Sleep And The Menstrual Cycle

Disclaimer: This article has been written in collaboration with Clue. This collaboration was not sponsored.

Please note that if you are using hormonal birth control, you may experience different hormonal changes than the ones described in this article. 

Top things to know:

• Fluctuating levels of estrogen and progesterone during your menstrual cycle can affect your sleep.
• Sleep quality, in turn, affects your period. Poor sleep quality is linked to heavier periods. 
• Hormonal changes during pregnancy and perimenopause can also affect your sleep.
• Practicing good sleep hygiene, getting regular exercise, and creating a soothing sleep environment can help you sleep better. 

Most adults need an average of 7.5 hours of good sleep each night, while some people require nine to ten hours (long sleepers), and others are fine with less than six hours (short sleepers) (1). Your sleep quality is determined by how long you sleep, how deeply you sleep, and how easily you wake up (2). When your sleep quality is good, you tend to feel well rested, refreshed, and more capable of managing your day (2). Poor quality sleep can make you tired and irritable and can negatively affect your concentration and memory (2).

Sleep can have a big impact on your menstrual cycle, and your menstrual cycle can also affect your sleep (3). Getting enough high quality sleep is an important part of your overall wellbeing, so understanding what influences your sleep can help you to improve your health. Read on to learn about the latest research on the relationship between the menstrual cycle and sleep.

The menstrual cycle and sleep

Changing hormone levels during the menstrual cycle can impact your sleep. Some women sleep better around ovulation (when an egg is released from one of the ovaries; this happens about two weeks before your period or roughly around day 14 of a typical menstrual cycle). The improvement in sleep around ovulation suggests a possible link between elevated estrogen levels and better sleep (4). In contrast, rises in progesterone can worsen sleep quality towards the end of your cycle, during the mid-luteal phase (5). The luteal phase is the second part of the cycle, and is the time between ovulation and one’s first period day, lasting approximately two weeks in a typical menstrual cycle. And, during the transition from the follicular phase (the first part of the cycle, from the first period day until ovulation) to the mid-luteal phase, when progesterone levels reach their highest point, it can be more difficult to fall asleep and stay asleep (6).

Falling levels of estrogen and progesterone in the days before your period are also linked to reduced sleep quality (7). Menstrual cramps and heavy bleeding can also make sleep more challenging during this time (8). In particular, women who suffer from premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), a more severe form of PMS, experience poor sleep more frequently than those without either condition (7,9). 

On the other hand, sleep quality can affect your cycle length. Sleeping poorly, sleeping too little, or experiencing sleep changes (like traveling across time zones) can lead to longer or shorter cycles than normal (3,10,11). And, sleeping poorly is also linked to heavier periods (10,11). 

The Clue app has useful tracking categories that allow you to record how long and how well you sleep. You can also track how you feel after waking up, whether you had vivid dreams, and if you had trouble falling asleep. Tracking sleep may help you identify patterns in your sleep in order to understand the relationship between sleep and your cycle.

Download Clue Here.

Pregnancy, perimenopause, and sleep

Hormonal fluctuations during other reproductive stages like pregnancy and perimenopause can also affect your sleep. In turn, sleeping well can affect reproductive stages: sleep quality, for instance, is linked to fertility. 

Fertility

Sleep can influence your chances of becoming pregnant (1). Sleep deprivation may reduce fertility in women. On the other hand, some studies have found that women who sleep seven to eight hours each night have higher conception rates than those who sleep four to six hours (2,3). More research is needed to understand the relationship between sleep and the menstrual cycle better (12), and its potential impact on fertility.

Pregnancy

As early as 10 weeks into pregnancy, fluctuating levels of estrogen and progesterone can make it difficult to fall asleep and remain asleep (13,14). These hormonal changes may also cause one to wake up feeling tired (7). Hormonal changes can lead to insomnia (difficulty sleeping) in 38% of pregnancies, with a higher prevalence in the third trimester (15).

Sleep quality also affects pregnancy. Sleeping well helps lower your chances of complications like gestational diabetes and preterm birth (16,17,18). Given the importance of sleep quality during pregnancy, it’s crucial to speak to your healthcare provider if you’re struggling to sleep well.

Perimenopause

Sleep disturbances affect up to 47% of women during perimenopause (19). Hormonal fluctuations can cause hot flashes and night sweats that lead to difficulty sleeping (7,20). One may also experience difficulty falling asleep, difficulty staying asleep, and difficulties sleeping later than desired, due to hormonal changes (7).

