“I always emphasize to my clients that sleep is non-negotiable. Prioritize it however you can, take medication if possible—your nervous system, mood, and overall well-being depend on it. But skip the wine; alcohol may feel relaxing, but it interferes with true restorative rest.”

For midlife women balancing demanding careers, family responsibilities, and the fast pace of Manhattan life, restful sleep can feel like an elusive luxury. Hormonal changes during perimenopause and menopause—combined with chronic stress, anxiety, and city living—often disrupt natural sleep patterns. For many professional women, this leads to a cycle of fatigue, irritability, brain fog, and reduced resilience, which affects performance at work, parenting, and overall quality of life.

In my private Manhattan practice, I see countless high-functioning women who are exhausted despite going to bed at a reasonable hour, only to lie awake with racing thoughts or wake multiple times during the night. While medical interventions such as hormone replacement therapy (HRT) or sleep medications can help, they often do not fully address the emotional and nervous system patterns that perpetuate insomnia. A holistic therapy approach, integrating EMDR, somatic techniques, mindfulness, and lifestyle strategies, supports deeper, more restorative sleep while addressing the root causes of stress.

Why Sleep Is Disrupted During Midlife