Period-Related Insomnia: Why Can't I Sleep?

Sleep problems are a common issue for people with periods in the days leading up to menstruation. This phenomenon is known as period insomnia or PMS insomnia. Research shows that people with premenstrual syndrome (PMS) are twice as likely to experience insomnia before and during their period, with around 70% of people with premenstrual dysphoric disorder (PMDD) reporting insomnia in the days before their period.

Hormonal changes are thought to be the main cause of period insomnia. Progesterone levels increase in the week before menstruation as the body prepares for a potential pregnancy. If pregnancy does not occur, progesterone levels then drop dramatically, triggering the start of the period. The sharp drop in progesterone just before the period may be why PMS gives you insomnia.

Hormonal changes, such as a drop in progesterone, can cause insomnia

Sleep disturbances in the days leading up to menstruation are common, with about 70% of women experiencing changes to their sleep. This phenomenon, known as "period insomnia", is often attributed to hormonal changes, particularly a drop in progesterone levels.

Progesterone is a hormone that plays a crucial role in the menstrual cycle. During the luteal phase, which occurs about one to two weeks before the start of the period, progesterone levels rise as the body prepares for a potential pregnancy. However, if pregnancy does not occur, progesterone levels then drop significantly, triggering the start of menstruation as the uterine lining is shed.

This sharp decline in progesterone levels just before the period is believed to be a key factor in period insomnia. Progesterone is known to have a sleep-inducing effect, so when its levels suddenly drop, it can disrupt sleep patterns. Additionally, the decrease in progesterone levels can cause a rise in body temperature, making it more difficult to fall asleep and maintain a comfortable sleeping environment.

The hormonal changes during the luteal phase can also impact the production of melatonin, a hormone that promotes sleep. Women with premenstrual dysphoric disorder (PMDD) have been found to produce less melatonin during this time, further contributing to sleep difficulties.

The impact of hormonal changes on sleep is complex and multifaceted. While the drop in progesterone levels is a significant factor, it is also believed that the rate of change in hormone levels can influence sleep quality. The steepness of the rise and fall of hormone levels can affect body temperature and melatonin production, ultimately influencing sleep patterns.

In addition to hormonal changes, other factors related to the menstrual cycle can also contribute to insomnia. Physical symptoms such as cramps, bloating, and breast tenderness, as well as mood symptoms like anxiety and depression, can make it challenging to fall asleep and maintain restful sleep.

People with PMS are twice as likely to experience insomnia

Other reasons for insomnia during this time include physical symptoms such as cramps, bloating, tender or swollen breasts, constipation or diarrhoea, and sensitivity to noise and light. Mood symptoms such as anxiety, sadness, irritability, anger, and tension can also contribute to sleep difficulties.

Additionally, people with PMDD, a severe form of PMS, may experience even greater sleep disturbances due to reduced melatonin levels and an increased response to melatonin during this time.

Heavy periods can cause sleep disturbances

Women who suffer from premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) experience poor sleep more frequently than those without either condition. PMS and PMDD can involve changes to sleep, such as sleeping for too long or not being able to sleep enough.

In addition, sleep quality can affect your cycle length. Sleeping poorly, sleeping too little, or experiencing sleep changes (like travelling across time zones) can lead to longer or shorter cycles than normal.

PMDD can cause insomnia and worsen sleep quality

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that causes more serious anxiety or depression in the one or two weeks leading up to a person's period. PMDD can cause insomnia and worsen sleep quality.

Research shows that women with PMS are twice as likely to experience insomnia before and during their period compared to those without the disorder. This number rises to 70% for women with PMDD. People with PMDD may experience insomnia, poorer sleep quality, and increased daytime tiredness compared to those without the disorder.

PMDD can cause insomnia due to hormonal changes. During this time, people with PMDD produce less melatonin, a hormone that promotes sleep. Their bodies also have a blunted response to melatonin. Increases in the hormone progesterone in the week before menstruation may also contribute to sleep troubles.

In addition to hormonal changes, other physical and mental symptoms of PMDD can also disrupt sleep. These include cramps, bloating, anxiety, depression, anger, and irritability.

Body temperature changes can impact sleep

Your body temperature naturally dips a bit before and during sleep. Running a bit hotter than usual might make it harder to fall asleep or sleep well throughout the night. A 2014 study with 27 women with PMS found that a steeper rise of progesterone in the days leading up to their period was tied to greater sleep disturbances. Progesterone is known to raise body temperature.

Cooling your room's temperature to around 65°F (18°C) can also help you fall asleep. That may mean keeping the window open at night or using fans.

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