Reflex overcorrection prolongs post-awakening instability

Menopausal awakenings can leave someone unable to fall back asleep even when hot flashes are suppressed; this proposed mechanism asks whether the body’s own pressure-control reflex keeps the disturbance going. The cardiovagal baroreflex, a pressure-control reflex that slows the heart through the vagus nerve, may overcorrect after an awakening. The hypothesis predicts a pressure rise, excessive cardiac slowing, a pressure undershoot, then sympathetic compensation, the body’s fight-or-flight response, and repeated swings that delay sleep re-entry. The crucial test is directional: weaker reflex signaling should shorten settling, while stronger signaling should prolong it. Human recordings could map this pattern; selective reflex weakening in a preclinical arm would test causality.