Sleep disruption during menopause is often caused by vasomotor symptoms like hot flashes, which create an adversarial thermal situation for sleep.

“it is a huge problem in um premenopausal and perimenopausal uh women and of course women going through uh menopause it's principally because of what we call the vasom motor symptoms of of menopause which is to say these hot flashes where you just get EX sort of really for the body at Le quite extreme increases in temperature you get so hot and don't forget in our um episode two we spoke about how you need to regulate temperature and there's a very beautiful and complex relationship between temperature and sleep and we said you need to stay cool to stay as sleep but here is a situation where when you're asleep you're not staying cool you're doing the opposite you're getting warm and that is the adversarial thermal situation for staying asleep and so individuals wake up and then they struggle to get back to sleep”