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7th June 2018

Trouble Sleeping During Your Period? 

Many women report feeling more tired or lethargic when they are on their period, consultant in sleep medicine and anaesthesia, Dr Sara McNeillis, discusses why women may experience increased tiredness, fragmented sleep during your menstrual cycle and ways to combat this.

Why do some women experience problems with sleep during their period?

Women may experience a change in their sleep patterns throughout their menstrual cycle. Sleep patterns tend to differ between the pre-ovulation time of the month (or follicular phase) and post ovulation (or luteal phase). Some women are more sensitive to the changes in sleep patterns. 

The common changes in sleep occur after ovulation in the luteal phase.  Women may feel increasingly sleepy in this period despite having a proper night’s sleep. They may also find that sleep is more broken (or fragmented). Most of these changes will improve from the beginning of the period.

Women who are not at risk of pre-menstrual syndrome do not have these changes in sleep patterns. 

Why do some women feel more sleepy during their period?

The reasons for sleepiness in the post ovulation phase is because of the effects a hormone called progesterone. Progesterone prepares and maintains the lining of the womb but also acts directly on the sleep centre, causing sleepiness.

Once a period starts, the levels of the progesterone reduce rapidly, however the sleepiness associated with the high levels of progesterone may take a few days to improve. 

What can women do to address period related sleep issues?

Core body temperature is increased over the two weeks following ovulation. In addition, core body temperature also increases to a maximum each day at approximately 9pm to 10pm. Sleep onset occurs when the core body temperature starts to drop shortly after 10pm. In women, the reduction in core body temperature in the post ovulation (or late luteal phase) is blunted which may cause the feeling of overheating at night. This may also lead to an alteration of the sleep pattern during these nights. 

Therefore it is important to make sure that the sleep environment allows the core body temperature to drop sufficiently to help sleep to occur. Ensure that your sleep environment is well ventilated and not too warm.  Also make sure that the room is dark and avoid using any blue light emitting devices. 

What can women do if they experience ‘restless legs’?

‘restless legs’ is another sleep issue which some women may experience during their period. Restless leg syndrome is characterised by the irresistible urge to move ones legs to subside uncomfortable sensations. It is more common for these symptoms to occur in the evening around bedtime and during the night. Restless leg movements may disturb sleep. One of the reasons for restless legs symptoms to worsen during the period is due to the drop in iron stores in the body. 

You can ask your GP to check your ferritin levels and if these are low then you will need to take some iron supplements to reduce the symptoms of restless legs. Patients who still have restless legs symptoms despite having normal ferritin levels can try some codeine tablets which may help.

Can changing your sleeping position or environment help to improve period related sleep issues?

Changing your sleep environment will help. The sleep environment should be comfortable and not too warm. The room should be dark and well ventilated. It is not too important to change your sleep position, however if you are a snorer then avoiding sleeping on your back will reduce the snoring related sleep disruption.

Can you plan ahead if you know that your period normally affects your sleep? What can you do if you have an important occasion or job interview that will fall during your period week?

It is known that some women who have significant sleep and mood disorder in their premenstrual period may have sleep timings which are not synchronised with their body circadian (or master clock) rhythms. Studies have shown that these women have improved with the treatment of bright light in the evening or sleep restriction therapy. 

It is also important to control the pain associated with your period as this will disrupt your sleep at night. 

Melatonin has also shown to help during this period but this will need to be taken on the advice of your doctor.

Preparing for an important occasion may lead to additional stress in the run up to the day. Keeping fit and exercising will help improve sleep quality and pain associated with your period. 

In some patients, sleep restriction a few days prior to the important day may also help, but this will need to be planned and monitored by sleep psychologist. 

With thanks toDr Sara McNeillis for this article, for further information on period related sleep issues head to or email [email protected]. 

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