While the relationship between the female menstrual cycle and sleep has historically been understudied, what we do know is there is a correlation between the two. Women are statistically more likely to suffer from poor sleep quality than men. The exact cause of this discrepancy is unknown, but one likely attributing factor could be the menstrual cycle, and the hormonal changes that come with it.
While the relationship between the female menstrual cycle and sleep has historically been understudied, what we do know is there is a correlation between the two. Women are statistically more likely to suffer from poor sleep quality than men. The exact cause of this discrepancy is unknown, but one likely attributing factor could be the menstrual cycle, and the hormonal changes that come with it. Restorative sleep is extremely important to one’s emotional, physical, and mental health, so if you are having intermittent episodes of poor sleep, it’s worth understanding if there is any correlation with your menstrual cycle.
Hormonal Changes During Menstruation
During your menstrual cycle, your hormones are constantly fluctuating. Hormones such as estrogen and progesterone rise and fall according to the different stages of menstruation. These hormonal changes have a significant effect on your body's physical and emotional processes, which explains why many women experience changes and symptoms in their bodies in the time leading up to their period.
One way in which these hormonal changes directly affect sleep is through body temperature and melatonin production. Progesterone can increase your body temperature to the point where it disrupts your sleep, and some studies have shown that your levels of melatonin, a hormone directly related to your sleep patterns and rhythm, can become altered during your cycle. In addition, your menstrual cycle can decrease the amount of REM sleep you get while increasing the amount of non-REM sleep, contributing to not feeling rested.
The majority of women are well aware of the bodily changes they might experience before their period. Their sleep may suffer to a limited degree, such as experiencing daytime sleepiness or an occasional episode of insomnia.There are however, a subset of people with profound symptoms related to their cycle that may be classified as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Suffering from PMS or PMDD can lead to sleeping too little OR too much.
Sleep And PMS
Premenstrual syndrome is defined as “extensive and bothersome symptoms that arise in the days preceding your period and can continue with menstruation.”
Women with PMS often suffer from poorer sleep than those without, i.e. having difficulty falling asleep, staying asleep, or being unable to go back to sleep once awakened. They are two times as likely to experience insomnia surrounding their period, which can often result in extensive fatigue during the day. This daytime sleepiness, compounded with other symptoms of PMS such as depression and headaches, can also lead to sleeping too much.
Sleep And PMDD
In comparison to PMS, PMDD(premenstrual dysphoric disorder) is defined as “a more severe condition involving at least five symptoms including significant changes to mood or emotional health.”
Much like PMS, women with PMDD have poorer sleep than those without and report feeling tired, depressed, and having sleep problems as their most prevalent symptoms. Studies have shown that women with PMDD see more of a “decrease in melatonin secretion as compared to non-PMDD women,” as well as more of a decrease in REM and slow-wave sleep. Over 70% of women with PMDD have reported having “insomnia-like problems” before the onset of their period.
One way you can combat the sleep issues associated with your menstrual cycle could be to talk to your doctor about your symptoms. If they suspect you may suffer from PMS or PMDD, you may be prescribed medication or supplements to alleviate your symptoms and help improve your sleep.
Another tactic is to focus on sleep hygiene in the days before your period. Incorporating methods such as going to sleep and rising at the same daily, limiting caffeine intake, and winding down before bed by meditating or reading a book can ensure you have a solid bedtime routine to help mitigate insomnia or other sleep problems related to your cycle.
NCBI - Sleep And Premenstrual Syndrome. (2017, February 23). National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323065/
Suni, E. (2022, March 11). PMS and Insomnia. Sleep Foundation. https://www.sleepfoundation.org/insomnia/pms-and-insomnia
Kennedy, K. E. R., Onyeonwu, C., Nowakowski, S., Hale, L., Branas, C. C., Killgore, W. D. S., Wills, C. C. A., & Grandner, M. A. (2021). Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample. Journal of Sleep Research, 31(1). https://doi.org/10.1111/jsr.13434