Can Premenstrual Syndrome Cause Insomnia?

Do you have difficulties falling asleep and staying asleep before or during your period? If so, you may be affected by PMS (Premenstrual Syndrome). Women with PMS have difficulty falling and staying asleep just before the beginning of their period and they may spend several restless nights tossing and turning in bed.

Each phase of the menstrual cycle impacts your sleep differently and hormones play a huge role in this. The levels of hormones such as estrogen and progesterone which regulate the menstrual cycle may fluctuate between the phases and in that way affect the quality of your sleep.

How Exactly Can PMS Give You Insomnia?

The menstrual cycle is divided into two main phases: follicular and luteal. Follicular phase is the first phase of the menstrual cycle during which the production of estrogen increases in your body leading to ovulation.

The second phase, the luteal phase, occurs after ovulation and during it the levels of progesterione increase causing a sophoric effect, which means that you will feel a bit drowsy. Then, just a few days before your next period begins, estrogen and progesterone levels drop and this is when many women have trouble sleeping and when they may experience insomnia. 

There are also some opinions that women who have higher amounts of progesterone and a more abrupt withdrawal of this hormone are more likely to have insomnia than other women with whom this is not the case. 

Also, women experience less REM sleep in the luteal phase of their cycle as during this stage, the increased production of progesterone increases the core body temperature, and REM sleep is known to occur at the time of the night when body temperature is lowest. This is why REM sleep is tougher to achieve during the second half of the menstrual cycle and why insomnia may appear. 

Melatonin, the sleep hormone, seems to be closely connected to these changes in the levels of estrogen and progesterone as well. Receptors for female hormones and melatonin both occur in the same areas of the brain, and melatonin is even found in ovarian fluid.

But, although the relationship between melatonin and the fluctuations in the hormone levels is evident, it is really complex. Some studies show that melatonin and progesterone oppose each other, while other studies show that they support the actions of each other. Estrogen, however, seems to reduce melatonin action. 

Serotonin levels which affect your mood can drop as progesterone drops causing cravings for sugars and carbs which can affect your sleep, and low mood also triggers sleep problems.

What Other PMS Factors Contribute to Insomnia?

Other Symptoms of PMS such as cramps and bloating can cause physical discomfort and make it difficult to fall asleep and stay asleep. Emotional variability, anxiety, stress, irritability and fatigue can also contribute to insomnia. 

Furthermore, cravings for sugar that we mentioned or caffeine can negatively impact the quality of your sleep especially if they are consumed in the evening or right before bedtime.

In addition, heavy meals eaten right before bedtime with lots of refined carbs can be hard to digest which may additionally increase the temperature of your body making it impossible to fall asleep. Low levels of iron in your blood during your period can also take a toll on the quality of your sleep. 

Alcohol is another factor that can contribute to poor sleep. During your period, your liver is working hard trying to regulate your body’s temperature and it may be hard for it to process alcohol as well. This too as the result may increase your body temperature and make you unable to fall asleep. 

How To Determine Whether You Have PMS?

To determine whether or not you have PMS, you can talk to your doctor who will give you instructions how to carefully track your cycles and moods on a graph for a few months. You will also have to measure your female hormones several times during the first half and second half of your cycle. This is done via using blood samples or saliva samples.

You should measure the pituitary hormones (FSH and LH) in your blood as well at least once in each half of the cycle and your melatonin in the second half of the cycle by testing saliva and keeping a journal of what you are eating during that time.

Keep a track of your pains and aches during that period as this may point to an inflammation which lowers the production of seratonin in your brain. This will help you be sure it is PMS, and together with your doctor you can further figure out what to do to relieve the symptoms and combat sleep problems related to them. 

How To Deal With PMS and Improve Your Sleep?

Women with insomnia caused by PMS may find relief by practicing the following:

  • Keep your bedroom cool and dark and practice a good sleep hygiene – Make sure your room is dark and cool. A cool temperature in the mid-60 degrees Fahrenheit is considered ideal for sleep. Try to keep your room as quiet as possible as well. If this is not possible, play some gentle music to block out any background noise such as traffic, go to bed at the same time every night and wake up at the same time every morning. 
  • Avoid using electronics before bedtime – You should avoid using electronic devices at least an hour before bed and avoid exposure to blue light which can affect the production of chemicals in your brain in such way that will interfere with your sleep. 
  • Exercise more – Exercising exhausts your body and improves your mood and in that way makes it easier for you to fall asleep at night. It also promotes deep-sleep stages which are necessary for complete relaxation and rejuvenation. However, you should avoid exercising right before your sleep as this will elevate your body temperature.
  • Manage your diet and avoid alcohol – The levels of progesterone are highest around ovulation and during the luteal phase, and they can exacerbate the effects of alcohol. Drinking alcohol at night can cause wakefulness and fragmented sleep. Eat your dinner two hours before bed and make sure you don’t eat too large meals rich in carbs and sugars. 
  • Try meditation and relaxation exercises – Meditation and breathing exercises can help you quiet the mind and relax before bed. 
  • Get a comfortable mattress – sometimes a comfortable cooling mattress can relieve the symptoms of PMS. Visit our mattress reviews page and find out which mattress would best work for you.

Other Treatment options

Sleep deprivation can help normalize cicardian rhythms, mood and REM sleep during the second phase of the menstrual cycle. Some women may also benefit from light therapy which has been found to reduce insomnia. Some doctors may prescribe antidepressants, certain progesterone or melatonin supplements or Z-drugs for PMS and PMDD which may help address related sleep problems.