The Battle Between Sleep and Menstrual Health

Is your menstrual cycle impacting your sleep? Or is having an irregular menstrual cycle affecting the quality of your sleep? Emerging evidence points to a strong connection between the menstrual cycle and sleep. Although thsi relationship is complex, breaking down the basics can help us better understand how to take control of nighttime sleep during menstruation.  

How the Menstrual Cycle Impacts Sleep

The circadian rhythm is a 24-hour cycle that influences different physiological activities, including sleep, and is regulated by environmental conditions such as light exposure, physical activity, and meals. When circadian rhythms are disrupted, such as during menstruation, shifts in how the body  functions can occur. 

For example, Baker and Driver explain how throughout the menstrual cycle, hormone levels fluctuate which impact body temperature [1]. Body temperature is an important driver of sleep as decreased body temperature marks the onset of sleepiness. During the luteal phase, which occurs approximately 14 days after ovulation, body temperature increases by about 0.4 ℃ due to elevated progesterone levels [1]. 

This increase in body temperature can delay the onset of sleep and reduce the amplitude of brain waves during sleep, meaning that people who menstruate may feel more wakeful when sleeping and experience disrupted sleep [1]. Study participants' sleep diaries across a wide age range also showed that sleep disturbances were more likely during the permentruation week, which is also known as the luteal phase [1]. 

Abnormal Menstrual Cycle and Sleep

On the other hand, the effects of abnormal menstrual cycles can be intensified from poor sleep. Studies have shown that sleep quality can in turn affect the menstrual cycle. Having insomnia was associated with more than a 2 times increase in the risk of menstrual cycle irregularity over one year in both women with initially normal and irregular menstrual cycles [2]. In addition, short sleep duration has been shown to contribute to the development of abnormal menstrual cycles [3]. 

Sleep on Menstrual Symptoms

Interestingly, many studies looked into the connection between menstrual cycle and sleep in female atheletes as poor sleep negatively impacts sports performance and injury recovery. These studies found that sleep disturbances and the time it took to fall asleep at night increased when more menstrual symptoms were reported [4][5]. Painful menstruation was shown to impair sleep quality, reduce sleep duration, and increase daytime sleepiness [3]. 

Regulating Your Sleep and Your Menstrual Health

There is a mountain of evidence supporting the connection between sleep and menstrual health. Although easier said than done, identifying whether your sleep habits or menstrual cycle are out of balance – keeping in mind that every body is unique – can help you narrow down where improvements can be made. 

Simply tracking the amount of sleep you get or your menstrual cycles and symptoms can make a meaningful difference by reveleaing potential patterns. Consulting your family doctor for irregular sleeping or menstrual patterns can also be a helpful step. Other factors that may influence sleep and menstrual health inlcude regular excercise, diet, eating habits near bedime, medication side effects (including oral contraceptives), and exposure to external or internal stress. Most importantly, listening to your body and responding to its needs for more or less sleep can make a great difference in managing menstrual symptoms.

References

1. Baker FC, Driver HS. Circadian rhythms, sleep, and the menstrual cycle. Sleep Medicine, 2007;8(6): 613–622. doi:10.1016/j.sleep.2006.09.011.

2. Kang W, Jang KH, Lim HM, Ahn JS, Park WJ. The menstrual cycle associated with insomnia in newly employed nurses performing shift work: a 12-month follow-up study. Int Arch Occup Environ Health. 2019;92(2): 227–235. doi:10.1007/s00420-018-1371-y.

3. Jeon B, Baek J. Menstrual disturbances and its association with sleep disturbances: a systematic review. BMC Women's Health. 2023;23(1): 470. doi:10.1186/s12905-023-02629-0.

4. Halson SL, Johnston RD, Pearson M, Minahan C. Menstrual-cycle symptoms and sleep characteristics in elite soccer players. Int J Sports Physiol Perform. 2024;19(9): 914–920. doi:10.1123/ijspp.2023-0049.

5. Pearson MA, Weakley JJS, McKay AKA, Russell S, Leota J, Johnston RD, Minahan C, Harris R, Burke LM, Halson SL. Menstrual cycle symptoms, but not oestrogen or progesterone concentrations, are associated with sleep in female athletes. Eur J Sport Sci. 2025;25(10): e70038. doi: 10.1002/ejsc.70038.