Insomnia is commonly associated with a range of conditions including stress, anxiety, depression and restless legs syndrome. Factors such as caffeine intake and low levels of melatonin are linked to impaired sleep patterns as well. However, not many are aware that PMS and female hormones, such as progesterone and estrogen, also play a significant role in affecting the amount and quality of sleep.
A survey carried out by the US-based National Sleep Foundation found that 33 per cent of women respondents experienced sleep disturbances during their menstrual cycles; another 16 per cent reported missing a day or more during a month because of sleep problems. In total, 67 per cent of women reported having issues with sleep a few nights a week.
“Women experience a rise and drop in levels of estrogen and progesterone during their menstrual cycles. These hormones are also linked to sleep and circadian cycles and therefore, can influence a woman’s sleep pattern as well as the quality of their sleep,” said Dr. Hiam Ahmed Harfoush, Specialist – Obstetrics and Gynecology, Burjeel Hospital Abu Dhabi.
The menstrual cycle is divided into two phases and lasts around 25-28 days. The first day of the cycle is when a woman’s period begins. The first phase, also called the follicular phase, sees estrogen levels peak. This also affects sleep patterns. Ovulation, which marks the start of the second phase, takes place around the fourteenth day. Progesterone, which rises in phase two, causes drowsiness. Levels of both hormones drop a few days before a woman’s periods, causing further sleep disturbances.
“Symptoms of pre-menstrual Syndrome (PMS), such as cramps, bloating, nausea, tenderness, headaches, lower back and abdominal pain and heavy bleeding, can also cause great discomfort and affect a woman’s sleep pattern. In fact, women often complain of disrupted sleep during the days before and the initial days of their period due to these problems,” said Dr Harfoush.
According to Dr Harfoush, there are several ways to alleviate insomnia. “A doctor can prescribe an over-the-counter NSAID (non-steroidal anti-inflammatory drug), especially if you have painful periods. The doctor may also recommend vitamin B and magnesium supplements, and a sleeping pill. Women who suffer from severe PMS symptoms including mood changes, depression, or anxiety (especially if they affect day-to-day life) should also seek medical help.
“Other steps include avoiding too much coffee, as caffeine can interfere with sleep. Yoga and meditation are good de-stressors and can help relax the mind. Exercising, especially early in the morning, is also recommended. Keeping a regular schedule of sleeping and rising is crucial, as consistency will help the body maintain normalize its sleep cycle,” said Dr Harfoush.