Premenstrual syndrome may manifest in different ways, including changes to your sleep cycle. So, if you have difficulty falling or staying asleep in the days leading up to your period, hormones may be the reason.
If you have premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), you may be more likely to experience sleep difficulties, like taking a long time to fall asleep, waking multiple times throughout the night, or not feeling rested after a night’s sleep.
Research shows an association between PMS and sleep disturbances, although the mechanisms underlying this relationship aren’t always clear.
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Symptoms of PMS-related insomnia may include:
- difficulty falling asleep
- waking up in the middle of the night
- difficulty returning to sleep
- feeling fatigued and sleepy during the day
- irritability and low mood
- challenges with concentration or memory
Other PMS symptoms may also keep you awake or interrupt your sleep:
- cramps
- bloating
- tender or swollen breasts
- constipation or diarrhea
- headache
- sensitivity to noise and light
- mood symptoms, like anxiety, sadness, and irritability
Not everyone experiences severe PMS symptoms or all of the above, including insomnia, but most people experience some of them at least once in their lifetime.
Hormonal fluctuations during the luteal phase (the 1 to 2 weeks before your period), particularly changes in estrogen and progesterone levels, may be behind the sleep disruption.
Hormonal shifts can elevate core body temperature and interrupt sleep, especially the REM sleep phase (when you dream).
The late luteal phase affects stage 2 sleep and REM (rapid eye movement) sleep even if you don’t have PMS symptoms.
Other PMS symptoms that may also lead to lack of sleep include physical challenges (cramps, bloating) and mood changes (anxiety, depression).
The following risk factors may also increase the chance of having insomnia:
- being female
- older age
- family history of insomnia
- high caffeine use
- high or frequent alcohol use
- irregular bedtime
- smoking
- lack of exercise
- high stress levels
- mental health conditions
Cognitive-behavioral therapy for insomnia (CBT-I) is a first-line treatment for insomnia.
Although there aren’t any quality studies that show its efficacy in people with PMS or PMDD, syncing CBT-I interventions with menstrual cycle phases may offer symptom relief to some people.
Melatonin supplementation may be an option for some people with PMS-related insomnia,
Natural remedies for insomnia
There are several things you can try at home to ease insomnia before your period:
- Keep a consistent sleep schedule. Go to bed and wake up at the same time throughout the week.
- Get regular exposure to daylight.
- Limit phone and TV use at night.
- Try all-natural sleep supplements like valerian, ashwagandha, CBD, kava, or theanine. (Be sure to check with a doctor first, though. Some of these remedies can interact with medications and other supplements.)
- Meditate daily to help manage stress.
- Exercise daily.
- Avoid caffeine close to bedtime.
- Eat a diet full of veggies, fruit, whole grains, and lean protein. Limit processed foods and sugary foods when you can.
People with PMS and PMDD are more likely to have insomnia and other sleep disturbances during their period and the days leading up to it.
Menstrual-related sleep problems are likely driven by fluctuating hormones as well as their rate of change. These hormonal changes may worsen sleep due to their effects on body temperature and melatonin production.
If you have PMS insomnia, consider talking with your primary care doctor or gynecologist about your symptoms so you can discuss your treatment options.
