Optimizing Sleep With Behavioral Tools. Is There A Role For Hormones?

When improving sleep, we often think about behavioral strategies like light exposure, temperature control, and managing caffeine. However, It may require addressing hormonal imbalances. This is especially true for women during perimenopause and menopause as optimizing hormone levels—particularly progesterone—can significantly improve sleep quality.

• Supports Cognitive and Physical Health: Quality sleep boosts cognitive function, immune system performance, wound healing, and skin
• Memory and Longevity: Plays a key role in memory retention, slows aging, and helps prevent age-related cognitive

• Mental Decline: Reduces clarity of thought and decision-making
• Accelerated Aging: Hastens cognitive decline and memory issues, making you feel older than your

• Enhanced Focus and Energy: Improved mental clarity, mood, and energy levels throughout the
• Boost in Performance: Sleep supports both mental and physical tasks, from problem-solving to athletic
• Healthier Aging: Proper sleep protects memory and reduces the risk of age-related

• Why Sleep and Hormone Balance are Interconnected:
  • Hormones such as melatonin, cortisol, progesterone, and testosterone directly impact your sleep
  • Poor sleep can lead to hormonal imbalances, contributing to fatigue, mood swings, and metabolic
• Key Hormones in Sleep Optimization:
  • Melatonin: Regulates the sleep-wake cycle and promotes sleep
  • Cortisol: High cortisol at night can prevent restful
  • Progesterone: A calming hormone that enhances GABA activity and helps with
  • Testosterone: Supports deep sleep quality and energy
• Practical Steps for Hormonal Sleep Optimization:
  • Light management: Control blue light exposure in the evening to help boost melatonin
    • Consider HRT or bioidentical hormones for women experiencing hormonal fluctuations during perimenopause or
    • Maintain regular sleep schedules to support consistent hormone production and
  • Benefits of Optimizing Sleep and Hormones Together:
    • Enhances recovery, promotes better mental clarity, and boosts physical
    • Prevents long-term negative effects such as weight gain, mood disorders, and fatigue associated with hormonal imbalances and poor

• Light and Dark:
  • Light (from sunlight or artificial sources) and darkness are powerful cues for regulating the sleep-wake
  • Exposure to light in the morning boosts alertness, while exposure to darkness at night triggers
• Temperature:
  • Your body’s core temperature naturally drops by 1-3 degrees as you fall
  • Cool environments promote sleep, while overheating can wake you
• Food:
  • What, when, and how much you eat can impact your sleep
  • Eating close to bedtime can disrupt sleep, while fasting or controlling food intake at night may promote better
  • Food timing in the morning is dependent on the Some it stimulates metabolism. Others fasting in the am works best.
  • Blood flow diversion to the stomach can cause drowsiness after This is a common complaint.
• Exercise:
  • Regular physical activity, especially cardiovascular and strength training, boosts body temperature, alertness, and overall
  • Timing of exercise can influence sleep quality—late-night exercise may increase cortisol and hinder sleep
• Caffeine:
  • Caffeine blocks adenosine, a molecule that builds up throughout the day and causes
  • Timing caffeine intake is crucial to prevent interfering with
• Supplements:
  • Key supplements like magnesium threonate and L-theanine enhance sleep by promoting relaxation and deep sleep
  • Inositol and other supplements such as glycine and GABA can aid those with specific sleep challenges, especially people on low-carb diets or dealing with

***Melatonin is a Hormone-but is it recommended as a supplement?

• • Melatonin is a hormone that your body produces naturally, regulated by light and
  • Light inhibits melatonin production, while darkness promotes it, helping you fall asleep
• Issues with Supplementing Melatonin:
  • The dosages of melatonin found in most commercial products are supraphysiological—much higher than the amounts naturally produced by your body.
  • This raises concerns because melatonin interacts with other hormonal systems, such as testosterone and estrogen, and even affects puberty development in children.
• Occasional Use Chronic Use:
  • Occasional use of melatonin (e.g., for jet lag) is likely safe and not
  • However, chronic use, especially in children, may have negative effects on hormonal balance and should be approached with caution.
• Alternatives to Melatonin:
  • Other supplements like Magnesium Threonate, Apigenin, and Theanine may be more suitable for promoting sleep without interfering with the body’s natural hormone

• In conclusion, melatonin can be useful for occasional sleep issues, but due to its impact on hormonal systems, it’s better to use alternatives for long-term sleep support.

