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Studies have found that due to hormonal changes in the body, women are more likely to experience poor sleep than men. These hormonal changes are related to a woman’s menstrual cycle particularly when experiencing signs of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD).
How does PMS and PMDD affect sleep?
Research found that women with PMS are at least twice as likely to experience insomnia before and during their period. Poor sleep can result in excessive drowsiness throughout the day leading to being unfocused, unproductive and unmotivated.
For some women, PMS requires them to sleep a lot more than usual as they experience extra fatigue and tiredness around their period. PMS can also cause mood changes such as depression that may lead to sleeping too much (hypersomnia).
Women who experience PMDD, usually experience heightened insomnia-like problems compared to women who experience PMS. Approximately 70% of women with PMDD experience insomnia-like problems before their period and approximately 80% of women describe feeling tired.
Why does PMS affect sleep?
Researchers aren’t certain about exactly why PMS negatively affects sleep although research highlights potential reasons for this symptom. Change in hormone levels and the rate of the change can influence a woman’s ability to fall asleep as well as contribute to additional sleep disruptions if she experiences PMS. To understand this further, it is important to recognise the four phases of a menstrual cycle and how they can alter your hormones, ultimately affecting you physically, emotionally and mentally.
Hormonal changes before and during your period can disrupt your sleep through effects on your body temperature and melatonin production. Studies have found that during a menstrual cycle, sleep worsens particularly at the late-luteal phase when PMS arises. It is in this phase that progesterone is at its peak. Progesterone is the hormone responsible for increasing your body’s temperature which can interrupt your sleep. Additionally, some research has discovered varying levels of melatonin in women with PMS during the menstrual cycle leading to period insomnia.
Although some results have been inconsistent, some research has found that women who have PMS, also have what is called altered sleep architecture. This means that stages of their sleep cycle are abnormal. An example of this from the Sleep Foundation (2022) was that some women “have less rapid eye movement (REM) sleep during the late-luteal phase. REM sleep involves heightened levels of brain activity and is associated with vivid dreaming. These changes to sleep architecture may occur even in women who do not have PMS.”
PMS can bring on some mood changes and trigger anxiety and depression which can contribute to pre-period sleep issues. Women may feel like they had a more difficult time falling asleep and wake up tired or less well-rested.
14% of women have extra heavy periods resulting in interrupted sleep to change pads and tampons throughout the night. These women sometimes suffer with greater anxiety around sleep in the case they have a night-time accident staining their pyjamas, sheets or mattress.
Where to go from here… how do I help my period insomnia?
As established above, period insomnia can happen for a few different reasons. Below are some recommendations based on information from the Sleep Foundation on steps you can take to help you sleep better during all phases of your menstrual cycle.
Sleep hygiene
Having good sleep hygiene will not necessarily eliminate PMS-related sleeping problems however, with consistency, it helps build stability by providing tools to help you fall asleep easier and fend off insomnia. Although it is important to focus on sleep hygiene throughout your whole menstrual cycle, it is additionally beneficial to focus on it before your period starts. Steps towards this include:
Manage symptoms of PMS
The days leading up to the beginning of your period is the most common time women experience sleeping problems. By managing symptoms of PMS, it may make the syndrome easier to cope with resulting in better sleep. If you’re experiencing PMS and it is affecting your sleep, make sure to talk to your doctor about these problems so they can make an informed choice about suitable treatment. Things that may help relieve symptoms:
Combatting leakage
For women who experience extra heavy periods and worry about bleeding excessively at night, here are some options for you:
Some hormonal terms discussed in this blog you may not know…
Estrogen: any of a group of hormones which promote the development and maintenance of female characteristics of the body.
Progesterone: a sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species.
Testosterone: a hormone that is considered a male sex hormone however women produce small amounts of testosterone in their ovaries and adrenal glands. Together with estrogen, this hormone plays an important role in the growth and maintenance of female reproductive tissue and bone mass, additionally they influence behaviour.
Melatonin:a “hormone that is essential to the regulation of circadian rhythm and regular sleep patterns.”
Additional resources
Suni, E. (2022). PMS and Insomnia. https://www.sleepfoundation.org/insomnia/pms-and-insomnia
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