starting points.
• Women's sleep deserves more research and individualized care. Pregnancy, postpartum recovery, perimenopause, and menopause each present different challenges. Understanding these life stages can help inform better research, technology, and healthcare support.

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