Waking Hot at Night in Perimenopause & Menopause

If this is happening to you, I want to start by saying this clearly: your body isn’t broken. It’s changing and asking for a different kind of care.

This matters because for many of us, this phase of life already feels full. Our sleep suddenly feels precious in a way it never did before. Careers may be at their peak or carrying more responsibility.

Home life can feel like a constant juggle: children who still need us, parents who are starting to need more from us, relationships, work, and the quiet pressure of holding everything together.

So, when sleep starts to fracture, and you wake up hot, unsettled, and confused in the middle of the night, it can feel deeply unfair. Not to mention exhausting and disorientating.

I know this because this has only just started happening to me. Normally, I run cold: cold hands, cold feet, always reaching for another layer.

I’m the kind of person who goes to bed with an electric blanket on, thick socks, and a heavy tog duvet (and keeps all of that well into early summer).

Now I'm waking up and pushing my feet out from under the duvet as quickly as possible.

Waking in the night feeling intensely hot, yet not hot to touch, stopped me in my tracks. I’m used to listening to my body, noticing patterns, and supporting others through change.

And still, this asked me to slow down, get curious, and meet myself with the same compassion I encourage in others.

If this feels sudden, confusing, or completely out of character for you, too, please know this: you’re not imagining it, and you’re not alone. We will explore why this happens and how to soften the symptoms.

What does “waking hot but not hot to touch” mean?

This particular experience is important to name. When we are ill or have an infection, the body is usually warm externally.

But waking with an internal heat, flushing, or a sense of being overheated from the inside out while the skin feels normal often points away from illness and towards hormonal and nervous system causes.

At around the midlife marker, this becomes incredibly common.

The hormonal connection (especially around 50)

During perimenopause and menopause, oestrogen and progesterone don’t decline smoothly; rather, they fluctuate.

These fluctuations affect the hypothalamus, which is the part of the brain that regulates temperature, sleep, and stress hormones.

What can happen is:

• The brain becomes more sensitive to small temperature changes

• It misreads normal signals as “too hot”

• It triggers a heat-release response (flushing, sweating, waking you up)

This can happen even if you’ve always been a cold person.

And if you run cold like me and have been joking to your friends about how you wish you’d have a hot flush to warm you up, you’re probably taking all that back now that you know how actually it feels.

In fact, many women who have never had hot flushes during the day notice night-time heat first. You certainly can’t ignore it when it wakes you up.

Why do you wake up hot in the night

If you're in your midlife, waking up hot in the night is very likely a time when you really don’t need your sleep interrupted.

Like many of us, you’re probably busy from the moment you wake and until you fall into bed and look forward to switching off for those precious hours of peace.

However, night-time is when:

• Your core body temperature naturally shifts

• Cortisol and melatonin interact

• The nervous system processes the day

If the nervous system is already carrying stress, grief, change, or hormonal instability, nighttime can be when it finally shows up.

The result is broken sleep, sudden waking, and that unmistakable rush of heat.  

Stress can cause you to wake up hot

The first few nights it happened to me, I not only found it disorientating but woke in the morning feeling robbed of sleep. This isn’t just about heat, though; it’s about regulation.

Hormonal change lowers our stress tolerance, and things that the body once handled quietly can now trigger a stronger response.

When the nervous system tips into sympathetic activation (fight/flight), the body generates heat. So night sweats and night heat are often a combination of:

• Hormonal fluctuation

• Nervous system overload

• Accumulated stress

• Reduced progesterone (which normally has a calming effect)

  
  

This is why addressing only the temperature of the room often isn’t enough.

Things that can make night heat worse

Even when hormones are the main driver, these often amplify symptoms, and (like me) you probably know this already, but it might finally be time to address this list if you haven’t already cleaned up your bedtime routine… which actually starts around lunchtime:

• Alcohol (especially wine)

• Sugar or heavy meals late in the evening (go easy on carbohydrates such as pasta, rice, and potatoes if you already tend to create heat in your body during digestion)

• Caffeine later in the day

• Overstimulation before bed

• Breathing practices that are heating or activating

• Pushing the body hard late evening

I’ve noticed for myself that how I unwind matters just as much as what I eat or how warm the room is.

Tips to help with waking up hot during menopause

I’m sharing these not as fixed answers, but as lived and ongoing experiments.

These are things I’m exploring in my own body while also drawing on what I know about nervous system regulation and gentle behavioural change.

I’m still early in this experience, but a few things have already made a difference.

1. Layered warmth, not all-or-nothing

Instead of ditching my usual warmth entirely, I now:

• Use layers that I can quickly and easily remove

• Turn the electric blanket off before I fall asleep

• Keep my duvet, but untuck it so it can be kicked off quickly

2. Nervous system calming

If I wake hot, I try not to resent the interruption to my sleep but appreciate that my body needs support in the moment, not more stress.

I place:

• One hand on my chest

• One hand on my belly

  
  

And breathe slowly, focusing on long exhales.

3. Turn down the heat on your pre-bedtime bath

Hot baths can actually worsen night heat and make night sweats more likely. Instead, aim for warm and soothing water, just enough to relax muscles without overcooking yourself (I am guilty of this!).

My tips for a calming bath:

• Keep the water around 37–38°C (98–100°F), comfortably warm, not hot

• Limit bath time to 15–20 minutes (this can be hard for me, like turning off Netflix before the next episode auto-plays, and another 20 minutes has passed)

• Add calming oils like clary sage, lavender or geranium (2–3 drops mixed with a tablespoon of carrier oil)

• Use this time to gently breathe, check in with your body, and soften tension

This kind of bath can become a luxurious nervous-system reset before bed, rather than a trigger for night heat.

4. Create a gentle bedtime routine

Finding time for self-care every night may not be realistic, but building a few core habits into your evening can signal to your nervous system that it’s time to wind down:

• Set clear boundaries for when you have your last coffee, turn off Netflix, or put your phone away

• Enjoy a cup of lavender or chamomile tea a couple of hours before bed

• Do self-care activities like a warm bath or meditation earlier in the evening when you have more energy. Anything left undone can (and will) wait until tomorrow

Even small, consistent habits help your body settle and can reduce night waking. For more tips on establishing some basic rituals, see Yoga for Menopause Symptoms: Mindfulness & Self-Care Rituals for Your Best Self.

When to seek medical support for night sweats

It’s always worth speaking to your GP if:

• Night sweats are severe or soaking

• Sleep disruption is affecting daily life

• You experience palpitations, anxiety, or mood changes

• You want to explore HRT or non-hormonal options

• You haven’t had thyroid levels checked recently

And don’t forget, support is not a failure; it’s a form of self-respect.

🌼Final thoughts

If this is happening to you, it doesn’t mean you’ve failed at self-care or that your body is letting you down. It means your body is changing, at a time of life when so much is already being asked of you.

For many women, midlife is anything but a pause; it’s a peak.

This is often a time of responsibility, leadership, emotional labour, and holding others while invisibly trying to hold ourselves together.

Sleep becomes sacred, and when it’s disrupted, it touches everything.

For those of us who have always run cold, night heat can feel especially unsettling, like we no longer recognise our own bodies.

But this isn’t betrayal, it’s simply communication. This is an invitation to listen more closely, soften expectations, and offer us a deeper, steadier kind of care.

You are not alone in it.

If you’d like quiet reflections, nervous-system wisdom, and gentle guidance like this delivered occasionally to your inbox, you’re very welcome to join my newsletter.