# Mood, anxiety and sleep during menopause · Midlife Nights > Source: https://midlifenights.com/topics/mood-anxiety-and-sleep ## Mood, anxiety and sleep Night-time worry, low mood and the foggy day after: how they tie in with hot flashes and lost sleep, and when to see a GP. 3 articles on this topic * [All topics](/topics) * [Every article](/articles) [ ](/articles/menopause-depression-and-sleep) #### [Low mood and broken sleep in menopause: which comes first ](/articles/menopause-depression-and-sleep) Does poor sleep bring on low mood in menopause, or does depression break your sleep? What the studies show about which comes first, and when to see a GP. 5 Nov 2026 [ ](/articles/anxiety-at-night-perimenopause) #### [Anxiety at night in perimenopause ](/articles/anxiety-at-night-perimenopause) Why anxiety and low mood in perimenopause often feel worse after dark, how they tie in with hot flashes and broken sleep, what helps at 3am and when to see a GP. 4 Nov 2026 [ ](/articles/menopause-tiredness-after-bad-sleep) #### [Tired after bad nights: menopause brain fog ](/articles/menopause-tiredness-after-bad-sleep) Why broken nights in perimenopause and menopause leave you tired and foggy all day, what the studies found about memory, and when fatigue needs a GP. 3 Nov 2026 What the sources say ### Mood, anxiety and sleep, in plain terms Worry, low mood and broken sleep turn up together so often in perimenopause that it can be hard to say which one is the problem. The [NHS symptoms page](https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/) lists anxiety among the effects of a hot flush and says that poor sleep can leave you irritable, stressed and anxious. It also warns that as the flushes and night sweats ease, low mood and anxiety can take their place. The pages here deal with that side of the night: what goes on in your head at 3am and how you feel the next day. If you wake with a pounding heart and a head full of dread, start with [anxiety at night in perimenopause](/articles/anxiety-at-night-perimenopause). It covers why fear and heat arrive together and what helps in bed, from a slow breathing exercise to keeping caffeine and alcohol well away from the evening. The link may run in both directions. In the Penn Ovarian Aging Study, [Freeman and colleagues](https://pubmed.ncbi.nlm.nih.gov/15879914/) found that women with moderate anxiety were nearly three times as likely to report hot flashes as women in the normal range, and those with high anxiety nearly five times as likely. Low mood follows a similar pattern. A [2018 review of the SWAN and Penn studies](https://pmc.ncbi.nlm.nih.gov/articles/PMC6226029/) reports a 2 to 5-fold rise in the risk of major depression during perimenopause for a subset of women. In one study it cites, midlife women who had sleep problems at the start were eight times more likely to have depression that lasted or came back over 13 years. Across adults in general, a [pooled analysis of 21 studies](https://doi.org/10.1016/j.jad.2011.01.011) found that insomnia roughly doubled the chance of depression later. [Low mood and broken sleep in menopause](/articles/menopause-depression-and-sleep) looks at which one tends to start first and the signs that low mood has become depression. Then there is the day after. Forgetting words, losing your train of thought and feeling slowed down are often put down to hormones alone, but lost sleep plays a large part. [Tired after bad nights: menopause brain fog](/articles/menopause-tiredness-after-bad-sleep) sets out what the studies found and which kinds of tiredness need blood tests or a sleep check. What helps most is a record. Add a line for mood and worry to each night of the [printable night diary](/articles/printable-night-diary-for-hot-flashes-night-sweats-and-sleep), rated mild, moderate or severe, and after two weeks you can see whether the bad days follow the sweaty nights or turn up on quiet ones too. The [NHS depression page](https://www.nhs.uk/mental-health/conditions/depression-in-adults/symptoms/) advises seeing a GP when low mood lasts most of the day, every day, for more than two weeks. In England adults can also refer themselves to [NHS talking therapies](https://www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/). If you feel unable to keep yourself safe, call Samaritans on 116 123 in the UK or the [988 Lifeline](https://988lifeline.org/) in the US straight away. For the nights themselves, the [insomnia and 3am waking](/topics/insomnia-and-3am-waking) section covers sleep habits, early waking and CBT for insomnia. To take your notes to an appointment, see [tracking and your doctor](/topics/tracking-and-your-doctor). ### Questions readers ask Can perimenopause make me anxious if I never was before? Yes. The NHS counts anxiety as a menopause symptom, so worry that is new in your forties is common. A racing heart with no heat behind it is still worth a GP check. How do I tell depression from plain tiredness? Tiredness tends to lift after a few decent nights. Depression lasts for weeks and brings hopelessness or a loss of interest in things you used to enjoy, and that is the point to book a GP. Does mood get better once the hot flashes stop? Often, though not always on the same timetable. The NHS notes that low mood can show up later, just as the flushes fade. Who can I call tonight if I cannot cope? Samaritans on 116 123 in the UK, or call or text 988 in the US. Both answer at any hour and are free. Related reading ### The other sides of a hard night [ Hot flashes at night Why the heat tends to come in the small hours, how night flashes change from perimenopause to the years after, and what NIA and the NHS suggest for the bedroom. ](/topics/hot-flashes-at-night) [ Night sweats Waking soaked: what counts, the signs that point away from menopause, what helps at night and when to see a doctor. ](/topics/night-sweats) [ Insomnia and 3am waking Trouble falling asleep, waking at 4am with no way back to sleep, and the habits the National Institute on Aging suggests. ](/topics/insomnia-and-3am-waking) [ A cooler bedroom Room temperature, layered bedding, a fan, what to wear to bed and the evening habits that make hot nights easier. ](/topics/a-cooler-bedroom) [ Tracking and your doctor Keeping a simple record of your nights and bringing it to your next appointment, so the conversation starts from facts. ](/topics/tracking-and-your-doctor) --- [ ](/) The night side of perimenopause and menopause: hot flashes, night sweats and 3am waking, with every health fact linked to its source. 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