I'm through the pause (58 next month :-) and my 40's were kind of like you describe with it being occasional, "gee, maybe this is hormones/perimenopause!" a surprise thought. I found, for me, it was all a slightly better version of my 20's again (I was much more emotional and had more problem in my 20's), the depression in my 40's wasn't quite as bad as in my 20's, the anxiety wasn't as bad, etc.

For sleeping, I used/use Benedryl children's flavored strips, they are usually just enough to make me sleepy but I'm very susceptible to meds. It all gets much worse when you get around 51 or 52 and the hormones go away completely, then it gets REALLY interesting, LOL. If you have a therapist, mine was a lot of help from about 46 to 54-55. Just having someone to help sort things out and lend a bit of support. I don't think doctors have enough time these days.