Quality sleep during perimenopause, on the other hand, can help reduce the risk of certain conditions, including diabetes, obesity and cardiovascular disease (21).

Tracking disturbances to your sleep with the Clue App as you transition to menopause can help you figure out what makes it better or worse. Tracking experiences, such as vivid dreams, trouble falling asleep, and how you feel waking up in the morning will allow you to keep a detailed record of your sleep.

Tips for improving sleep

#1 Create a consistent sleep routine

A consistent sleep schedule can help to improve the quality of your sleep. Go to bed and wake up at the same time each day, even on the weekends. A consistent sleep schedule helps to regulate your body’s internal clock, which supports your sleep, energy levels, hormone balance, and mood (22).

#2 Create a calming sleep environment

Keep your sleep environment quiet, dark, and cool (23). Using an eye mask, ear plugs, a white noise machine, or blackout curtains can help you sleep better.

#3 Avoid eating too much right before bedtime 

Eating too much close to your bedtime may affect how well you sleep (24). Eating high-calorie meals that are rich in carbohydrates and fats, less than an hour before bed, can keep you awake (24).  If you feel hungry before bed, a light snack can be a good option. Try eating a banana with almond butter or a cup of Greek yogurt. 

#4 Exercise regularly 

Regular physical activity improves sleep quality. That being said, strenuous activity within one hour of your bedtime can negatively affect sleep quality (25). 

To find workouts you can fit into your day, no matter how busy you are, sign up for FitOn and get access to thousands of workouts led by world-class trainers. You’ll find the perfect HIIT, cardio, or strength class to kickstart your day. Or, calming stretches and yoga flows can help you wind down your day and get ready for a restful night’s sleep. 

Download FitOn Here. 

#5 Manage stress

Stress is associated with poor sleep quality (26). Regular physical activity, a healthy diet, and a consistent sleep routine, can help to reduce your stress levels, which is also good for your overall health. Meditation can also lead to moderate reductions in stress (27). 

Consider incorporating one of these FitOn meditations into your evening routine to help quiet your mind as you prepare for bed. 

• Rest & Restore DeAndre Sinette 
• Complete Relaxation with Vytas 
• Bedtime Stretch Kenta Seki 

Supporting your sleep throughout your cycle 

Hormonal fluctuations during the menstrual cycle, pregnancy, and perimenopause, affect your sleep quality. Given that sleep quality is crucial for all aspects of health, it’s important to pay attention to sleeping well. Tracking your sleep regularly with Clue, along with exercising and meditating regularly with FitOn, can help you find ways to improve your sleep quality. 

Download Clue here. 

Download FitOn here. 

