Hi, I to am knee deep in perimenopause. I was already on Neurontin for Trigeminal neuralgia and it is also used off label for hot flashes so I haven't had those. The waking up at 4am? Oh yeah I am so there!!!!! It is just awful it ruins my whole day! My gyno put me on birth control pills and it has helped with the sleeping some. I still have to take 2 benadryl and an xanax to sleep at nite. You would think that would keep me down and out but nope! My headaches start in the late morning right before I wake up for the second time, that's when I do my dreaming so I wake up then with my headache and sweating from my dream. If I don't dream then everything is great. Just don't get it.