Why don't I sleep well before my period?

Is it time to get out of bed already?

As if cramps, bloating, and mood swings aren’t enough, you may also experience disturbances in sleep before your period. Whether you toss and turn all night until your 6am alarm rings and feel like nodding away at your desk all day, the fatigue can make it hard to be your usual self at work or home.

Sleep issues are common during premenstrual syndrome (PMS). So yes, if you find that your sleep schedule is messed up in the days leading up to your period, it could be because of PMS! It can be frustrating feeling irritable and badly rested no matter what you do, especially the week that you need it the most. Your sleep quality also affects your overall mood - we’ve all been weirdly cranky and snappy without realising that the culprit may be restless sleep.

You may be tempted to just give up on good sleep and rely on strong filter coffee or adrak ki chai for some temporary energy - why not instead understand what’s happening in your body and how you can deal with it better?

Why does this happen?

PMS affects everyone a little differently. Some people may have difficulty falling or staying asleep, causing fatigue and irritability.

These irregularities with sleep are because of (you guessed it) hormonal fluctuations. Particularly, fluctuations in your reproductive hormones.

Progesterone rises during the luteal phase of the menstrual cycle. This is before the menstrual phase, which is when bleeding happens.

Here are some of the notorious things high progesterone does during this phase:

• It makes your internal body temperature higher than usual, making it harder to fall asleep. Having the fan on 5 isn’t enough!

• Higher progesterone makes another chemical called allopregnenalone fall. When there’s lower allopregnenalone, your brain produces less amounts of dopamine, the chemical that helps you feel motivated and improves your mood. Since there’s lower dopamine, you may feel more tense or anxious than usual, causing poor sleep.

• It affects the amount of melatonin your brain produces. Melatonin is a hormone that helps you fall asleep. During the premenstrual phase, that is, the part of your menstrual cycle just before your period, melatonin levels drop. Low melatonin could explain why you struggle to fall and stay asleep.

• When we sleep, we go through a series of sleep phases. One of these is the rapid eye movement (REM) phase. It’s been found that REM sleep decreases during the premenstrual phase, making you sleepy during the day (source). This also happens because of high progesterone and low melatonin levels.

How common is this?

There are reports that up to 68% of women in India aged 36 and above struggle with insomnia (source). Specifically, an Indian study found that over 75% of people with moderate to severe PMS had insomnia as one of their symptoms (source). Although it may not be as commonly talked about as other PMS symptoms like mood swings and bloating, it’s clear that sleep disturbances and fatigue affect lots of menstruators.

It’s no surprise that sleep quality also affects your mood. The premenstrual symptoms you experience could be tied together - not getting a good night’s sleep can make you feel more irritable and easily overwhelmed the next day. There’s evidence that people with premenstrual dysphoric disorder (PMDD), a more severe form of PMS, may have improvements in mood when their sleep quality is better (source).

How you can deal with it better

Feeling cranky and badly rested but still having to go about your day as normal isn’t ideal. But like with other period-related symptoms, there are always solutions.

If you struggle to fall or stay asleep and counting sheep just isn’t doing it for you anymore, these easy at-home fixes could help:

• Keep note of your sleep patterns for a few months to check if your sleep is more disturbed during PMS.

• Avoid looking at screens before bedtime. This can be a difficult one to follow, but the light from your phone or laptop stops you from being able to fall asleep. Put those Bollywood reels away for another time!

• No caffeine from midday onwards. Is your evening chai worth the lack of sleep?

• Keep your room at a lower temperature. Since your body temperature is higher before and during your period, keeping your bedroom a little cooler can help you feel more comfortable, allowing you to fall asleep faster. An ideal room temperature for good sleep is 20°C, especially in the scorching summer months.

• Try activities that help you relax. You could be feeling more stressed or anxious than usual around your period, which could also be due to PMS. This stops you from getting a good night’s rest. Try to clear your mind with meditation or play some relaxing white noise in the background while you fall asleep.

Are you on the other side of the boat and find yourself sleeping through alarms or having to take naps frequently? Rest is important, but so is balance. Some of these tips could help you feel recharged and refreshed for the next day:

• Raise your energy levels in the morning with some mild exercise. A brisk walk or an activity like dancing or yoga can be a great start to the day.

• Have a fixed night-time routine. This helps you get in the zone and in a restful headspace.

If you feel that your fatigue is still so bad that you can’t function no matter what, we recommend speaking to a trusted doctor to figure out if there’s another underlying cause. Remember that you’re never alone in facing these challenges! Ultimately, you’re in charge of keeping your mind and body healthy, and we are here to give you the resources to make that possible.

- Team Cranberry

Sources:

Bhaskar, S., Hemavathy, D. and Prasad, S., 2016. Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), p.780. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353813/

Jehan, S., Auguste, E., Hussain, M., Pandi-Perumal, S.R., Brzezinski, A., Gupta, R., Attarian, H., Jean-Louis, G. and McFarlane, S.I., 2016. Sleep and premenstrual syndrome. Journal of sleep medicine and disorders, 3(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323065/#:~:text=The%20menstrual%20phase%20is%20known%20to%20influence%20stage%202%20sleep,early%20follicular%20phase%20%5B20%5D

Nicolau, Z.F., Bezerra, A.G., Polesel, D.N., Andersen, M.L., Bittencourt, L., Tufik, S. and Hachul, H., 2018. Premenstrual syndrome and sleep disturbances: results from the Sao Paulo epidemiologic sleep study. Psychiatry research, 264, pp.427-431. https://www.sciencedirect.com/science/article/abs/pii/S0165178117315299

Raval, C.M., Panchal, B.N., Tiwari, D.S., Vala, A.U. and Bhatt, R.B., 2016. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder among college students of Bhavnagar, Gujarat. Indian Journal of psychiatry, 58(2), p.164. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919960/