What is insomnia?

Awake in the middle of the night? It may just be a sign that your menstrual period is coming. 

Insomnia is a sleep disorder in which it is difficult to fall asleep or stay asleep. This may be a long-term problem or may last for a few days or weeks.

How well you sleep matters. If you’re not getting quality sleep, it may affect how you function in the daytime. You are likely to feel anxious, tired, or irritable when you have insomnia.

When your insomnia lasts for several months it may be classified as chronic insomnia. Chronic insomnia increases your risk of:

• Cancer
• Coronary heart disease
• Diabetes
• High blood pressure

Is it normal to get insomnia before your period?

About 70% of all women say that they experience changes in their sleep before their period begins. This usually starts 3 to 6 days before their period. For some women, sleep issues are the only symptom of their premenstrual syndrome (PMS).

About 20% to 40% of women in the US experience PMS symptoms. About 3% to 8% experience severe symptoms. This is known as premenstrual dysphoric disorder (PMDD).

Other PMS symptoms include emotional responses, including:

• Anxiety
• Confusion
• Irritability
• Angry outbursts
• Depression
• Social withdrawal
• Changes in sexual desire
• More naps
• Crying spells

‌

Physical symptoms include:

• Fatigue
• Headache
• Stomach pain
• Weight gain and bloating
• Breast tenderness
• Food cravings
• Skin problems

Why does PMS give you insomnia?

Women are about 1.25 times more likely to have insomnia than men. This may be due to hormonal changes during menstrual periods.

Hormonal changes. The two main hormones that control your menstrual cycle are estrogen and progesterone.

In the week before your period, your progesterone levels increase. Your body prepares itself for a potential pregnancy. But if you do not become pregnant, your progesterone levels then drop dramatically. This causes the start of your period as the lining of your uterus is shed.

Progesterone has a sleep-inducing effect. The sharp drop in progesterone levels just before your period may be why PMS gives you insomnia.

Body temperature changes. Sleep and body temperature are linked. Your body temperature naturally lowers near bedtime. The drop in body temperature allows you to move into the deeper stages of sleep.

Throughout your menstrual cycle, your core body temperature changes. It’s about 0.3 degrees Celsius to 0.7 degrees Celsius higher after ovulation, and remains high until your period begins.

Your body temperature then drops back down to your regular temperature. As your body temperature is higher just before your period, it may have an effect on your sleep.

Polycystic ovary syndrome (PCOS). If you have polycystic ovary syndrome, you may have irregular menstrual periods, lower progesterone levels, and high testosterone levels. This can make your sleep disturbances worse.

Studies have also shown that people with PCOS may have a higher risk of sleep apnea. This is when you stop breathing for short periods during sleep.

These short pauses in breathing may happen up to 400 times a night. They might not wake you up but can still disturb your sleep. Some symptoms include:

• Feeling sleepy in the daytime
• Fatigue
• Irritability
• Forgetfulness
• Morning headaches
• Less interest in sex
• Mood changes

Perimenopause and insomnia

If you’re near menopause (perimenopause), your hormone levels fluctuate often and your menstrual periods become irregular. This can cause night sweats and hot flashes, which are feelings of warmth that spread over your body. This may make you wake up at night.

How to deal with PMS insomnia

To find out if your insomnia is linked to your menstrual cycle, keep a diary of your symptoms for a few months. List your daily symptoms, and the dates of your period.

This will help you figure out if there’s a link between your period and sleep problems. It also means you have a list of symptoms handy if you’re talking to a health professional.

Here are some tips on managing PMS insomnia:

• On the days leading up to your period, try to get more rest and sleep.
• Exercise more. 
• Try to get more sunlight before and during your period. 
• Maintain a healthy diet. 
• Eat less salt and sugar, and more foods rich in calcium.
• Cut down on alcohol and caffeine.
• Some women with PMS may have low melatonin levels. Talk to your doctor about taking melatonin. 
• Don’t stress too much about your sleep problems. Remember that it’s only temporary and will improve when your period is over. 

Relaxation therapy may also help. This includes:

• Breathing exercises
• Yoga
• Meditation
• Massages
• Biofeedback. This uses sensors to teach you to control body processes that are involuntary. 
• Self-hypnosis