How to Sleep Through an Australian Summer in Perimenopause
If you’ve noticed that your sleep fell apart around the same time the weather warmed up, you’re not imagining it. Many women in perimenopause find that the first hot nights of an Australian summer bring more night sweats, more tossing and turning, and that frustrating wide-awake feeling at 3am.
There are real physical reasons for this. The good news is that once you understand them, there’s quite a lot you can do.
Your brain’s thermostat gets more sensitive.
Deep in your brain, an area called the hypothalamus works like a thermostat. Its job is to keep your core temperature within a comfortable range. If you become slightly too warm, it switches on cooling: blood vessels near your skin open up, and you start to sweat. If you become slightly too cold, you shiver.
Most people can tolerate small changes within that range. Your temperature can drift up a fraction, and nothing happens.
Research has shown that in women who experience hot flushes, this comfortable range becomes much narrower (Freedman, 2014). A tiny rise in core temperature that you wouldn’t have noticed at 35 can now tip you over the edge and set off the full cooling response: the wave of heat, the racing heart and the sweat. When this occurs at night, we refer to it as a night sweat.
Oestrogen plays an important part here. It normally helps keep a group of nerve cells near the thermostat in check. As oestrogen falls and fluctuates in perimenopause, those cells release more of a messenger called neurokinin B, which makes the thermostat more sensitive (Mathur & Baber, 2024).
Why summer makes it harder
Now add a Sydney summer. To fall asleep and stay asleep, your core temperature naturally needs to drop in the evening. Sleep tends to begin when your temperature is falling fastest (Harding et al., 2019). Your body releases heat through your skin, especially your hands and feet, but in a hot bedroom that heat has nowhere to go.
A 2023 study that tracked people’s sleep and bedroom temperatures at home found that once rooms climbed from 25°C up to 30°C, sleep efficiency fell by around 5 to 10 per cent (Baniassadi et al., 2023). That may not sound like much, but across a whole summer of nights it adds up.
So in perimenopause, summer hits you twice. It’s harder to cool down enough to fall asleep, and you start every night closer to the trigger point for a night sweat.
Night sweats and the 3am wake-up
Women often tell me, “I don’t even remember the sweat. I just wake up.” That makes sense. Sleep studies have found that nighttime hot flushes are closely linked to waking during the night, even when women don’t feel them as a classic flush (Baker, 2023).
Night sweats aren’t the whole story, though. Hormone changes, stress, mood and other health conditions all affect sleep at this stage of life. If cooling your room doesn’t fix your sleep, it’s worth considering other factors.
Alcohol is also worth mentioning at this time of year. A glass of wine can help you fall asleep, but research shows it makes the second half of the night more broken (Ebrahim et al., 2013). That’s often exactly when the 3am wake-up happens.
Setting up your bedroom for hot nights
I want to be honest about what these steps can and can’t do. They help your body cool down so you sleep better. They may not stop hot flushes altogether, but they can make nights much more bearable.
Keep the room cool. Sleep experts usually suggest a temperature of around 18 to 20°C (Sleep Foundation, n.d.). If you can’t get it that low on a hot night, aim to keep it under 25°C. Close the blinds during the day and use a fan or air-conditioning if you have it.
Choose lighter bedding. Cotton and linen breathe better than synthetics. Pack away the heavy doona.
Layer so you can adjust. A light sheet plus a thin blanket lets you change things through the night without fully waking.
Keep cool water by the bed. A few sips and turning your pillow to the cool side can help you settle again.
Have spare nightwear handy. If you wake damp, a quick change in the dark makes it easier to get back to sleep.
Evening habits that may help
Notice your own triggers. For some women, spicy food, caffeine or alcohol in the evening make night sweats worse. Limiting them may help (Australasian Menopause Society, 2024). A simple two-week diary of what you ate, drank and how you slept can reveal your pattern.
Give your body time to cool. A large, late dinner or vigorous exercise close to bedtime can leave you running warm.
