Why Do I Get Insomnia Right Before My Period?

I work with many women who share their experiences of sleepless nights leading up to their periods. They describe it as if insomnia takes hold like clockwork—2 to 3 nights before their period is expected, they find themselves tossing and turning, unable to find rest. Some express a sense of general discomfort, dealing with temperature fluctuations, pain, and other physical symptoms, while others say they feel fine yet simply can’t fall asleep.

It’s important to recognize that this is a common concern; around one-third of women report sleep disruptions before their periods. Yet, did you know that there has been relatively little research on this phenomenon? While the scientific community is still exploring the depths of this issue, here’s what we do know:

Hormonal Fluctuations:

• Estrogen and Progesterone: The dramatic drop in progesterone during the late luteal phase (just before menstruation) can significantly impact sleep quality. The key factor here is the shift in hormone levels. Progesterone typically promotes calm and restful sleep, and its decrease can lead to lighter, more restless nights.

• Impact on Mood and Stress: Hormonal changes can also heighten feelings of anxiety and stress, both of which are well-known contributors to insomnia.

Circadian Rhythm Sensitivity:

• Disrupted Sleep-Wake Cycles: Hormonal fluctuations may interfere with your body’s natural circadian rhythm, making it more challenging to fall asleep at your usual time. These hormonal changes can affect your body’s thermostat, leaving you feeling warmer at night.

Physical Discomfort:

• Cramps, Bloating, and Headaches: It’s no secret that physical symptoms can create discomfort, which can hinder your ability to fall or stay asleep.

What You Can Do About It:

Sleep Scheduling and Sleep Hygiene:

• Regular Sleep-Wake Time: I can’t emphasize enough how vital it is to maintain consistent sleep and wake times, even through different phases of your cycle. This consistency can prevent 1-2 difficult nights from spiraling into chronic sleep problems.

• Pre-Bedtime Routine: While we shouldn’t expect miracles, calming pre-bedtime routines—like a warm bath, mindfulness meditation, or gentle stretching—can help relax both your mind and body, potentially alleviating some physical and mental discomfort.

Cognitive Restructuring:

• Addressing Sleep Anxiety: Pay attention to your thoughts about sleep. Negative beliefs, like “I’ll never get enough sleep before my period,” can heighten stress and make sleep even more elusive. Instead, try shifting your perspective: “Even if I don’t sleep well, my body will still rest, and I can get back on track tomorrow.”

• Cognitive Defusion: Remember that you are not defined by your thoughts. Work on creating distance from unhelpful thoughts about physical symptoms, like “If I’m in pain, there’s no way I’ll be able to sleep.”

Behavioral Techniques:

• Stimulus Control Therapy: Reserve your bed for sleep and intimacy only, steering clear of activities like watching TV or using electronics, which can foster unhealthy associations with wakefulness.

• Sleep Restriction Therapy: If you don’t feel sleepy, it’s best to avoid getting into bed. Waiting until you feel tired can help you bypass the frustration of being unable to sleep and reinforce a stronger connection between your bed and restful sleep in the future.

Relaxation Training:

• Progressive Muscle Relaxation, Mindfulness, or Guided Imagery: There are numerous apps, YouTube videos, and podcasts that can guide you through relaxation and breathing exercises. I encourage you to explore different options until you find one that resonates with you. For the best results, practice regularly, not just during stressful times.

Tracking Sleep and Symptoms:

• I encourage you to track your sleep patterns and symptoms throughout your menstrual cycle. This can help you identify patterns and decide when to implement new strategies. It also allows us to tailor cognitive and behavioral interventions to better suit your needs.

It’s completely natural to experience sleep disruptions due to hormonal fluctuations, and I want you to know you’re not alone in this. Many people face similar challenges, especially during certain phases of their cycle. The good news is that there are effective techniques you can incorporate to help manage these changes.

I encourage you to explore these strategies, particularly during the premenstrual phase, as they can significantly enhance your sleep quality and overall well-being. Remember, small adjustments can make a big difference, and it’s all about finding what works best for you.

If you ever feel overwhelmed or just need someone to talk to, please don’t hesitate to reach out. We’re here to support you every step of the way. Your well-being matters, and together, we can find the best path forward.

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