Many women can instinctively sense the approach of their menstrual cycle without checking a calendar or a period tracker, thanks to unmistakable indicators such as bloating, breast tenderness, and mood swings. While these are some of the more widely recognised symptoms of premenstrual syndrome (PMS), they are by no means the only ones. Among the less-discussed but equally significant symptoms? The challenge of sleeping soundly.

For certain women, the issue during this phase of their menstrual cycle isn’t outright insomnia. Instead, they find themselves waking up without feeling refreshed or requiring more sleep than usual to achieve a sense of well-restedness. Many report heightened daytime fatigue as well.

Dr Phua Chu Qin, an otolaryngology consultant specialising in sleep surgery at Sengkang General Hospital, explains more.

Dr Phua Chu Qin, an otolaryngology consultant specialising in sleep surgery at Sengkang General Hospital

Every month, there will be several days where I will either have trouble falling asleep at night or suffer from really poor quality sleep. After doing some tracking, I realised that this often occurs before or during my period. Is there any connection between insomnia and menstrual cycles?

In a 2011 global survey by the Sleep Health Foundation, seven in 10 women say that they experience changes in their sleep just before their period begins. Studies have shown that women experiencing premenstrual syndrome (PMS) suffer from changes in their sleep, including poorer sleep quality, longer sleep onset, shorter sleep duration, and poorer sleep maintenance. Other factors, such as rapid eye movement (REM) sleep, which refers to the stage of deep sleep where most dreams happen, are also noticeably less during the luteal phase – the period right before menstruation – of a menstrual cycle.

Why does PMS affect my sleep quality so negatively?

There are several potential factors as to why our sleep is impacted during menstrual cycles. Hormonal fluctuations occur in a woman’s body before and during her menstrual cycle. Research suggests that elevated levels of progesterone can lead to a rise in body temperature, resulting in disrupted sleep patterns. Additionally, variations in melatonin levels, a hormone responsible for regulating the sleep-wake cycle, have been found to impact sleep during this period.

Another reason for sleeping problems before and during menstrual cycles involves heavy or significant menstrual bleeding. About 14 per cent of women worldwide experience heavy period flow during their menstrual cycle, and this causes them to wake up during the night to change pads or tampons. This could even lead to higher anxiety levels about sleep due to the possibility of staining sheets or mattresses. In addition, some patients also experience painful menstrual cramps, bloatedness and headaches, which increase their discomfort during sleep.


Are there any side effects on women’s health when it comes to sleep deprivation?

Sleep deprivation can cause daytime sleepiness, mood shifts, difficulty concentrating, and slower thinking. In cases of chronic sleep insomnia, for example, if someone is affected for three months or longer, it can cause negative impacts on their health, including associations with heart disease, type 2 diabetes, and increased risk of developing depression.

We often hear about the negative effects of PMS, but are there any potential benefits or positive aspects of the menstrual cycle that can impact sleep quality?

Yes, there can be potential benefits: For instance, progesterone, which is usually increased after the ovulation stage of the menstrual cycle, has sleep-promoting effects, and can help some women ease into sleep better. It is important to note that experiences can vary significantly from person to person. While some individuals may perceive positive effects on sleep during their menstrual cycle, this might not be the case for others.

How do we improve our sleep during our menstrual cycle?

Here are a few suggestions that may help in alleviating the PMS symptoms and give you some proper shut-eye:

1. Optimise your sleep environment: Create a sleep-inducing environment in your bedroom by keeping it quiet, dark and cool. Consider getting blackout curtains if the outside lights are disruptive. Avoid bringing work to your bedroom, such that you associate the bedroom with sleep and restful activities. Keeping the room temperature cool can help reduce body heat during PMS, and allow you to fall asleep more easily.

2. Improve your diet: Incorporating foods such as whole grains, fruits and vegetables can help to reduce PMS symptoms and improve sleep. Plus, fatty fish and nuts provide essential nutrients like vitamin D, omega-3 fatty acids, magnesium and zinc that can improve overall sleep.

3. Spend ample time outdoors: during the day, exposure to sunlight is important to promote sleep as it helps to regulate one’s circadian rhythm, keeping the body’s natural sleeping and waking cycle in sync.

4Create a bedtime routine: Establish a consistent bedtime routine that signals your body and mind to wind down and prepare for sleep. This can include taking a warm bath, reading a book, or practising relaxation techniques.

Text: Cheryl Lai-Lim/HerWorld