First off, you’re not alone. While cramps, bloating and mood swings are some of the most common signs that your period is coming, many women also experience insomnia, nightmares and frequent awakenings. Women with premenstrual syndrome are twice as likely as other women to have insomnia. And about seven in 10 women who have a more severe form of PMS called premenstrual dysphoric disorder, or PMDD, routinely struggle to get a good night’s sleep in the days before their period.
So what gives? Cramps, muscle pain and headaches can wreak havoc on a woman’s sleep. Plus it is normal for core body temperature to rise during menstruation, which makes it harder to doze off. On top of that, the abrupt rise and fall of progesterone, estrogen and other hormones during a woman’s period can influence her circadian rhythm and alter the different stages of her sleep, worsening her sleep quality. Women with severe premenstrual syndrome have also been shown to secrete lower levels of melatonin, the hormone that ushers us to sleep at night.
So what can you do? For starters, if you use birth control pills, consider whether they’re impacting your sleep. Some research indicates that women who use hormonal contraceptives experience more insomnia and daytime sleepiness than women who are not on the pill. On the other hand, some experts speculate that certain contraceptives, particularly those that contain progestin only, might actually help with insomnia. Unfortunately, there is not a lot of data on how contraceptives may impact sleep, but it may be worth discussing their potential impact on sleep with your doctor.
Second, there are things you can try besides sleep medications. Cognitive behavioral therapy, which can help ease stress and anxiety, is one of the best ways to combat insomnia. Another treatment for sleep problems called bright light therapy has been shown to help women with severe PMS. Scientists are not exactly sure why light treatment works. But it involves using a light box to get regular exposure to artificial light, which affects melatonin as well as the hypothalamus, a region in the brain that regulates mood and sleep. You can learn about the best light therapy lamps in this article from Wirecutter.
Lastly, focus on your sleep hygiene in the days before you get your period. Avoid alcohol, which can affect hormone levels and stir you awake at night. Keep a strict sleep schedule, going to bed and waking up at the same time every day. Don’t overdo it on caffeine, and be sure to exercise daily, which can help promote a smoother night of slumber.