How Periods Impact Your Sleep

Sleep is essential for both our physical and mental health – but hormone fluctuations caused by the menstrual cycle can have a big impact on sleep quality and quantity. In this blog, we highlight the ways your period can impact your sleep and how to manage these changes.

Hormones affect far more than the reproductive system

Female hormones influence multiple systems across the body, including your immune system, metabolism and sleep patterns. Research has shown that women generally experience poorer sleep quality than men due to hormonal fluctuations, with many women reporting significant changes in their sleep throughout their menstrual cycle.

The impacts of hormonal changes on sleep vary between people. Some women report extreme fatigue (known as ovulation fatigue) and need more sleep, others feel restless and struggle to sleep, while others suffer from insomnia.

How each menstrual cycle phase impacts sleep

Each phase of your menstrual cycle signals changes in your hormone levels – and consequently, your sleep. Understanding what kind of sleep you can expect from each phase of your cycle is an important first step towards better rest.

Week 1: Your period can disrupt your sleep

Day 1 of your cycle begins on the first day of spotting or bleeding – this is also the beginning of your follicular phase. At the beginning of your cycle, all hormone levels are at their lowest, reducing your energy levels.

Week 2: Your follicular phase peaks

The follicular phase begins on day 1 of your cycle and peaks at ovulation, around day 14. During this phase, your oestrogen levels gradually rise – giving you a much-needed energy boost after your bleed.

The follicular phase is the time when you’re likely to get the best sleep – both in terms of quality and quantity. You’re no longer dealing with period symptoms and are more active, allowing your body to exert itself and rest more easily.

Oestrogen is also responsible for temperature regulation, so high oestrogen levels during this phase mean you’re able to stay more comfortable when sleeping.

Week 3: Your luteal phase begins

Your luteal phase begins at ovulation. During this phase, your progesterone levels steadily rise.

Progesterone is responsible for promoting sleep. It stimulates the production of a neurotransmitter called gamma-aminobutyric acid (GABA). GABA makes you feel tired and relaxed, encouraging better quality sleep.

Week 4: PMS and your sleep

The late luteal phase is when you’re most likely to experience poor sleep quality.

In the final stage of your cycle, around 3-6 days before your period begins, both progesterone and oestrogen levels drop significantly. This drop lowers GABA production and triggers PMS symptoms, leading to poorer sleep quality.

Does PMS cause insomnia?

Yes, PMS can cause insomnia, and the hormonal changes that occur during this phase of the menstrual cycle play a pivotal role. Two key hormones, oestrogen and progesterone, undergo significant fluctuations during the menstrual cycle, impacting various bodily functions, including sleep.

Menstrual cramps and discomfort associated with PMS can also contribute to difficulty sleeping. Pain and physical discomfort may make it challenging for women to find a comfortable sleeping position.

PMS is thought to impact around 12% of women, with nearly 75% experiencing some form of PMS in their lifetime.

What about PMDD?

PMDD, or premenstrual dysmorphic disorder, is an extreme version of PMS. There’s no single way to diagnose PMDD, but it’s defined as symptoms having a significantly negative impact on your lifestyle, relationships and well-being.

Research into Sleep and Premenstrual Syndrome has shown that it’s not just the changes in hormone levels that impact sleep quality – but the speed at which they change. Women with PMS and PMDD experience faster and more dramatic hormone changes than women without, making them more likely to experience a noticeable decline in sleep quality.

PMS and PMDD symptoms that can disrupt your sleep include:

• Pain and discomfort: including bloating, cramping, headaches, breast tenderness and muscle aches. 
• Body temperature: some women also have a higher basal body temperature in the lead-up to their period, again making it less comfortable to sleep.
• Poor mental health: poor mental health during the luteal phase is particularly common for women with PMDD and can reduce sleep quality.
• Melatonin response: some women experience altered levels of melatonin in their luteal phase – the chemical that regulates your sleep patterns. In particular, women with PMDD showed a decreased response to melatonin supplements in their luteal phase compared to their follicular phase.
• Sleep cycle changes: women with PMS have also been shown to move through the sleep cycle differently. It’s thought that women in the late luteal phase have less rapid eye movement (REM) sleep. This is the type of sleep where you are more active with more vivid dreaming – an important part of your brain’s processing and development time.