References 

1. Caetano G, Bozinovic I, Dupont C, Léger D, Lévy R, Sermondade N. Impact of sleep on female and male reproductive functions: A systematic review. Fertility and Sterility. 2021;115:715-731.
2. Nelson KL, Davis JE, Corbett CF. Sleep quality: An evolutionary concept analysis. Nurs Forum. 2022 Jan;57(1):144-151. doi: 10.1111/nuf.12659. Epub 2021 Oct 5. PMID: 34610163.
3. Lateef OM, Akintubosun MO. Sleep and reproductive health. Journal of Circadian Rhythms 2020;18.
4. Kravitz HM, Janssen I, Santoro N, Bromberger JT, Schocken M, Everson-Rose SA, Karavolos K, Powell LH. Relationship of day-to-day reproductive hormone levels to sleep in midlife women. Arch Intern Med. 2005;165:2370-2376. doi:10.1001/archinte.165.20.2370.
5. Caufriez A, Leproult R, L’Hermite-Balériaux M, Kerkhofs M, Copinschi G. Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women. The Journal of Clinical Endocrinology & Metabolism. 2011;96(4). doi:10.1210/jc.2010-2558 
6. Sharkey KM, Crawford SL, Kim S, Joffe H. Objective sleep interruption and reproductive hormone dynamics in the menstrual cycle. Sleep Med. 2014;15:688-693.
7. Baker FC, Driver HS. Circadian rhythms, sleep, and the menstrual cycle. Sleep Med. 2007;8:613–622.
8. American College of Obstetricians & Gynecologists. Sleep Health and Disorders. FAQ523. 2021. Available from: https://www.acog.org/womens-health/faqs/sleep-health-and-disorders
9. Moderie C, Boudreau P, Shechter A, Lespérance P, Boivin DB. Effects of exogenous melatonin on sleep and circadian rhythms in women with premenstrual dysphoric disorder. Sleep. 2021;44.
10. He H, Yu X, Chen T, Yang F, Zhang M, Ge H. Sleep status and menstrual problems among Chinese young females. BioMed Research International. 2021;2021:1-6.
11. Kennedy KE, Onyeonwu C, Nowakowski S, Hale L, Branas CC, Killgore WD, Wills CC, Grandner MA. Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample. Journal of Sleep Research. 2021;31.
12. Nam GE, Han K, Lee G. Association between sleep duration and menstrual cycle irregularity in Korean female adolescents. Sleep Medicine. 2017 Jul;35:62–6.
13. Okun ML, Coussons-Read ME. Sleep disruption during pregnancy: how does it influence serum cytokines? J Reprod Immunol. 2007;73:158–65.
14. Okun ML, Kline CE, Roberts JM, Wettlaufer B, Glover K, Hall M. Prevalence of sleep deficiency in early gestation and its associations with stress and depressive symptoms. J Womens Health (Larchmt) 2013;22:1028–37.
15. Sedov ID, Anderson NJ, Dhillon AK, Tomfohr‐Madsen LM. Insomnia symptoms during pregnancy: A meta‐analysis. Journal of Sleep Research. 2020 Nov 2;30(1).
16. Wang R, Xu M, Yang W, Xie G, Yang L, Shang L, Zhang B, Guo L, Yue J, Zeng L, Chung MC. Maternal sleep during pregnancy and adverse pregnancy outcomes: A systematic review and meta-analysis. Journal of Diabetes Investigation. 2022;13:1262-1276.
17. Li R, Zhang J, Zhou R, Liu J, Dai Z, Liu D, et al. Sleep disturbances during pregnancy are associated with cesarean delivery and preterm birth. The Journal of Maternal-Fetal & Neonatal Medicine. 2016 May 16;30(6):733–8.
18. Micheli K, Komninos I, Bagkeris E, Roumeliotaki T, Koutis A, Kogevinas M, et al. Sleep Patterns in Late Pregnancy and Risk of Preterm Birth and Fetal Growth Restriction. Epidemiology. 2011 Sep;22(5):738–44.
19. National Institutes of Health State-of-the-Science Conference statement: management of menopause-related symptoms. Ann Intern Med. 2005;142(12 Pt 1):1003–1013.
20. Jones HJ, Zak R, Lee KA. Sleep disturbances in midlife women at the cusp of the menopausal transition. Journal of Clinical Sleep Medicine 2018; 14: 1127–1133 
21. Luyster FS, Strollo PJ Jr, Zee PC, Walsh JK; Boards of Directors of the American Academy of Sleep Medicine and the Sleep Research Society. Sleep: a health imperative. Sleep. 2012 Jun 1;35(6):727-34. doi: 10.5665/sleep.1846. PMID: 22654183; PMCID: PMC3353049.
22. McMahon WR, Ftouni S, Phillips AJK, et al. The impact of structured sleep schedules prior to an in-laboratory study: Individual differences in sleep and circadian timing. PLoS One. 2020;15(8):e0236566. Published 2020 Aug 12. doi:10.1371/journal.pone.0236566
23. Okamoto-Mizuno K, Mizuno K. Effects of thermal environment on sleep and circadian rhythm. J Physiol Anthropol. 2012;31(1):14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427038/.
24. Crispim CA, Zimberg IZ, dos Reis BG, Diniz RM, Tufik S, de Mello MT. Relationship between food intake and sleep pattern in healthy individuals. J Clin Sleep Med. 2011;7(6):659-664. Available from: https://pubmed.ncbi.nlm.nih.gov/22171206/.
25. Stutz J, Eiholzer R, Spengler CM. Effects of Evening Exercise on Sleep in Healthy Participants: A Systematic Review and Meta-Analysis. Sports Medicine. 2018 Oct 29;49(2):269–87.
26. Abdullah D. Alotaibi, Faris M. Alosaimi, Abdullah A. Alajlan, and Khalid A. Bin Abdulrahman. The relationship between sleep quality, stress, and academic performance among medical students. J Family Community Med. 2020 Jan-Apr; 27(1): 23–28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984036/
27. Goyal M, Singh S, Sibinga EMS, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med. [Author manuscript] Available from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142584/ (Accessed on 9th August 2023).