Do you notice that your sleep changes through your monthly cycle? If you have a natural menstrual cycle, when do you sleep best, and when might you toss and turn? Do you know how your hormones affect sleep?
Sleep promotes physical and mental recovery, is a time for maintenance and repair within the brain and facilitation of learning and memory. Every woman is unique and experiences different physical and emotional symptoms during her menstrual cycle.
A normal cycle is divided into three stages:
- The Follicular phase starts on day 1 of the menstrual period and ends on the day of ovulation
- The Luteal phase occurs after ovulation and lasts until menstruation starts.
How does sleep change over the cycle?
During your menstrual period, you may find that your sleep is disrupted by heavy bleeding, pain or cramps, this then settles during the follicular phase, and the good news is that the best sleep of your cycle is just after ovulation.
Things change during the luteal phase as levels of oestrogen and progesterone rise. Sleep efficacy can reduce through the luteal phase. Progesterone has sleep-promoting effects, so you may feel sleepy during the day and wake more at night. Gaba receptors in the brain are bimodal; they respond to the metabolite of progesterone differently in women. Some experience a calming and sedating effect, and others a deterioration in mood, which can affect their sleep.
Most women who have trouble sleeping at different times in their menstrual cycle have problems just before and after the start of their period, as the oestrogen and progesterone levels then drop, especially if there is a rapid fluctuation of these hormones. The fall in oestrogen can affect temperature control and cause hot flushes and night sweats. A drop in body temperature signifies it is time for us to sleep, but if a fall in oestrogen is keeping us warmer, it’s hard to sleep. Falling oestrogen can also affect our mood, causing anxiety and depression, which can also make sleep difficult now.
What can you do if you are tossing and turning?
- Carve out time for stress-reducing self-care – De-stress before bed by listening to music or using essential oils
- Reduce stress; too much cortisol hinders the production of oestrogen and progesterone and the balance of it, which affects our sleep
- Get enough sunlight in the day
- Keep your bedroom cool
- Cut down on caffeine
- Keep a constant sleep/wake schedule
- Exercise regularly
- Keep a sleep journal for 2-3 months if you are struggling
- Stop smoking and drinking alcohol
- Resist the urge to nap
Written by Dr Carys Sonnenberg (drcaryssonnenberg)
MBChB DCH DRCOG DFFP MRCGP