Sleep hygiene is important for everyone, but menopause-related insomnia needs specific adaptations.

CBT-I (Cognitive Behavioral Therapy for Insomnia): This is the gold standard, with Level I evidence for treating insomnia in midlife women. It is more effective than sleep medications long-term and has no side effects. Core components:

1. Stimulus control: Use your bed only for sleep and sex. No phones, tablets, TV, or work in bed. If you cannot fall asleep within 20 minutes, get up and do something calm in dim light until you feel sleepy.

2. Sleep restriction: Limit time in bed to your actual average sleep time. This increases "sleep drive" and consolidates sleep. Gradually increase as sleep efficiency improves.

3. Environmental optimization:

  • Temperature: 18-20°C (cooler is better)
  • Complete darkness (blackout curtains or eye mask)
  • White noise or earplugs if noise is a problem
  • Consistent wake time, even on weekends

4. What to avoid:

  • Caffeine after 2 PM
  • Alcohol 3+ hours before bed (alcohol fragments sleep)
  • Large meals within 2 hours of bedtime
  • Intense exercise within 2 hours of bedtime