Is there anything more annoying than crawling into bed after a long day only to find yourself unable to fall asleep? It turns out there is: this scenario happening month after month right before your period.
Period insomnia is a real thing. You might find it hard to fall asleep and stay asleep, and you may wake up not feeling as refreshed as you usually do when your period is on the horizon.
What’s worse, sleep problems before your period can change across your life, and even from period to period, making them hard to plan for and manage.
While we can’t control our hormones, there are some things you can do to get a better night’s sleep at this stage of your cycle.
Below, we’ll dive into what causes insomnia before your period and how you can use the RISE app to get more sleep, no matter what time of the month it is.
Disclaimer: The scientific literature uses gendered language when talking about periods. We have used the term “women” in this article, but this advice is for anyone who experiences insomnia before their period.
Period insomnia is the name for the sleep problems you can get before — and sometimes during — your period. You may have trouble falling asleep or trouble staying asleep through the night. It’s so common that starting your periods at the onset of puberty is linked to a 2.75-fold increased risk for insomnia.
Many women experience sleep issues as part of PMS or PMDD. Premenstrual syndrome (PMS) is the name for the symptoms you can feel in the run-up to your period and, while it’s not clear, it’s thought to be down to hormone fluctuations.
PMS symptoms include:
These symptoms can appear at the start of your luteal phase — the phase after ovulation, but before your period — be their worst in the late luteal phase just before your period, and end when your period is over.
Women with menstrual-related problems like PMS are at least twice as likely to report insomnia. On the flip side, some women with PMS experience hypersomnia, where they sleep too much.
Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS.
Symptoms of PMDD include:
These symptoms can start six days before your period and reach their most severe two days into your period. Women with PMDD have poorer sleep than those without it, and 66% of women with PMDD report sleep problems.
While many women experience poor sleep before their period, there is some research that says you may feel your sleep is worse than it really is. One small study found women reported lower sleep quality in the three days before and four days during their period. But their total sleep time, how long it took them to fall asleep, and how often they woke up during the night were not impacted. These women didn’t have PMS or PMDD, however.
The sleep data was also self-reported, meaning it could be inaccurate. We all experience retrograde amnesia, meaning we can’t remember the minutes before falling asleep or the sub-10-minute micro-awakenings throughout the night. This makes it hard to judge how long we really sleep for.
Another study compared women with severe PMS and those with minimal symptoms. It found those with PMS reported poor subjective sleep quality when they had symptoms before their period. But objective sleep measures didn’t show any changes. They did experience anxiety, though. And the worse their anxiety, the worse their sleep quality was and the more they thought they woke up during the night.
There is research out there showing pre-period sleep problems can be real, however. One study found it took women longer to fall asleep during their luteal phase and their sleep efficiency (the measure of how long you spend in bed actually sleeping) was lower. Data was self-reported here as well, though.
Do your sleep problems and tiredness linger long into your period? You can learn why you’re so tired on your period here.
Period insomnia is common — women report more sleep disturbances during the week before and the first few days of their period than any other time of the month. But is it actually insomnia?
According to the third edition of the International Classification of Sleep Disorders (ICSD-3), insomnia is confirmed when all four of the following criteria are met:
ICSD-3 differentiates insomnia to be either less than three months (acute) or three-plus months (chronic).
So, while the sleep problems you get before your period may not fit the traditional definition of insomnia, it may easily fit most of the criteria.
Besides, even if it’s not full-blown insomnia, having sleep problems each and every month can still have a huge impact on your mental and physical health, mood, and energy levels.
It’s not entirely clear why women get insomnia before their periods. More research needs to be done, and the studies we do have on the topic are often small or lack controls for oral contraception usage or ovulation timing.
Here’s what we do know about why you have trouble sleeping before your period.
Most of us know our hormones are all over the place around our period, and they can be to blame for our sleep issues just before this time.
In the luteal phase of your menstrual cycle, which happens before your period, you’ll have increased levels of progesterone and decreased levels of allopregnanolone, which is made in the body from progesterone.
These increased levels can cause anxiety, and increased progesterone can also increase your body temperature, which can make it hard to fall and stay asleep.
Estrogen levels fall during the luteal phase, and this too can wreak havoc with your body temperature and anxiety levels.
Heads-up: Your follicular phase is the time from the start of your period to ovulation. And your luteal phase is from ovulation to the start of your next period.
It may also be the fluctuations in hormones that cause sleep problems. Research suggests a steeper rate of increase of progesterone levels from the follicular phase to the mid-luteal phase is linked to more time awake in the night in the late luteal phase, which is just before your period.
Beyond progesterone and estrogen, other hormones are impacted by your menstrual cycle. Women with PMDD have shown a decreased secretion of melatonin, the hormone that primes your body for sleep, during the luteal phase of their menstrual cycle. This could result in trouble falling asleep and trouble maintaining a regular sleep cycle.
Right before your period, levels of progesterone and estrogen are at their lowest, and this can stop melatonin from being released effectively. But more research needs to be done to know what’s happening for sure. Different studies show melatonin secretion is decreased, delayed at night, or there may be no change at all.
Your sleep architecture — or how your body moves through sleep stages — can also be affected before your period. During the mid-luteal phase, stage 2 sleep — also known as light sleep — increases, while rapid-eye-movement sleep (REM sleep) decreases.
Irritability, anxiety, and a depressed mood are all common PMS symptoms. You might have added worries about your upcoming period, too. Perhaps you’re anticipating the cramps that come with menstruation or feeling nervous about it starting when you’re least expecting it.
But anxiety can easily cause disturbed sleep. It can make it hard to fall asleep, both at the start of the night and if you wake up during the night.
You can learn more about the connection between anxiety and sleep loss here.
