Sleep issues, including insomnia or frequent waking, can be the direct result of fluctuating hormone levels. Low progesterone before menstruation or dropping estrogen during perimenopause can significantly disrupt sleep architecture, often leading to night sweats. Stress and anxiety, which are also often cycle-related, further impact sleep quality. If chronic sleep deprivation is impacting your health, consulting a physician specializing in women's health or sleep medicine is recommended.