Why Hot Flashes Wake You Up… But Your Brain Might Be Keeping You Awake
We all know this one.
You’re finally asleep 😴
Then suddenly… you’re hot. Like, throw-the-covers-off, why-is-my-neck-sweating hot.You wake up. Maybe you cool off. Maybe you don’t.
And then comes the real problem.
You’re wide awake. Staring at the ceiling. Brain fully online like it’s 10am and not 2:17 in the morning.
So of course we say, “My hot flashes are ruining my sleep.”
And yes… that’s true.
But a newer study adds a really important layer that I think a lot of women feel, even if they’ve never put words to it.
👉 It’s not just the hot flash waking you up.
👉 It’s what your brain does after.
Let’s talk about what the study actually found
Researchers looked at about 100 perimenopausal and postmenopausal women and measured three things:
How bad their hot flashes were 🔥
How they thought about their hot flashes 🧐
How bad their insomnia was 👀
Now, the first finding is obvious.
Women with worse hot flashes had worse sleep.
<Groundbreaking, I know>
But here’s the interesting part.
👉 Women who had MORE negative thoughts about their hot flashes also had worse insomnia.
And this was true even when the researchers accounted for how severe the hot flashes actually were.
Let me say that another way.
Two women could have the same exact hot flashes. Same frequency. Same intensity.
The one who is more stressed, worried, or frustrated about them… sleeps worse.
What do they mean by “negative beliefs”?
This isn’t anything dramatic. It’s the stuff most of us think at 2am:
“Great. I’m never going to fall back asleep.”
“This is going to completely ruin tomorrow.”
“Why is my body doing this to me?”
“WTF I can’t seem to control this.”
Totally normal thoughts. 😫
Also… not super helpful for sleep per the study results.
The 2am spiral is the real problem
Here’s what’s happening in your body.
The hot flash itself is already activating your system. Your hormones shift so your brain raises your internal temperature, your heart rate, your overall level of arousal.
Then your brain jumps in with the commentary.
Now you’re not just physically awake. You’re mentally awake too.
Your nervous system shifts into a more alert state. Cortisol can rise. Your brain starts scanning, predicting, worrying.
And suddenly it’s not just a hot flash.
It’s a whole freaking experience.
This is where it turns into insomnia
The study talks about something we see all the time clinically.
It becomes a loop.
You have a hot flash
You wake up
Your brain says, “This is a problem”
Your body ramps up even more
You struggle to fall back asleep
The next night, you go to bed already anticipating it
Now your brain is on high alert before you even fall asleep.
Prior to hot flashes, have you every just had a run of insomnia where it got to the point you were anticipating bad sleep? Self-fulfilling prophecy.
That’s how occasional disruption turns into chronic insomnia.
And it can go both ways
Here’s the other piece I think is important.
Bad sleep also makes everything worse.
When you’re sleep deprived:
Your brain is more reactive
Your stress tolerance is lower
You’re more likely to interpret things negatively
So now you’re more sensitive to the hot flash… and more likely to spiral about it.
Which then makes the next night harder. It feeds itself.
So is this “just in your head”?
No.
Let’s be very clear. Hot flashes are real, physiological, hormone-driven events.
Estrogen is declining. The brain’s temperature regulation is shifting. The threshold for triggering a heat response gets narrower. This is biology. But your brain is part of your biology too.
Your thoughts, your expectations, your interpretations all influence your nervous system.
So this isn’t about blaming yourself or “just think positively.”
It’s about understanding that there are multiple levers here.
What this means for you
If you’ve been focusing only on:
supplements
cooling pajamas
fans
hormone therapy
All of that can absolutely help. I’m a huge fun of all those things.
But it might not be the whole picture.
Because if your brain is doing a full anxiety monologue before you go to bed or every time you wake up, your body is going to stay activated.
And activated bodies don’t sleep well.
The goal is not perfection
You are not going to eliminate every hot flash. That’s not realistic. The goal is to change what happens after.
Less:
“This is going to ruin everything.”
More:
“Annoying, yes. But my body will settle again.”
Less:
“I’ll never fall back asleep.”
More:
“I’ve fallen back asleep before. My body knows how to do this.”
You’re not trying to be Zen all the time because that’s not possible. You’re just trying to not throw gasoline on the fire.
My take as someone who does this work all day
Hormones matter. A lot. But so does the nervous system. And so does the story your brain tells in the middle of the night. This is one of those areas where science and real life overlap beautifully.
Because every woman reading this has felt it.
The hot flash wakes you up. But the thoughts can be what keeps you there.
The bottom line
Yes, hot flashes can disrupt your sleep.
But your brain’s response to them can make that disruption a lot bigger.
When you understand that, you get more options. And more options you can directly control is exactly what you want in perimenopause.
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Resources:
My favorite cooling bamboo pajamas and sheets (because no forever chemicals, thank you) are Cozy Earth. Use code DRJONES for 20% off
My favorite magnesium (code DRJONES for 10% off). I take 1-2 scoops before bed