For many of us in midlife, broken sleep becomes all too familiar, even when we feel bone-tired. Is it hormones? Stress? That late-night glass of wine or coffee? Or – is it your bladder nudging you awake again?
Sleep often becomes trickier as we move through our forties and fifties. Our bodies are changing, our lives are busy, and the things that never used to bother us can suddenly feel like big hurdles to rest.
Here's the most common reasons we're waking up at night - and how to manage them for a good night's sleep:
Your bladder thinks it's time to party
One of the most common reasons for disturbed sleep in midlife is the need to pee during the night. For some of us, we are woken by a real urge; for others, it’s more of a niggly, “just in case” trip to the loo that interrupts our much-needed rest. Hormonal changes, a less supportive pelvic floor, and even day-to-day stress can all make the bladder more sensitive and reactive at night.
Nocturia is a condition where you find yourself waking at least once during the night to pee. It’s something that many adults experience in midlife and beyond as we get older. For women, hormonal changes can contribute to nocturia, but changes to our lifestyle can help ease the wakings and help you get more rest. Nocturia can occur even if you don’t experience leaks or urgency in the day - but they often do go hand in hand.
Cutting back on caffeine and alcohol later in the day, making sure you’re drinking enough water earlier on, and doing regular pelvic floor exercises can all help. Ensure you empty your bladder before bed, too. Keeping a bladder diary or journal to keep track of your diet, fluid intake and any triggers that are contributing to the need to pee during the night can support lifestyle changes to ease the need.
If night-time bladder trips are frequent or getting worse, it’s worth checking in with your GP to rule out infections or other conditions.
Your hormones are declining
Oestrogen and progesterone play a big role in our sleep quality. As these hormones fluctuate and decline during perimenopause and menopause, you might notice night sweats, hot flushes, or restless legs cropping up - all of which can wake you up and keep you unsettled at night. Progesterone is naturally calming, so when our levels fall, it can be harder to get the deep, restorative sleep we need.
Hormone changes are also linked to mood swings, anxiety, and low mood, which can feed into restless nights. While we can’t stop the hormonal rollercoaster and this important milestone in our lives, making tweaks like keeping your bedroom cool, layering breathable bedding, and limiting alcohol and caffeine can all help to ease the impact.
You can't switch off the mental load
Even when the house is quiet, our mental load often doesn’t switch off. How many of us lie there in the dark, running through overwhelming lists and tasks until the early hours? Midlife can be one of the busiest times of all as we juggle work, children, ageing parents, and everything in between. It’s no wonder many of us find 2am is when worries seem loudest.
Stress hormones like cortisol can interfere with our natural sleep-wake cycle, making it harder to drift off again once we’re awake. Building calming rituals into your day can make a real difference. Whether it’s deep breathing, gentle stretches, or a short wind-down routine before bed, creating space to slow down signals to your body that it’s safe to rest.
You're missing simple triggers
Sometimes the causes are surprisingly simple - but easy to overlook. Evening caffeine, a late-night scroll through your phone, or even a heavy meal close to bedtime can all keep your body alert. As we age, we often become more sensitive to these triggers. What never used to bother us suddenly leaves us tossing and turning.
If sleep is elusive, it’s worth experimenting with small, simple changes. Try switching coffee for herbal tea, leaving your phone in another room, or eating your main meal a little earlier. Even these super small changes can help your body reset its rhythm for better sleep.
You have health niggles that disturb sleep
It’s easy to assume poor sleep is just part of midlife, but sometimes it’s a signal to pay attention to your health. Conditions like thyroid imbalance, joint pain, or restless legs can all make it harder to rest. If you’ve tried adjusting your lifestyle and sleep is still elusive, it’s always worth speaking to your GP. Sleep is too important to dismiss.
5 Tips for better rest and sleep in midlife
While not every night will be perfect, making small adjustments can help you reclaim more consistent, restorative sleep. A few ideas to try:
Keep a regular bedtime and wake-up time to anchor your body clock.
Make your bedroom cool, dark, and quiet to prioritise rest.
Avoid caffeine and alcohol in the hours before bed.
Try gentle breathing exercises or meditation to calm the mind before sleep.
Support your bladder with good hydration habits during the day and a pelvic floor routine, and always empty your bladder before bedtime.
Apps like Sleepio can help calm you before bed, and ready for your brain for sleep.
