This episode explores one of the most frustrating perimenopause symptoms: being exhausted but completely unable to fall asleep — or waking up at 2 a.m. like your brain just slammed on the gas pedal. Dr. Greg breaks down the hormone shifts that wreck sleep, including cortisol, progesterone, blood sugar instability, and the often-overlooked liver connection that makes your body “wake up hot.” By the end, listeners will understand why sleep falls apart in midlife and the first steps toward restoring deep, restorative rest.

Episode SummaryMany women in perimenopause feel bone-tired all day, only to lie awake at night with racing thoughts, panic, or predictable 1–3 a.m. wake-ups. In this episode, Dr. Greg explains why this isn’t “just stress” or anxiety — it’s physiology. Progesterone decline, cortisol rhythm disruption, nighttime blood sugar crashes, liver overload, neurotransmitter imbalance, and circadian rhythm breakdown all collide to hijack sleep. Sleep issues are often the earliest sign that hormones are shifting — and one of the last systems to fully recover without root-cause support.

Key Takeaways• Poor sleep in midlife is not random — it’s hormonal and physiological• Progesterone decline weakens the body’s natural calming and sleep signals• Cortisol dysregulation causes “tired but wired” nights and early-morning wakeups• Blood sugar crashes can trigger cortisol spikes during the night• The liver has its own circadian rhythm and becomes more active overnight when overloaded• Gut health affects serotonin production, which impacts melatonin conversion• Sleep is a keystone vital sign — when it collapses, the body is signaling distress

What Can Help Support Better Sleep• Stabilizing blood sugar in the evening• Reducing screens and blue light before bed• Supporting progesterone and cortisol rhythm• Morning sunlight exposure to reset circadian timing• Supporting liver and detox pathways• Paying attention to cycle timing and symptom patterns

Resources & Next StepsInitial Evaluation: https://drgreg.practicebetter.io/#/5e8a349a2a982306d08c1c14/bookings?s=62290cf8c925874c9b56b394&step=date

Hormone Symptom Tracker: https://drgreg.practicebetter.io/#/5e8a349a2a982306d08c1c14/forms?f=6807f2f8c009a18d7c98e558
Functional Testing & Care Options: https://www.vitaefm.com
Ask Dr. Greg a Question: [email protected]

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Keywordsperimenopause sleep, waking up at 2am, tired but wired, progesterone and sleep, cortisol imbalance, blood sugar and sleep, liver detox and sleep, midlife insomnia, hormone disruption, women’s health podcast, functional medicine, Dr Greg Mongeon