If you are finding symptoms of perimenopause keeping you up or waking you up every night or on going, see you gynecologist or general practitioner. There are some things you can control (like your sleep habits) and things you can't control (like your hormones, without medication). Using good sleep hygiene, do everything in your power to stack the odds for good sleep and hopefully you can make up for the hot flashes and other natural sleep obstacles.
I stress that women need to be consistent with wake up times and give themselves time to fall asleep at night. Build a very tight sleep structure and sleep environment by paying attention to your sleep environment .
Hormone replacement therapy (HRT) works by supplementing estrogen hormone that is no longer being made by your body in the same way as it was before perimenopause. Estrogen reduces hot flashes, vaginal symptoms, and difficulty with urination. HRT is recommended for shortest possible term in the lowest possible dose. HRT has been found to help women. I know many women who have gone back on their HRT simply because they need to sleep. Again, sleep is so vital. One has to weigh the consideration of good sleep when we are discussing whether or not to discontinue HRT.
Another of the things that helps some women is a low-dose birth control pill, which acts to stabilize mild fluctuations of estrogen that may be occurring.
There are some herbal products that have been tried but I don't recommend them. The data shows that