Period Insomnia: Symptoms, Causes, And Treatment

The menstrual cycle has a significant effect on every woman's life. Around a week before their period begins, some women start experiencing various symptoms, many of which can be unpleasant. One of them is disturbed sleep.

Studies¹ show that menstruation can have some effect on sleep phases. The problem may be related to hormonal fluctuations. While more research is needed to identify the exact cause, several ways to control period insomnia exist. Let's take a closer look at what they are.

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What is period insomnia?

Period insomnia is a condition that can last for several days before your period and continue into menstruation. Sleep issues are among the most common symptoms attributed to PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder).

While this condition requires more research, scientists have some theories about its causes. If you have sleep problems before and during menstruation, you should speak to your doctor. They can suggest effective treatments for menstrual insomnia.

Stages of the menstrual cycle

To get a better understanding of the causes of period insomnia, it's essential to learn the basics of the menstrual cycle. A normal cycle varies from 21-40 days, with the average being 28 days.

What are the stages of the menstrual cycle?

The three stages of the menstrual cycle are:

Follicular stage

This stage begins on the first day of menstruation. Your body releases follicle-stimulating hormone (FSH), and ovarian follicles start developing. This continues for 10-17 days.

Ovulation

At this point, your body produces luteinizing hormone (LH), and the follicle releases an egg that survives for up to 24 hours, waiting to be fertilized.

Luteal stage

After ovulation, estrogen declines, and progesterone levels increase. Progesterone stimulates the growth of the uterine lining, which can house a fertilized egg. If fertilization doesn't occur, progesterone levels start dropping. This stage lasts for about 14 days.

The menstrual phase is part of the follicular stage. During this stage, your body understands that it's not pregnant. It starts discarding the unnecessary lining and getting ready for the next ovulation. The menstrual part of the follicular stage lasts around five to seven days.

PMS and PMDD

PMS, PMDD, and sleep disruption symptoms usually occur during the luteal phase of your menstrual cycle.

  • PMS: A combination of physical and emotional symptoms that reduce your quality of life. Common symptoms include tender breasts, bloating, headaches, irritability, tension, and sleep problems.

  • PMDD: Symptoms of this more severe form of PMS can include fainting, poor coordination, depression, agitation, and lack of control.

The exact causes of PMS and PMDD are currently unknown. Scientists often link them to hormonal fluctuations.

How common are PMS and PMDD?

Around 90% of women experience some PMS symptoms. Premenstrual dysphoric disorder is more severe but less common, occurring in 3 to 30% of women².

Causes of period insomnia

Researchers have done several studies to determine the cause of poor sleep quality during the luteal phase. Around 66%³ of women with PMDD say they have trouble falling and staying asleep several days before their period. While poor sleep quality is a symptom of severe PMS, scientists are yet to discover why. 

Effects of progesterone

During the luteal phase, the amount of progesterone produced by your body increases to build the uterine lining for a possible pregnancy. Once the body realizes that pregnancy didn't occur, progesterone levels start decreasing.

Besides a variety of functions, progesterone is also a calming and soothing hormone. It has a hypnotic function⁴ that helps people sleep. When the amount of progesterone dips, it could affect sleep quality.

Effects of estrogen

Estrogen also affects your sleep-wake cycle. It keeps your body temperature low at night, helping you sleep better. This hormone can also have an anti-depressant effect, stimulating better sleep quality.

The drop in estrogen levels during the luteal phase could cause sleep problems.

Effects of melatonin

Women with PMDD and insomnia during the luteal phase have decreased melatonin secretion.

Melatonin is a naturally-occurring hormone. When it's dark, the pineal gland in your brain starts producing melatonin to facilitate your transition to sleep. The hormone plays an essential role in regulating your circadian rhythm.

Problems with melatonin secretion could be the reason behind period insomnia. However, researchers still need to conduct studies to confirm the link.

Effects of anxiety

Anxiety, depression, and mood swings are common PMS and PMDD symptoms. These problems can directly affect your quality of sleep.

If you are depressed and anxious during the day, you will likely experience sleep problems. Insufficient sleep leads to even more mood swings during the day.

Additionally, unpleasant symptoms such as bloating, pelvic pain, headaches, and muscle aches could keep you awake.

How to sleep better before your period

If period insomnia is something you struggle with, contact your doctor. They may suggest several ways to alleviate the symptoms.

Improve sleep hygiene

Sleep hygiene is a set of tactics aimed at improving your sleep quality. They include:

  • Going to sleep and waking up at around the same time every day.

  • Avoiding daytime naps.

  • Not staying awake in bed for more than 15 minutes. If you can't fall asleep, sit in a chair or stand until you feel sleepy again.

  • Avoiding TV, reading, or using mobile devices in bed.

  • Avoiding caffeinated drinks later in the day.

  • Ensuring there’s fresh air in your bedroom. You can either keep it open during the night or for at least five minutes before going to sleep if it’s too cold.

  • Ensuring your bedroom is comfortable: Lights off, comfy mattress, no snoring partner.

Following these tips every night can help you rest better regardless of the stage of your menstrual cycle.

Take medication

Your doctor may prescribe medication to control your PMS symptoms, including insomnia.

Supplements

Melatonin supplements could help improve your sleep during the luteal phase. There is some evidence that progesterone supplements may also help, but this requires further research.

Pain relievers

If aches and pains related to PMS and PMDD interfere with your sleep, common over-the-counter pain relievers, such as NSAIDs, can control the symptoms.

Besides medication, your doctor may also suggest changing your diet. An unhealthy diet could worsen PMS symptoms by contributing to bloating, constipation, and fluid buildup.

The lowdown

Many women who experience PMS and PMDD face sleep problems. Talk to your doctor if you are having trouble falling and staying asleep for a few days before your period.

While scientists are working hard to identify the reason behind period insomnia, you can address the problem by improving your sleep hygiene, taking medication, and sticking to a healthy diet.

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