When Hot Flashes Hit at Night: What Perimenopausal Women Should Know About Their Heart Health
- Dr. Sheetal Shah, MD
- Aug 28
- 3 min read
Hot flashes are more than just uncomfortable—they might be quietly signaling something about your heart health. A striking new study from The Menopause Society reveals that nocturnal hot flashes, especially those that occur in the second half of the night, may raise the risk of cardiovascular(heart health) issues.
Understanding this connection could empower women to take proactive steps for long-term wellness. The Menopause Society
What the Study Found
Researchers monitored healthy, perimenopausal women aged 43–54—none of whom were on hormone therapy or had heart disease.
Through objective measures (sternal skin conductance), they identified the timing of hot flashes during sleep: 41% occurred in the first half, while 59% occurred in the second half of the night, which coincides with more REM sleep.The Menopause Society
Why does this matter? REM sleep is the deepest stage, when thermoregulation is reduced. Disruptions during this stage may heighten the potential for cardiovascular risk.The Menopause Society
Though this is preliminary data, the findings point to an intriguing link between nighttime hot flashes and heart health—warranting further research.The Menopause Society
Context: Linking Hot Flashes to Heart Health
This isn’t the only study raising flags about hot flashes—and especially when they happen at night:
A 2020 pooled analysis involving over 23,000 women found that severity of symptoms mattered more than frequency. Women with severe hot flashes or night sweats had significantly higher cardiovascular risk—hazard ratios of approximately 1.6 to 2.1
medicine.uq.edu.au+10AJOG+10Verywell Health+10PubMed
The University of Queensland found that women with postmenopausal vasomotor symptoms were 70% more likely to experience heart attack, stroke, or angina—and symptoms before menopause still raised risk by 40%. medicine.uq.edu.au+2RACGP+2
Early evidence also links hot flashes to systemic inflammation, as detected via physiological monitoring—not just self-reports—highlighting another pathway to heart disease.The Menopause Society
The American Heart Association points out that hot flashes and night sweats are associated with elevated blood pressure and other cardiovascular risk factors during the menopause transition. americanheart.org
*CVD/Atherosclerosis risk= Increase risk of heart disease, stroke, vascular disease
Study / Source | Population | Key Finding | Cardiovascular Risk |
Menopause Society (2023) | Healthy women, 43–54 yrs | Late-night hot flashes disrupt REM sleep | Linked to ↑ heart risk |
UQ Study (2020) | >23,000 women | Severe vasomotor symptoms strongest risk | 70% ↑ CVD events |
SWAN Study (20 years) | ~3,300 women | Persistent hot flashes across surveys | Doubled CVD risk |
MsHeart Study (2023) | Perimenopausal women | Hot flashes → higher inflammation (CRP) | ↑ Atherosclerosis risk |
Why Nighttime Timing Matters
REM sleep is when the body is most vulnerable—thermoregulation falters, making hot flashes more disruptive and potentially more physiologically impactful.
Frequent awakenings, disturbed sleep architecture, and autonomic stress during REM could exacerbate cardiovascular strain over time.
What Women Can Do About It
See these symptoms as early warning signs—especially if hot flashes occur frequently at night.
Assess your heart health proactively, even if you're otherwise healthy—monitor blood pressure, cholesterol, and other indicators.
Adopt integrative approaches: good sleep hygiene, stress management, guided lifestyle shifts, and if appropriate, hormone therapy—especially considering the "timing hypothesis" that suggests starting therapy early in menopause may offer cardiovascular benefits.
Make lifestyle your first line of defense: regular exercise, balanced nutrition, sleep consistency, and emotional well-being can help both vasomotor symptoms and long-term heart health.
Conclusion
Nocturnal hot flashes may do more than disrupt your sleep—they could be early whisperings of heart risk. This study highlights the importance of paying attention to timing, not just frequency or severity. As we continue research, these insights can empower women to approach menopause with both awareness and resilience.
If this resonates with your experience—or if you're looking for guidance beyond relief from symptoms—join our upcoming class. We’ll dive deep into integrative strategies to help manage hot flashes while nurturing your overall cardiovascular wellness.
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