13 Ways to Deal With Menstrual Insomnia

Tossing and turning before your period? You're not alone.

What is menstrual insomnia?


According to a poll by the National Sleep Foundation, 67 percent of women who menstruate toss and turn for two or three days during every menstrual cycle. Not only is it harder to get to fall asleep, but their sleep isn’t as good quality once they do doze off. One 2010 study in the journal Sleep found that women hit the REM sleep phase for less time in the premenstrual phase than they do for the first few days of their periods. REM is the deepest and most restorative sleep stage, which could explain why women feel so groggy when they have PMS. (Read more about sleep stages and why they matter.)

So what’s going on when you have menstrual insomnia?


Bloating, backaches, breast tenderness, and other PMS pains could all make it tough to fall asleep, but that’s just the tip of the iceberg. After ovulation, your body starts building up progesterone, which makes you drowsy. A few days before your period, though, progesterone spikes back down, which could be why the worst sleep tends to come with PMS. Plus, your core body temperature could be a half to a degree higher during these days than the rest of the month, so when you hit the sack, you might feel uncomfortably hot and restless. Luckily, there are some ways to work with your body to get a good night’s sleep. (Don't miss these other things your period wants to tell you.)

Make sleep a priority


“Sleep should be considered as much of an important factor as things like diet, stress, exercise, and smoking,” says Margaret Moline, PhD, former head of the sleep center at Weill Cornell Medical College in New York. Unfortunately, most of us don’t realize how pivotal sleep is to our health, particularly during our monthly cycles. Being alert by the time you’re headed to work in the morning is part of your body’s natural rhythm, Dr. Moline explains. If you’re falling asleep during your commute instead, it means you’re not getting the sleep your body needs. Don't miss these other signs you don't get enough deep sleep.

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Keep track of your sleep


“The first step against insomnia is to develop a sleep log,” says Dr. Moline. That way, you can tell whether there’s a link between menstrual-cycle symptoms and sleep, between relationships and sleep, between work and sleep, between hormone fluctuations and sleep—in fact, between anything and sleep. (Related: Here are more period problems never to ignore.)

Plan ahead


If your sleep log reveals that you have insomnia every month at the same time, you could ask your doctor to prescribe a sleeping pill, says Kathryn Lee, RN, PhD, FAAN, professor emerita with sleep research at University of California, San Francisco. Then take the medication proactively on the two or three nights when you know you won’t sleep. Or try these tips to naturally sleep better without drugs.

Adjust your pill times


On the other hand, if you’re already taking another medication that has drowsiness as a side effect, ask your doctor if you can take that drug an hour before bed instead of whenever you’ve been taking it. A side effect like drowsiness can work against you during the day, but you can use it to your advantage at night.

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Make a sleep schedule


Sticking to a sleep schedule that has you waking up and going to bed at the same time every day—yes, even while your period makes you feel like spending the day in bed—will also increase your ability to fall asleep. Don't fall for these sleep mistakes that keep you up at night.

Consider oral contraceptives


Some studies suggest that women who use oral contraceptives have less cycle-related insomnia. Just don’t expect a cure-all—other research has shown women taking combined oral contraceptives have less deep sleep than a control group, though researchers don’t know if it impacts women when they’re awake. Plus, you’ll still feel the same temperature rises that you would do if you weren’t on the pill. You should discuss the possibility of switching to oral contraceptives with your doctor if you’re concerned about monthly sleeplessness. These are signs you're on the wrong birth control pill.

Watch out for wild cards


“Some women may have other conditions that worsen during their cycle,” says Dr. Moline, and any associated sleepiness may become exaggerated, possibly because of changes in blood volume. When blood volume increases, your blood levels of medication may drop outside the therapeutic window. Again, keeping a log of your symptoms—including those related to your condition—will help identify the problem. And once you share the information with your doctor, you’re only a step away from a solution.

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Don’t put up with twitchy legs


See your doctor if you are bothered by tingly or creepy-crawly legs. Women with heavy periods seem to be predisposed to restless legs syndrome (RLS), but this irritating condition can be treated. A blood test will help your doctor determine how much extra iron and folate your body requires during your period to keep your legs calm. Give these RLS home remedies a try.

Kill the pain

iStock/Piotr Marcinski

If pelvic pain keeps you up during your period, talk to your doctor about taking an over-the-counter NSAID (non-steroidal anti-inflammatory drug) like ibuprofen, plus a vitamin B complex and magnesium supplement. And don’t forget the old remedies of a heating pad or sex to relieve the pain. You can also often block the chemicals that produce pain with a daily aerobic workout. (Related: Don't miss these other secrets pain doctors won't tell you.)

Frisk your OTCs


We know to avoid coffee and tea six hours before bed because the caffeine will keep us up. But many of us don’t stop to think about what’s in the over-the-counter drugs we use. Since caffeine also boosts the analgesic effects of aspirin, for example, it’s frequently dropped into popular over-the-counter remedies advertised for pain relief during menstruation. That’s fine—just as long as you use it during the morning and early afternoon. Otherwise, it can interfere with your sleep as effectively as a cup of coffee. You might want to avoid over-the-counter drugs with antihistamines added in as well, especially those that have Benadryl, says Dr. Lee. “They may work for men who weigh 50 pounds more than you do,” she says, “but because of the difference in body weight, many women who take them feel hung over the next morning.” Check out these other secrets sleep doctors want you to know.

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Pay attention to basics

iStock/Niels Kliim

Increase the likelihood you’ll sleep by creating a restful environment. Make your sleep area a comfortable, dark place in which you feel safe. Keep soothing teas and herbal hot packs within reach. Try these bedroom setups that help you sleep.

Stick with just a nibble


Menstruating women sometimes get so hungry they seem to eat every couple of hours. But eating heavily right before bed could leave you wide awake with an overly full belly. If you’re hungry close to bedtime, stick with just a bite or two of something light, like a few nuts. Find out the best foods to eat during your period here.

Channel your thoughts


Focus on things you love, like the flowers you might put in the garden next spring or remembering taking your kids to see the ocean for the first time. Trying to work out problems right now will only leave you wide-eyed and anxious.

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