When that time of the month comes round, women can find themselves tossing and turning in bed far more often than usual. With age, as periods stop and menopause begins, sleep problems can persist or worsen. Like sleep, menstrual cycles and menopause are natural bodily occurrences. How can these essential functions disrupt sleep? Let’s dig in. 

How does your period affect sleep? 

Women undergo physical and emotional changes before and during their period, some bothersome, some painful. Many women report that their menstrual cycle affects their sleep in some way, and it is most common for these sleep problems to occur in the 3-6 days leading up to the period (when menstrual bleeding begins). The severity of sleep issues can range from a few restless hours to insomnia-like problems. 

Is PMS linked to insomnia? 

Sleep-related symptoms that occur around your period may be linked to Premenstrual Syndrome (PMS), the combination of symptoms that occur a week or two before a period begins. PMS doesn’t necessarily occur during every menstrual cycle, but three in four women report experiencing PMS symptoms at some point in their life.  

Women who have PMS are twice as likely to experience insomnia before and during their period. The more severe the premenstrual symptoms, the more likely it is that sleep is disrupted and sleep quality will decline. 70% of women diagnosed with Premenstrual dysphoric disorder (PMDD), a more severe form of PMS, have insomnia.  

What causes sleep problems during PMS? 

Every woman is unique, experiencing different physical and emotional symptoms before and during their period. Researchers are still uncovering what happens during PMS that can lead to sleep disruptions, but studies suggest that period-related sleep issues are most likely triggered by the causes below: 

  • Changing hormone levels: This is the most common, and the most significant cause of disturbed sleep before and during PMS. Hormones rise and fall throughout your menstrual cycle. Estrogen builds up during ovulation, and progesterone levels rise after ovulation. Before the start of the period, levels of both estrogen and progesterone drop. Researchers believe that this is when many women have trouble sleeping. It is also theorized that the faster the withdrawal or the larger the decrease of the hormones, the more likely a woman is to experience insomnia.  
  • Increased body temperature: Low estrogen levels around your period can lead to hot flashes and night sweats, which can disturb your sleep. Progesterone can also increase body temperature during menstrual cycles, which has a negative impact on sleep.  
  • Mood changes: PMS may lead to feelings of anxiety and depression, which are strongly linked to sleep issues. Emotional mood swings can lead to conflicts and tension with friends and family, further exacerbating anxiety at night time and affecting sleep. 
  • Pain: Headaches and cramps are common symptoms related to periods. Severe pain can keep women from getting good sleep during their cycle.  
  • Significant menstrual bleeding: Once periods begin, the disturbed sleep can continue. Women who have a heavy flow may have to get up multiple times throughout the night to change pads or tampons, making it harder for them to fall asleep. 

How does menopause impact sleep?  

When women stop menstruating and ovaries stop producing estrogen and progesterone, menopause begins. This is considered the end of a woman’s reproductive years. The loss of hormones can lead to unpleasant emotional and physical symptoms that can disrupt sleep. Over 35% of women experience sleep disorders throughout perimenopause into post-menopause.  

  • Hot flashes: One of the most common menopausal symptoms, hot flashes are a  sudden temporary warming of the body, often accompanied by flushing, adrenaline, and sweating. When they happen at night, hot flashes are called night sweats and can significantly disturb sleep and impact overall sleep quality.  
  • Insomnia: In part due to the disturbances of hot flashes, it is common for menopausal women to experience insomnia and regularly have difficulty sleeping. Over half of postmenopausal report insomnia symptoms.  
  • Sleep apnea and sleep-disordered breathing: Studies indicate that menopausal women, specifically those in the postmenopausal stage, are more likely to develop Obstructive Sleep Apnea (OSA) or sleep-disordered breathing (i.e., snoring) than non-menopausal women.  

How to sleep better while on your period and during menopause: 

  • Keep your bedroom cool, avoiding heavy pajamas and blankets 
  • Cut down or try to avoid  caffeine and alcohol and other liquids close to bedtime
  • Reduce stress and anxiety through meditation, breathing techniques, or a calming bedtime routine 
  • Maintain a consistent sleep and wake schedule 
  • Exercise regularly 
  • Keep a journal to determine what other factors may be contributing to your sleep problems  

Talk to a doctor if you experience ongoing disrupted sleep that impacts your daily activities. Whether you’re experiencing monthly periods or are in the throes of menopause, your sleep quality may suffer. As you gain a deeper understanding of the profound changes your body is going through, you can arm yourself with the necessary steps that work for you to improve your sleep.