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Where Are You in Your Menopause Journey?
Take Our QuizPoor sleep during perimenopause and menopause isn't just exhausting—it's linked to increased cardiovascular disease risk, depression, anxiety, weight gain, cognitive decline, and reduced quality of life. Yet for decades, women's sleep complaints have been minimized, dismissed, or blamed on just getting older.
In this episode, Dr. Mary Claire Haver sits down with board-certified sleep medicine specialist Dr. Andrea Matsumura to unpack what's really happening to women's sleep during the menopause transition and what we can actually do about it. Dr. Matsumura completed her medical degree at the University of Texas Health Science Center San Antonio and her internal medicine residency in Portland, Oregon before returning to Oregon Health & Science University for a fellowship in sleep medicine, where she discovered the critical connection between women's hormones and sleep disorders.
Up to 50% of menopausal women have undiagnosed sleep apnea, and women present so differently than men that they're consistently missed by gender-biased screening tools like the STOP-BANG questionnaire, which actually gives women a lower risk score simply for being female. The conversation explores the role of estrogen, progesterone, and testosterone in sleep regulation, from thermal control to airway support to deep sleep maintenance, and why even women on hormone therapy can still struggle with insomnia. It also reveals why 30% of postmenopausal women battle restless leg syndrome and the connection to ferritin levels that most doctors miss.
Dr. Matsumura breaks down what Cognitive Behavioral Therapy for Insomnia actually involves, describing it as behavioral retraining that's like building muscle rather than a quick fix. She introduces her Dream Sleep Method, an acronym covering daytime activity, resting environment, emotions, archetype or chronotype, and medical conditions, providing a comprehensive framework for addressing root causes of sleep disruption rather than just masking symptoms. The discussion covers why melatonin production drops by 50% by age 50, why the pineal gland is the first gland in the body to calcify, and what that means for sleep quality in midlife.
Dr. Matsumura explains how to build the perfect sleep environment with three key elements: dark, cool, and quiet. She covers why sleep restriction or the accordion effect can help retrain the brain, and how sleep trackers can be both helpful and harmful depending on how you use them. This episode provides women with the knowledge that their sleep struggles are treatable medical conditions, not inevitable consequences of aging, and that small improvements in sleep quality can yield significant health benefits for women in perimenopause and menopause.
Guest links:
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Dr. Andrea Matsumura (Instagram)
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Dr. Andrea Matsumura (Facebook)
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Dr. Andrea Matsumura (LinkedIn)
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Dr. Andrea Matsumura
- The D.R.E.A.M. Sleep Method: A Midlife Woman’s Guide to Restoring Rest
- Shop The D.R.E.A.M. Sleep Essentials
- Sleep Goddess Archetype Quiz
Articles:
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Worldwide estimation of restless legs syndrome: a systematic review and meta-analysis of prevalence in the general adult population (Journal of Sleep Research)
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Association Between Obstructive Sleep Apnea and Cardiovascular Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies (Medicina)
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Why sleep apnea deserves priority in public health: a call to action (European Journal of Public Health)
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Poor Quality Control of Over-the-Counter Melatonin: What They Say Is Often Not What You Get (Journal of Clinical Sleep Medicine)
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Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US (JAMA)
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Sleep disorders impact hormonal regulation: unravelling the relationship among sleep disorders, hormones and metabolic diseases (Diabetology & Metabolic Syndrome)
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Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management (International Journal of Environmental Research and Public Health)
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Chronobiological perspectives: Association between meal timing and sleep quality (PLOS One)
- Effects of red light on sleep inertia (Nature and Science of Sleep)
Other Resources:
- Seven or more hours of sleep per night: A health necessity for adults (American Academy of Sleep Medicine)
- American Academy of Sleep Medicine