Do you have difficulty falling and staying asleep in the days leading up to your period? Your hormones may be why.

Insomnia is more common among females than males. One contributor to this disparity may be hormonal changes related to the menstrual cycle.

If you have premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), you are even more likely to experience sleep difficulties.

If you’re having a difficult time falling asleep or staying asleep in the days leading up to your period, you may have PMS insomnia.

“PMS insomnia” refers to an inability to sleep because of your menstrual cycle.

Many people with premenstrual syndrome (PMS), and the more severe form of PMS known as premenstrual dysphoric disorder (PMDD), experience sleep disturbances.

Research shows that women with PMS are at least twice as likely to have insomnia before and during their period. And about 70% of women with PMDD have problems falling asleep and staying asleep in the days leading up to their period.

Symptoms of PMS insomnia may include:

  • difficulty falling asleep
  • waking up in the middle of the night
  • difficulty returning to sleep
  • feeling fatigued and sleepy during the day
  • irritable or low mood
  • poor concentration or memory

The following PMS symptoms may also keep you awake:

  • cramps
  • bloating
  • tender or swollen breasts
  • constipation or diarrhea
  • headache
  • sensitivity to noise and light
  • mood symptoms, like anxiety, sadness, and irritability

Most people experience a milder form of these symptoms. However, a 2009 French study found that 12.2% of women have PMS symptoms severe enough to impact their daily lives.

Menstrual-related sleep problems tend to increase during the late luteal phase (1 to 2 weeks leading up to your period) compared with other menstrual cycle phases. The late luteal phase is the same time when PMS symptoms tend to arise.

According to 2016 research, the late luteal phase affects stage 2 sleep and REM (rapid eye movement) sleep regardless of PMS.

These sleep difficulties are likely being driven by both the changing hormones during this time and their rate of change. These hormonal changes may worsen sleep due to their effects on body temperature and melatonin production.

A small 2014 study with 27 women with PMS found that a steeper rise of progesterone in the days leading up to their period was tied to greater sleep disturbances. Progesterone is known to raise body temperature.

A 2016 study found that women with PMDD had a decreased response to melatonin in their luteal phase than in their follicular phase (the first day of your period to ovulation).

Other menstrual-related reasons for lack of sleep may be physical symptoms (cramps, bloating) or mood symptoms (anxiety, depression) of PMS. In addition, research estimates heavy periods affect up to 14% of menstruating people. Heavy periods may necessitate getting up at night to change a pad or tampon.

The following risk factors may increase your risk of insomnia:

  • being female
  • older age
  • family history of insomnia
  • heavy caffeine use
  • heavy alcohol use
  • irregular bedtime
  • smoking
  • lack of exercise
  • high stress levels
  • mental health conditions

Light therapy may be used for people with PMS insomnia. Light therapy can help regulate your circadian rhythm and release serotonin and melatonin, all of which may help with mood and sleep.

Selective serotonin reuptake inhibitors (SSRIs) may also treat PMS. A 2013 review of 31 random controlled trials found that SSRIs effectively reduce the symptoms of PMS. However, adverse side effects, such as nausea and decreased energy, are common.

Since a hormone imbalance can contribute to insomnia and vice versa, it’s important to have your hormone levels checked via a simple lab test.

In particular, progesterone supplementation may be helpful for insomnia if you have a known progesterone deficiency or an excess of estrogen.

Hormone blood tests can check for the following hormones:

  • estrogen
  • progesterone
  • follicle-stimulating hormone (FSH)
  • thyroid hormones
  • testosterone/DHEA

PMS insomnia natural remedies

There are several things you can do at home to ease PMS insomnia:

  • Keep a consistent sleep schedule. Go to bed and wake up at the same time throughout the week.
  • Get regular exposure to daylight.
  • Limit phone and TV use at night.
  • Try all-natural sleep supplements like valerian, ashwagandha, CBD, kava, or theanine. (Be sure to check with a doctor first, though. Some of these remedies can interact with medications and other supplements.)
  • Meditate daily to help manage stress.
  • Exercise daily.
  • Avoid caffeine close to bedtime.
  • Eat a diet full of veggies and fruit, whole grains, and lean protein. Limit processed foods and sugary foods when you can.

People with PMS are at least twice as likely to have insomnia around the time of their period. This number jumps to 70% for those with PMDD.

Menstrual-related sleep problems are likely driven by fluctuating hormones as well as their rate of change. These hormonal changes may worsen sleep due to their effects on body temperature and melatonin production.

If you have PMS insomnia, consider talking with your primary care doctor or gynecologist about your symptoms so you can discuss your treatment options.