Keep a steady routine. Similar bed and wake times support your body clock, and your temperature rhythm with it.
Wind down your mind. A racing mind at night can make you feel even hotter.
What the evidence says works best.
As a counsellor, I feel strongly about this part. Of the non-drug options for hot flushes and night sweats, cognitive behavioural therapy (CBT) and clinical hypnosis have the strongest evidence (The North American Menopause Society, 2023). In one well-known trial, around two-thirds of women who did CBT found their hot flushes and night sweats much less of a problem, compared with about one in five women who had no treatment (Ayers et al., 2012). Both the Australasian Menopause Society and the Australian Government list CBT and hypnosis as options that can help.
You may be wondering about herbs. The honest answer is that the evidence for herbal medicines and hot flushes is mixed, and some herbs interact with medications or aren’t suitable after a hormone-sensitive cancer (Australasian Menopause Society, 2024). Natural doesn’t automatically mean safe, so this is best discussed with a qualified practitioner who knows your full health history.
When to talk to your GP
If night sweats are ruining your sleep every night, please don’t just try to cope. Your GP can speak with you about menopausal hormone therapy (MHT), which current Australian guidance describes as safe and effective for most healthy women, and about non-hormonal prescription options (Australian Government Department of Health, Disability and Ageing, 2026). Also see your GP if night sweats are new and you’re not sure they’re related to menopause, or if you have fevers, unexplained weight loss or feel unwell.
Where I come in is alongside that care: looking at your sleep, stress, nutrition and the whole picture, and offering counselling support. You don’t have to choose one or the other.
If you’d like help figuring out what’s causing your sleep problems, I’d love to support you.
Watch the full episode on my YouTube channel, Natural Transition with Sue: Night Sweats in Summer? Why Perimenopause Makes Hot Nights Harder.
References
Australasian Menopause Society. (2024). Nonhormonal treatments for menopausal symptoms [Information sheet]. Read the information sheet.
Australian Government Department of Health, Disability and Ageing. (2026). Managing menopause-related symptoms [Fact sheet]. Download the fact sheet (Word document).
Ayers, B., Smith, M., Hellier, J., Mann, E., & Hunter, M. S. (2012). Effectiveness of group and self-help cognitive behaviour therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): A randomised controlled trial. Menopause, 19(7), 749–759. https://doi.org/10.1097/gme.0b013e31823fe835
Baker, F. C. (2023). It’s not just about the hot flashes: menopausal hormone changes and disrupted sleep. The Journal of Clinical Endocrinology & Metabolism, 108(2), e25–e26. Read the article.
Baniassadi, A., Manor, B., Yu, W., Travison, T., & Lipsitz, L. (2023). Nighttime ambient temperature and sleep in community-dwelling older adults. Science of the Total Environment, 899, Article 165623. https://doi.org/10.1016/j.scitotenv.2023.165623
Ebrahim, I. O., Shapiro, C. M., Williams, A. J., & Fenwick, P. B. (2013). Alcohol and sleep I: Effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539–549. https://doi.org/10.1111/acer.12006
Freedman, R. R. (2014). Menopausal hot flashes: mechanisms, endocrinology, and treatment. The Journal of Steroid Biochemistry and Molecular Biology, 142, 115–120. https://doi.org/10.1016/j.jsbmb.2013.08.010
Harding, E. C., Franks, N. P., & Wisden, W. (2019). The temperature dependence of sleep. Frontiers in Neuroscience, 13, Article 336. https://doi.org/10.3389/fnins.2019.00336
Mathur, S., & Baber, R. (2024). Fezolinetant: A new oral nonhormonal treatment for menopausal hot flushes. Medicine Today, 25(4), 62–66. Read the article.
Sleep Foundation. (n.d.). Best temperature for sleep. Read the guide.
The North American Menopause Society. (2023). The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause, 30(6), 573–590. https://doi.org/10.1097/GME.0000000000002200
This article is general information only and is not a substitute for individual health advice.