Waking up at night? Your gut or muscles may be why

As women approach menopause, they often experience sleep disturbances that can range from difficulty falling asleep to waking up frequently throughout the night. While declining estrogen levels and hot flashes have been the primary focus of research, scientists are now investigating other factors that may contribute to these sleep issues. Two areas garnering attention are the gut microbiome and muscle mass.

The gut microbiome refers to the diverse community of microorganisms residing in our digestive tract. Recent research suggests that these bacteria play a crucial role in maintaining overall health and may even influence sleep quality. A study published in the journal Menopause in 2026 proposes viewing menopause as a systemic process in which hormones, the gut, the immune system, and the brain interact with one another.

The gut bacteria, particularly those involved in estrogen metabolism known as the estrobolome, could be responsible for the varying experiences of women during menopause.

Another aspect that researchers are exploring is the impact of muscle mass on sleep. As women enter menopause, they experience a decline in estrogen levels along with other age-related changes that lead to sarcopenia, or the loss of muscle mass and function. This decline in muscle mass affects energy use, insulin sensitivity, inflammation, and the body's ability to handle physical demands.

Moreover, physical activity triggers the release of myokines, which are signaling molecules that communicate between muscles and other organs, including the brain.

A study conducted in Brazil involving 160 women with an average age of 69 found that a 12-week resistance training program significantly improved sleep quality in participants. Additionally, the same study showed improvements in mental health, daily functioning, and cognitive abilities. Combining exercise with mind-body activities also showed strong evidence in improving sleep quality in perimenopausal and postmenopausal women.

In summary, sleep problems during menopause might be just one symptom of broader changes occurring within the body. To improve sleep quality during this stage, researchers suggest adopting a multifaceted approach. This includes maintaining a fiber-rich diet with various plant-based foods, legumes, whole grains, vegetables, and fruits, as well as engaging in regular strength training exercises.

While no specific probiotic strain has been proven to alleviate menopausal sleep disturbances, promoting a diverse gut microbiome through dietary habits may contribute to better sleep.