What you are describing has a name: hyperarousal. Your nervous system is stuck in a state of alertness even when your body is genuinely tired, and the two are not communicating properly.

In perimenopause, fluctuating oestrogen and progesterone affect GABA — a calming neurotransmitter — and disrupt the natural cortisol rhythm that should fall in the evening. The result is a brain that doesn’t receive the “wind down” signal it used to. You feel the fatigue but can’t access sleep.

The good news is that this pattern responds well to specific treatment. Cognitive Behavioural Therapy for Insomnia (CBT-I) has the strongest evidence for this kind of sleep disruption — better than sleeping tablets in the long term, and without the dependency risk. CBT-I works by resetting the association between bed and wakefulness, rebuilding sleep pressure, and changing the thought patterns that keep the nervous system activated at night. Online programmes are available in India.

Key principles that help immediately: keep a consistent wake time every day regardless of how badly you slept (this builds sleep pressure), get out of bed if you have been lying awake for more than 20 minutes (counter-intuitive but it works), and avoid screens for at least an hour before bed. Bright light in the morning helps reset your circadian rhythm.

If hot flashes are contributing to the hyperarousal, treating those (with HRT if appropriate) can make a significant difference to how quickly your nervous system winds down.