Pain and periods come hand in hand, but often the pain can start before your period even begins. Cramps, bloating, breast tenderness, migraines, and body aches are common symptoms of PMS or PMDD, and they can all make falling and staying asleep hard to do.
To make matters worse, sleep deprivation makes you feel pain more intensely, so you can easily fall into a vicious circle of increased pain and increased sleep loss.
Polycystic ovary syndrome (PCOS) is a condition that causes your body to produce higher-than-normal amounts of male sex hormones. With PCOS, you may have lower progesterone levels and higher testosterone levels, both of which can mess with your sleep before your period.
Sleep disturbances and disorders like sleep apnea are also more common in those with PCOS.
Although women with PCOS tend to be overweight, and being overweight makes you more likely to have sleep problems and develop sleep apnea, research shows the increased risk for sleep problems is still there, even when body mass index (BMI) is taken into account. And women with PCOS who have a healthy weight can still have sleep problems.
This may be due to changes in the hormones cortisol and melatonin, the insulin resistance PCOS women can develop, or symptoms such as anxiety and depression that contribute to sleep issues.
We can’t do much about our hormones, but we can improve our sleep in other ways. Here’s what to do to get better sleep before your period.
Sleep hygiene is the name for the set of healthy sleep habits you can do each day to help you fall asleep faster and wake up less often each night.
The good news about sleep hygiene is that it can help you get better sleep all month long, not just before your period. But you may want to pay extra attention to your sleep hygiene when you know your period is coming up to help you get the best sleep possible during this time.
Improve your sleep hygiene by:
To stay on top of it all, the RISE app can help you do 20+ sleep hygiene habits each day by telling you the ideal time to do each one to make them more effective.
RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.
Anxiety is a common PMS symptom, but it can easily keep you up at night. Here’s how to soothe anxious thoughts and drift off more easily:
We’ve covered more ways you can sleep with anxiety here.
RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.
RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification
Try keeping a sleep diary to track when you get sleep problems in your cycle and what symptoms you get. This can help you see which symptoms you need to address — can you figure out if it’s pain or anxiety keeping you up, for example?
Plus, a diary can also be useful when talking to a healthcare professional about treatment options.
You can use the RISE app to track your sleep times and see when you’re getting less sleep than usual and when you’re waking up during the night.
Light therapy usually involves getting light exposure from a light box at prescribed times of day and at a prescribed brightness.
Bright light therapy has been shown to reduce depression, premenstrual tension, and stress in those with PMDD — and reducing these symptoms could help you drift off more easily.
One study found 30 minutes of white light exposure in the evening helped reduce depression and tension in women with symptoms in their luteal phase.
Speak to a healthcare professional or a sleep specialist if you want to try light therapy to make sure you’re getting the right exposure.
Purposefully cutting your sleep short sounds counterintuitive when you’re trying to get more shut-eye, but sleep restriction has been shown to be an effective treatment for insomnia. It’s commonly used as part of cognitive behavioral therapy for insomnia (CBT-I).
For those with PMDD, sleep restriction may help by reducing mood symptoms, which could be contributing to sleep problems.
One study found both going to bed late and waking up early to create sleep deprivation helped improve the mood of those with PMDD. And another study found the moods of those with PMDD were improved after an early or late partial sleep deprivation followed by a night of recovery sleep. The study did note that a placebo effect could be at play, however.
Again, we recommend speaking to a healthcare professional if you want to try sleep restriction for your period insomnia.
CBT-I aims to change your thoughts and behaviors around sleep. It has been shown to be effective at treating insomnia, and it’s often a first-line treatment for the sleep disorder. But there isn’t much research on whether it can help period-related insomnia specifically.
It has, however, been shown to be effective for insomnia during menopause, postmenopause, and during pregnancy.
You can learn more about menopause sleep problems here, including perimenopause when you’ll still be getting your periods and potentially any insomnia they bring.
If pre-period pain is keeping you up, reach for over-the-counter pain relief. Daily magnesium tablets have been shown to treat and even help prevent cramps and menstrual migraines, and taking 1,200 milligrams of calcium a day may help reduce physical and mood PMS symptoms.
If your pre-period sleep problems are affecting your everyday life, it may be worth trying medication to help you get more sleep.
This could include:
Speak to your healthcare provider to get the best treatment option for you.
Struggle to sleep when your period arrives, too? We’ve covered how to sleep on your period, whether you can sleep with a tampon in, and more about female fatigue in general and whether or not women need more sleep than men here.
You already have to deal with periods themselves, so it can feel like you’ve drawn the short straw when you experience insomnia before your periods, too. But there are some things you can do to get more sleep at this stage of your cycle.
Try managing your anxiety, keeping a sleep diary, and speaking to a professional about light therapy or sleep restriction. The RISE app can help you build bulletproof sleep hygiene by reminding you when to do 20+ habits at the right time for your body clock.
Sleep hygiene will help you fall asleep faster, wake up less often, and get the most restorative sleep possible before, during, and after your period, to help you feel your best every day of the month.
Yes, period hormones can cause insomnia. Changing levels of progesterone and estrogen can increase your body temperature and anxiety levels, and the more they fluctuate, the more time you may find yourself awake during the night.
How many days before your period you get insomnia will all depend on your hormones and symptoms. And this may change from period to period. You may get PMS symptoms at the start of your luteal phase and PMDD symptoms six days before your period.
Periods make it hard to sleep as fluctuating hormones change your body temperature, anxiety levels, and melatonin production. You may also struggle to sleep due to period-related pain and anxiety.
Treatments for insomnia before your period include improving your sleep hygiene, reducing your anxiety, and speaking to a professional about light therapy, sleep restriction, and medication.
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