Women’s bodies experience hormonal changes throughout the month and over our lifetime. These natural shifts in hormones, such as during the menstrual cycle, pregnancy, and menopause, can affect how well you sleep. Let's talk about how hormones affect women's sleep and some ways to manage those effects for a better night’s rest.
Menstrual cycle effects on sleep
In women with menstrual cycles, the female hormones estrogen and progesterone rise and fall at different during the cycle to facilitate ovulation and menstruation. This change in hormone levels becomes most pronounced late in the cycle, and some women may experience perceptible changes in sleep and mood as they near “that time of the month”.
In the days before and during your period, it is also common to experience symptoms such as cramps, headaches, and bloating that can affect the quality of your sleep. Some women may feel more fatigued during the day, or may need more sleep than usual to feel well-rested.
Additionally, women with menstrual cycle disorders are at an increased risk of sleep disorders. In particular, up to 70% of women with premenstrual dysphoric disorder (PMDD), a much more severe form of premenstrual syndrome (PMS), have insomnia symptoms before their period.1 Studies have also shown that women with polycystic ovarian syndrome (PCOS), a condition typically accompanied by irregular menstrual cycles, are at a up to 10-fold higher risk of sleep apnea.2 This is when you stop breathing for short periods during your sleep resulting in disturbed and unrefreshed sleep.
Pregnancy and postpartum sleep
Pregnancy is another phase of a woman’s life where hormones can disrupt sleep. As pregnancy progresses, the many physical and physiological changes increases symptoms of sleep apnea and restless legs syndrome.3 Finding a comfortable sleeping position can also become increasingly difficult due to the growing uterus. While it's normal to feel sleepy during pregnancy due to elevated progesterone levels, discomfort and pain can make it difficult to get the restful sleep you need.
For many women, sleep-related issues persist postpartum where hormone levels drop. This sudden shift in hormones, along with frequent nighttime awakenings associated with caring for a newborn, can worsen sleep quality and increase sleep deficits after childbirth.4
Menopause and sleep
And then there's menopause. During this natural phase of life, estrogen and progesterone fluctuates and decreases over time. For many women, sleep issues become more common and worsen during perimenopause to postmenopause. Insomnia is a common experience during this time, with symptoms including difficulty falling asleep and staying asleep, and waking up too early.5 Physical and physiological changes during the menopause transition also increases the risk of sleep apnea, which is characterized by snoring and gasping for breaths during sleep, and fatigue in the day.6
Other common menopausal symptoms like hot flashes, night sweats, anxiety, and mood changes may also perpetuate sleep disturbances. It can be challenging to feel well-rested and energized when dealing with these symptoms, but many women experience sleep disturbances even in the absence of these symptoms.
Treating sleep disorders due to hormonal changes
There are many ways to manage the effects of hormonal changes on your sleep. For example, hormone therapy can improve perceived sleep quality in women experiencing sleep disturbances due to hot flashes and night sweats.7 When it comes to insomnia, CBT-i is the recommended first-line treatment, and have been shown to help with insomnia even during pregnancy,8 as well as the menopause transition.9
If sleep is something you’re struggling with, do speak with your doctor to discuss the best options for managing your symptoms. By taking a proactive approach to sleep health, you can look forward to a better quality of life for you and the people you care about.