Perimenopause is the period leading up to menopause. This period is characterized by hot flashes which send heat surges through the body as estrogen levels fluctuate. Insomnia is also a common complaint during perimenopause. It usually involves inability to sleep through the night. Typically, a woman will wake up in the middle of the night and be unable to go back to sleep. Night sweats often accompany this inability to return to sleep. Some women also wake in the middle of the night with a pounding heart or a in a state of anxiety. The general consensus among the medical fraternity is that these problems affecting sleep are due to the body’s inability to maintain a consistent temperature due to hormonal fluctuations. As the hormonal levels begin to stabilize the insomnia related problems usually diminish.