Morning Routine:

• Morning Sunlight: Getting exposure to natural sunlight in the early hours regulates the circadian rhythm and boosts It is recommended that you get outside with natural sunlight within the first 30 minutes of waking.
  • This am sun exposure helps to regulate the cortisol spike in the am which in when cortisol should spike.
    • While cortisol is often seen as a stress hormone, it is essential to have a morning cortisol peak for optimal daily This cortisol spike helps increase:
      • Focus
      • Energy
      • Metabolic rate
  • This helps regulate a wake – sleep Cortisol spike in the am directs to melatonin increase at the 16 hour mark after the cortisol spike.
  • Sunlight stimulates specific neurons in the eye, which send signals to the suprachiasmatic nucleus (SCN), the brain’s master clock that governs the sleep-wake
  • Natural sunlight is Sunlight provides 5-90 X greater lux energy than artificial blue lights.
    • Full sun requires less time exposure (5 min), cloudy (10 min) and thick cloud cover or rain (20-30 min)
    • Sunglasses or windows are not fully effective at getting the eyes the photo energy
  • Science-Backed Practice:
    • Morning sunlight exposure is crucial for regulating wakefulness throughout the day and improving sleep quality at night.
    • Supported by hundreds of peer-reviewed studies, this is a foundational tool for maintaining optimal sleep-wake cycles.
  • Exercise: Light to moderate exercise in the morning enhances alertness and can help you fall asleep faster at
    • It is recommended to hit 10,000 steps a day for low intensity fat burning with the added benefit of
      • Sunlight exposure if outside
      • Mood
      • Physical activity
  • Body temperature
    • Your body temperature naturally drops by 1-3 degrees when you fall This drop is crucial for initiating sleep and helps maintain it throughout the night.
    • Conversely, if your body temperature increases by 1-3 degrees, it will wake you up, as the rise disrupts the sleep cycle.
    • Cooling Down to Sleep:
    • Actively cooling your body can aid in falling asleep This can be done by:
      • Taking a warm bath or shower before bed, which triggers a cooling effect as your body releases heat
      • Sleeping in a cooler room, around 65°F (18°C), which is optimal for most
    • Deeper stages of sleep, particularly REM sleep, are more sensitive to body
    • Caffeine Delay: Wait 90-120 minutes after waking before consuming caffeine to avoid disrupting sleep later in the Caffeine to early in the day, can lead to an afternoon period of sleepiness.

Evening Routine:

• Light Sensitivity in the Evening:
  • Dim Lights: Reducing exposure to artificial blue light signals your brain that it’s time to wind
  • After sunset, avoid bright indoor or overhead
  • In the evening, your brain and body are highly sensitive to light, and even small amounts can disrupt your sleep-wake
  • It’s recommended to minimize light exposure between 10 m. and 4 a.m., which are critical hours for maintaining sleep quality.
  • Getting early evening sunlight (low solar angle before sunset) can help offset some of the negative effects of artificial light exposure later at This exposure signals to your body that the day is winding down and nighttime is approaching.
• Temperature:
  • Cool Bedroom: Lower the temperature in your bedroom to improve the depth and quality of
  • Taking a hot bath, sauna, or hot shower in the evening for 20-30 minutes can induce a compensatory cooling effect, where your core body temperature drops after exiting, helping you fall asleep more
• Avoid Alcohol: Alcohol may induce drowsiness, but it disrupts the sleep cycle, impairing the overall restfulness of sleep.
• No Food intake in the 2 hours before This increases cortisol late in the evening and can interfere with sleep.