What if my period cramps are so bad I can’t sleep?

Period cramps have long been dismissed and minimised by medical professionals. However, new research shows some period cramps are more painful than a heart attack.

Painkillers like ibuprofen can ease milder cramps, whilst hot water bottles or heat pads can help relieve tension in your muscles. More innovative solutions such as TENS machines or CBD-infused products can also help ease period cramps when you’re trying to sleep.

Can a lack of sleep affect my menstrual cycle?

A temporary lack of sleep won’t cause any significant changes to your menstrual cycle. However, inadequate sleep over a long period can affect your menstrual cycle, and the mechanisms underlying this relationship involve hormonal imbalances and disruptions to the body’s circadian rhythm.

• Hormonal Imbalances: Sleep plays a crucial role in regulating hormone production, including those involved in the menstrual cycle such as luteinising hormone (LH), follicle-stimulating hormone (FSH), oestrogen, and progesterone. Insufficient sleep may disrupt the delicate balance of these hormones, potentially leading to irregularities in the menstrual cycle.
• Disruption of the Circadian Rhythm: The body’s internal clock, known as the circadian rhythm, governs various physiological processes, including the release of hormones related to the menstrual cycle. Lack of sleep or irregular sleep patterns can disturb the circadian rhythm, influencing the timing and amplitude of hormone secretion, which may, in turn, affect the regularity of the menstrual cycle.

• Increased Stress Hormones: Sleep deprivation can elevate stress hormones such as cortisol. Elevated cortisol levels may interfere with the production and regulation of reproductive hormones, potentially leading to menstrual irregularities.
• Impaired Immune Function: Chronic lack of sleep can weaken the immune system, and immune system health is closely linked to reproductive health. Immune system dysfunction may contribute to inflammatory responses that impact the ovaries and other reproductive organs, affecting menstrual regularity.

What can I do to improve my sleep quality?

Making a few small changes to your sleep hygiene can go a long way to improving your sleep quality throughout your period.

• Prioritise Adequate Sleep: Aim for 7-9 hours of quality sleep per night to support overall health, including hormonal balance and menstrual regularity.
• Establish a Consistent Sleep Schedule: Maintain a regular sleep routine by going to bed and waking up at the same time each day, even on weekends, to reinforce the body’s circadian rhythm.
• Create a Sleep-Friendly Environment: Ensure a comfortable and dark sleep environment, free from disturbances, to enhance the quality of sleep.
• Limit Stimulants Before Bed: Reduce or eliminate the consumption of stimulants like caffeine close to bedtime to avoid interference with the ability to fall asleep.
• Manage Stress: Practise stress-reduction techniques such as mindfulness, meditation, or deep breathing exercises to mitigate the impact of stress on hormonal balance.

How much sleep do you need on your period?

As a general rule, you should aim for 7-9 hours of quality sleep a night while on your period. You may need more sleep during your period due to low energy, discomfort and reduced sleep quality. Everyone is different, so the best advice is to listen to your body and rest when you need to. That includes taking days off work if you’re struggling with sleep.

Can I track my hormone fluctuations across my period?

If you’re struggling with poor sleep during your menstrual cycle and want some answers, our female hormone mapping blood test can help. It checks the 4 key hormones – oestrogen, progesterone, LH and FSH – on day 14 and day 21 of your cycle. We then use a groundbreaking algorithm to accurately map your hormone fluctuations across your entire cycle. This can help you understand what’s causing you to suffer from poor sleep. You can view a demo report here.

“Menstrual periods can disrupt sleep due to hormonal fluctuations, causing discomfort, cramps, and increased body temperature, making it harder to fall asleep and stay asleep. Pain and anxiety associated with periods can also lead to restlessness and disturbed sleep patterns, impacting overall sleep quality. Lifestyle changes can help mitigate some of these, but ultimately, if you’re struggling then a conversation with your GP may be helpful.”

Dr Thom Phillips