Why the menstrual cycle can affect sleep

Many cyclical changes take place during the menstrual cycle, both hormones and body temperature and metabolic activity. Due to these changes and their effects on circadian rhythms, it is believed that the menstrual cycle can affect sleep significantly.

The latter can translate into difficulty falling asleep and staying asleep; Or, it can manifest itself in the opposite way: an excessive need for sleep. For example, there are those who report the need to sleep more than 10 hours during the menstrual cycle, and in contrast, there are those who report insomnia during some specific days.

According to some studies, these sleep disturbances may be due to different factors associated with physiological changes in the menstrual cycle. In this article we are going to review some of these factors, as well as the general functioning of both sleep and menstruationso that we can better understand your relationship.

• Related article: "Circadian Rhythm Disorders: Causes, Symptoms, and Effects"

Circadian cycle and menstrual cycle

Our entire body works in cycles. We have, for example, circadian cycles, which are those that last around 24 hours. That is why they are called “circa”, which means “around”; and “diano”, which means “day”.

Part of what regulates circadian cycles are wakefulness and sleep. This regulation occurs through two biological rhythms that we call synchronizers. internal (such as hormonal rhythms, blood pressure, body temperature, in the system metabolic); and external synchronizers, such as light and dark, noise, events that cause tension, among others.

When the time of rest and sleep approaches, these synchronizers adapt to our need to rest, that is, they prepare the body for the decrease in energy that we require when sleeping deeply. Thus, our physiology produces a whole series of functions during wakefulness, and others during sleep, in coordination with external stimuli.

On the other hand we have infradian cycles, which are those that last more than 24 hours. These cycles are what regulate physiological events that occur less than once a day, such as the menstrual cycle, which occurs every 28 days.

• You may be interested: "The 5 phases of sleep: from slow waves to REM"

How does the menstrual cycle work?

During the menstrual cycle takes place the interaction of hormones of the hypothalamus, the pituitary gland and also the ovaries. This system is known as the hypothalamic-pituitary-ovarian system (HHO) and is activated by the secretion of different hormones, such as gonadotropins (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).

From this secretion, the menstrual cycle is divided into two phases: follicular phase (where FSH is secreted to begin releasing the eggs and the necessary hormones); and the luteal phase (which is when hormonal secretion decreases around day 23 of the cycle, which causes vascular transformations in the endometrium and finally its detachment, that is, the menstruation).

It is precisely the luteal phase that has been related to the emergence of a set of somatic and physical changes typical of the menstrual cycle, among which are sleep cycle disturbances.

Sleep disturbances and menstrual cycle

A normal sleep cycle is one that is divided into two different states; one is Non-REM sleep (characterized by slow wave eye movements), and the other is REM sleep (characterized by fast wave movements).

In this last, brain activity occurs faster, which requires a series of important hormonal changes. It secretes, for example, growth hormone, prolactin (which stimulates the production of breast milk), testosterone, melatonin (which helps regulate the circadian rhythm related to light and dark), and some others that participate in an important way in menstruation.

For example, it has been related a decrease in melatonin secretion with different premenstrual stresses, which significantly modifies the circadian cycles related to light and dark.

Endocrine activity during sleep and related symptoms

As we have seen, one of the internal factors that participates in the regulation of sleep cycles is endocrine activity (the system responsible for releasing hormones within our body).

When the activity of this system is intensified, for example, during the luteal phase of the menstrual cycle, our sleep can also be modified. In addition, the hormones GnRH, LH and FSH, have a significant release peak in the non-REM sleep phase, which which means that their concentration levels increase according to specific periods of the cycle of dream.

The latter has been especially associated with women who have PMS. accompanied by affective symptoms, and also in women who have a psychiatric diagnosis related to mood.

In other words, some studies on the subject suggest that significant changes in sleep quality during the menstrual cycle occur more frequently in women who have mood disturbances, while women without these symptoms of negative affect, do not usually present significant changes in the quality of dream.

In the same sense, some studies suggest that, although it is likely that many women have sleep disturbances in the luteal phase of the cycle menstrual, are those women with other more severe premenstrual symptoms who are more likely to experience alterations in said phase, specifically daytime sleepiness.

Bibliographic references:

• Arboledas, G. (2008). Physiological and anatomical bases of sleep. Evolution of sleep in childhood and adolescence. International Classification of Sleep Disorders. Sleep habits in the Spanish population. Comprehensive Pediatrics. XIV (9): 691-698.
• Adresic, E., Palacios, E., Palacios, F. et al (2006). Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PDD): Retrospective study of prevalence and associated factors in 305 university students. Latin American Journal of Psychiatry, 5: 16-22.
• Baker, F. and Driver, H. (2006). Circadian rhythms, sleep, and the menstrual cycle. Sleep medicine, 8 (6): 613-622.
• Manber, R. and Bootzin, R. (1997). Sleep and the menstrual cycle. Health Psychology, 16 (3): 209-214.
• Driver, H., Dijk, D.J., Biedermann, K., et al (1996). Sleep and the sleep electroencephalogram across the menstrual cycle in young healthy women. The Journal of Clinical Endocrinology & Metabolism, 81 (2): 728-735.
• Lee, K., Shaver, J., Giblin, E. C. et al (1990). Sleep patterns related to menstrual cycle phase and premenstrual affective symptoms. Sleep: Journal of Sleep Research & Sleep Medicine, 13 (5): 403-409.