1. Progesterone (“Feel-Good” Hormone):

• Brain Receptors: Progesterone binds to receptors in the brain that regulate mood and sleep
• GABA System: It increases GABA activity, promoting relaxation and deeper
• Studies: Research shows that progesterone enhances slow-wave sleep and reduces anxiety, making it easier to fall asleep and stay

1- Progesterone and GABA Receptors:

Study: Backstrom et al. (2014) demonstrated that neurosteroids derived from progesterone, like allopregnanolone, significantly modulate GABA receptors, increasing their inhibitory function, leading to reduced anxiety and improved sleep quality.

Conclusion: This study highlights how progesterone supports relaxation and sleep by enhancing GABA’s role in the brain.

Link: Study on Progesterone and GABA Study on Progesterone and GABA

2- Progesterone’s Effect on Sleep Architecture:

Study: Friess et al. (1997) found that progesterone supplementation improves slow-wave sleep (deep sleep), which is the most restorative phase of sleep. Women in the study experienced less sleep fragmentation and more rejuvenating rest.

Conclusion: Progesterone helps promote deeper, more restorative sleep by influencing slow-wave sleep cycles. Link: Study on Progesterone and Sleep Architecture

3- Progesterone in Perimenopausal Women:

Study: Schmidt et al. (2020) found that progesterone therapy in perimenopausal women improved sleep quality and reduced symptoms of anxiety and depression, common during hormone fluctuations.

Conclusion: Hormone therapy using progesterone is effective in improving sleep quality, especially in women undergoing hormonal transitions.

Link: Study on Progesterone and Sleep in Perimenopause

2. Testosterone’s Role in Sleep

• Testosterone also has a significant impact on sleep, particularly in While progesterone supports deep, restful sleep in women, testosterone plays a similar role in men.
• Sleep Architecture:
  • Testosterone promotes slow-wave sleep, which is essential for physical recovery and mental Men with low testosterone often experience fragmented sleep and reduced time in slow-wave sleep.
• Testosterone and REM Sleep:
  • Testosterone helps regulate REM sleep, which is important for cognitive functioning, emotional processing, and overall brain Reduced testosterone levels, such as those seen in aging men, are often linked to reduced REM sleep.
• Testosterone and Sleep Apnea:
  • Testosterone deficiency is linked to an increased risk of sleep apnea, a condition where breathing repeatedly stops during sleep, disrupting rest and reducing sleep

3. Other Hormones That Affect Sleep

• Estrogen:
  • Estrogen plays a significant role in sleep regulation for Low estrogen levels, particularly during perimenopause and menopause, are linked to insomnia and fragmented sleep. Estrogen helps maintain body temperature regulation and impacts serotonin, which supports mood and sleep.
  • Key Studies:
  • Baker et (2019) found that estrogen replacement therapy improves sleep quality and duration in perimenopausal women.
  • Link: Study on Estrogen and Sleep
• Cortisol:
  • Cortisol, the stress hormone, is regulated by the circadian rhythm and peaks in the Chronically elevated cortisol levels, often due to stress, can disrupt sleep, making it harder to fall asleep or causing frequent wakefulness.
• Melatonin:
  • Melatonin, produced by the pineal gland, regulates the sleep-wake cycle. While melatonin supplementation can help people fall asleep, especially when circadian rhythms are disrupted (such as during jet lag), excessive use can interfere with other hormone systems, including estrogen and

• Hormone Testing: Assess hormone levels, especially for women in perimenopause and menopause, and men with low Bioidentical progesterone or testosterone therapy may improve sleep.
• Lifestyle Balance: Combine hormonal optimization with good sleep hygiene—exercise, light exposure, temperature control, and relaxation practices like Yoga Nidra.