The week or two before a person’s period are often marked by premenstrual syndrome (PMS), which includes a host of bothersome symptoms like mood changes, bloating, breast tenderness, and trouble sleeping. Some people refer to sleep issues during this time as PMS insomnia or period insomnia.
The drivers behind PMS insomnia are multifaceted and not fully understood, but one thing is for sure: With the right steps, you can get better sleep leading up to and during your period. Below, we’ll discuss what might lead to PMS insomnia, when it starts, and steps you can take to get better rest during this stage of your cycle.
Can PMS Cause Insomnia?
PMS is associated with insomnia and subjective lower quality sleep, especially in the days right before menstruation (late-luteal phase) through the first couple days of a person’s period.
There are a variety of reasons why sleep might be impacted during PMS. Sex hormones, like estrogen and progesterone, have an impact on areas of the brain that regulate sleep. PMS is also associated with a wide range of physical and psychological symptoms that can have a negative impact on sleep.
What complicates the question is the fact that while many people report having trouble sleeping during the late-luteal phase of their menstrual cycle, sleep disturbances aren’t often picked up by laboratory sleep studies.
Does PMDD Cause Insomnia?
Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. While PMS usually involves one to four symptoms, PMDD is marked by five or more symptoms, one of which is mood-related.
Similar to PMS, PMDD is associated with insomnia during the late-luteal phase due to a sharp drop in hormone levels during this time. In PMDD specifically, lower estrogen levels can lead to a drop in neurotransmitters like serotonin, which can in turn trigger insomnia. Those with PMDD also show a lessened response to melatonin during their luteal phase.
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Why Is It Hard to Sleep Before Your Period?
Women are 40% more likely to experience insomnia than men, and many report that the time right before their period is when they have the most trouble sleeping. There are many processes going on in a person’s body before their period, so it stands to reason that sleep would be impacted. Here, we outline the main drivers of PMS insomnia.
Hormonal Changes
A person’s menstrual cycle is marked by the fluctuations of four main hormones, and they affect more than just the reproductive system. The specific level of a hormone has less impact on sleep than when hormone levels change, which explains why sleep disturbances are most common during the late-luteal phase when hormone levels drop significantly.
Hormonal changes impact sleep in the following ways:
- Less deep sleep: Studies show that people experience more deep sleep during the parts of their cycle when progesterone levels are higher, underscoring the theory that progesterone promotes sleep. During the days leading up to a person’s period, progesterone drops, and sleep quality worsens.
- Increased body temperature: Progesterone is associated with a higher core body temperature during the beginning of the luteal phase, including a smaller nighttime temperature decline. Because temperature regulation is involved in sleep, this is one proposed contributor to premenstrual sleep complaints.
- Reduced REM: Rapid eye movement (REM) — the sleep phase associated with high brain activity and vivid dreams — is reduced during the luteal phase. This may exacerbate any emotional symptoms of PMS, as less REM sleep is associated with more emotional reactivity.
Mood Changes and Stress
Due to fluctuations in hormone levels, mood changes are hallmark symptoms of PMS, and their impact on sleep cannot be understated.
- Anxiety and stress: Feelings of anxiety and stress are common during PMS and can impact a person’s ability to fall and stay asleep. Those who develop insomnia may also start to experience anxiety around sleep itself.
- Depression: Some people with PMS or PMDD experience symptoms of depression, which is highly linked to insomnia. Lack of sleep due to insomnia can also worsen symptoms of depression.
- Daytime fatigue: It’s worth noting that in studies where self-reported sleep disturbances didn’t appear in lab tests, researchers theorize that anxiety is likely the factor at play. Even among those who don’t necessarily experience PMS insomnia, anxiety can lead those with PMS to feel much less rested during the day.
While mood changes are common during PMS, if you experience symptoms of anxiety or depression that impact your functioning, it’s important to talk to your doctor.
Physical PMS Symptoms
PMS also comes with a variety of physical symptoms, many of which get in the way of a good night’s sleep:
- Bloating
- Breast tenderness
- Fatigue
- Headaches
- Hot flashes and night sweats
Some PMS insomnia lasts through the first few days of a person’s period. Painful abdominal cramping during this time can make it difficult to sleep.
When Does PMS Insomnia Start?
PMS insomnia usually starts during the late-luteal or premenstrual phase, which is a few days before menstruation. Just as not all people experience a predictable menstrual cycle, timing of PMS insomnia can vary substantially. Interestingly, those with more variable menstrual cycles are more likely to experience PMS insomnia.
PMS insomnia tends to improve after a person’s period begins, but some still have trouble sleeping during the first couple of days when abdominal cramping is at its worst.
How to Sleep on Your Period
PMS insomnia can be highly disruptive, but there are ways that you can sleep better before and during your period.
Establish a Bedtime Routine
A calming bedtime routine will prepare your mind and body for sleep each night. Try going to bed and waking up around the same time each day and doing something relaxing before bed, like light stretching, journaling, or taking a bath.
Get Sunlight Each Day
Sun exposure, especially in the morning, helps to regulate your internal body clock. Just be sure to stay away from artificial light — from phones and other screens — an hour or two before bed.
Limit Caffeine and Alcohol
Try to limit your coffee to the morning, and avoid alcohol, especially close to bedtime.
Try Magnesium
Magnesium supplements can sometimes help improve sleep quality, and they can also help reduce PMS symptoms like mood changes, irritability, and bloating. Talk to your doctor before starting any supplements.
Track Your Period and Sleep
To see if your sleep issues coincide with your premenstrual phase, keep a sleep diary for a while. Record the day of your cycle and any sleep problems you may have had. After a couple of months, look for any correlations.
Consider Medication
Some people have found that taking birth control helps their PMS symptoms, including insomnia. Antidepressants can also be helpful for anyone with more severe anxiety or depression. Be sure to talk to your doctor.
When to Talk to Your Doctor
Some disrupted sleep is bothersome, but you should talk to your doctor if your PMS insomnia interferes with your daily life. Chronic insomnia is characterized as trouble sleeping several nights a week for at least three months. Your doctor will be able to discuss insomnia treatment options with you.
If your PMS symptoms are severe, it’s also a good idea to talk to your doctor to see if you might have PMDD.
Frequently Asked Questions
Do you need more sleep on your period?
There are no separate sleep guidelines for people on their period. The American Academy of Sleep Medicine recommends that all adults get at least seven hours of sleep per night.
However, because your sleep is likely to be disrupted by changing hormone levels and/or physical symptoms like abdominal cramps, you may feel like you need more sleep during your period. Many people also experience fatigue before and during their period and might need extra rest.
Why do I sleep so much on my period?
There are several factors that might make you feel like you need to sleep more during your period, a phenomenon that many call menstrual or period fatigue. Symptoms like mood changes or cramps can interrupt your sleep, leading you to sleep in or take a nap to make up for lost sleep.
People who experience heavy bleeding during their periods may also have low iron levels, which can cause fatigue. Your body goes through a lot during your period, and you may just feel that you need extra rest.
Can lack of sleep affect your period?
Lack of sleep can make your PMS or period symptoms worse. Sleep disturbances can make it more difficult to regulate your emotions and can exacerbate aches and pains. There’s also some evidence to suggest that lack of sleep may also make your cycles more irregular.
