From monthly cycles to different stages in life, hormones can play a role in the amount and quality of sleep women get. Dr. Padmini Santosh looks at how to navigate and get the best sleep possible.
TL;DR: Women experience unique sleep challenges because their hormone levels fluctuate throughout life, from puberty and the menstrual cycle to pregnancy and menopause. These hormonal changes can influence when we feel sleepy, how deeply we rest, and how easily we wake up.
- Estrogen and progesterone are the main hormones impacting sleep, promoting relaxation and restorative rest when balanced.
- During the menstrual cycle, hormone dips can make it harder to fall or stay asleep.
- Pregnancy and sleep changes are linked to rising progesterone, which can make women feel more tired, especially in the first trimester.
- In menopause, declining estrogen can trigger night sweats and fragmented sleep.
- Healthy habits like limiting caffeine, managing stress, and maintaining a consistent bedtime can help regulate hormones and improve overall sleep quality.
As women go through life, we learn that hormones impacting sleep are the culprit for most of the physical and emotional changes we experience. That’s true both during monthly cycles and through different life stages. It’s also normal for hormonal fluctuations to contribute to changes in our sleep patterns.
Hormones are chemical messengers that travel through our bodies, affecting growth and development, metabolism, sexual function, reproduction, mood, and appetite. Sleep is no exception.
Let’s look at the connection between hormones and sleep at night as well as how hormones can impact drowsiness or wakefulness during the day. I’ll also share some tips for managing the other factors affecting our sleep to get a better night’s rest. Read on to learn how to sleep well, even when hormones could be working against you!
Hormones and Sleep: Differences in Women and Men
Sleep is a universal need for all life forms, including humans. In fact, we spend about one-third of our lives asleep. The long-term absence of adequate sleep can result in serious physiological consequences. Lack of sleep can affect the ability to regulate stress hormones, lead to high blood pressure, and increase the risk of obesity, type 2 diabetes, and cardiovascular disease.
The amount of sleep humans require decreases with age. Newborns sleep about 16 to 18 hours per day. By adolescence, sleep decreases to about 9 to 10 hours per night. Most adults only require 7-9 hours of sleep, but older adults require even less.
As you age, you’ll find you tend to go to sleep earlier and wake up earlier.
As age progresses, there is also a decline in the efficiency and quality of sleep.
However, hormones impact sleep differently in women and men. Research suggests that women have longer total sleep time, less total wake time, and overall better sleep efficiency than men. However, women have about a 40% higher risk of insomnia than men. These differences begin during puberty, when fluctuating levels of estrogen and progesterone start influencing the brain’s sleep centers.
In women, estrogen tends to promote deeper, more restorative sleep, while progesterone has a relaxing, sedative effect. But the monthly rise and fall of these hormones can also make sleep less predictable. This is especially true before a period, after childbirth, or during menopause.
In contrast, men experience fewer hormonal fluctuations, which helps keep their sleep cycles more stable throughout life.
Sleep and the Menstrual Cycle: How Hormones Affect Rest
Have you ever noticed that it can be more difficult to fall asleep or stay asleep around the same time of your monthly cycle?
Estrogen and progesterone are the major female hormones. Their rise and fall throughout a woman’s menstrual cycle can contribute to challenges with sleep. Estrogen controls the phases of the menstrual cycle, while progesterone helps maintain pregnancy. Progesterone is known as the relaxing hormone, and it has a mildly sedative effect.
During the follicular phase of a woman’s cycle, estrogen and progesterone levels rise, preparing the body to release an egg. Women may report feeling drowsier during this phase. After ovulation, estrogen and progesterone levels peak, and sleep may come more easily.
However, just before a period starts, during the luteal phase, progesterone levels drop dramatically. A lot of women find it difficult to get a good night’s sleep during this phase.
Remember that these monthly hormonal fluctuations are completely normal. They don’t mean that your hormones are “out of whack.” They are only part of the story when it comes to women’s quality and quantity of sleep.
What we consume, the devices we use each day, and the stresses of life have more of an effect on our sleep than hormones.
Pregnancy and Sleep: Why Hormones Can Make You Tired
If pregnancy occurs during a cycle, progesterone and estrogen levels don’t drop — instead, they skyrocket to prepare the body for carrying a baby. Their role is to bolster the immune system and relax the uterus so that it can grow.
During early pregnancy, high progesterone levels make many women feel unusually sleepy during the day. That’s a natural response to the body’s increased energy needs. It’s your body’s signal to slow down and adjust to all of the changes it’s going through.
As pregnancy progresses, changes in breathing, back pain, and fetal movement can make quality sleep harder to achieve. Practicing good sleep hygiene and using supportive pillows can help improve rest during this time.
These hormones even out by the third trimester. However, other symptoms can interfere with sleep as a woman nears the end of her pregnancy. Pressure on the bladder can cause frequent trips to the bathroom through the night, and circulation issues can also disrupt the ability to fall or stay asleep.
Menopause, Estrogen, and Sleep Disruptions
Another phase of life when dramatic hormone fluctuation can affect sleep is the period of time leading up to and during menopause. Estrogen and progesterone decrease during this phase, which can lead to irritability. Hormonal changes also lead to vasomotor symptoms like hot flashes and night sweats that can interfere with sleep.
Women in this stage of life are often dealing with a lot of life stress that can lead to poor sleep quality. The “sandwich generation” is often taking care of their parents as well as children who have returned home or never left.
Patients Ask: Does Estrogen Make You Sleepy?
Estrogen plays a vital role in maintaining serotonin levels and REM sleep quality. More importantly, it can impact your body’s ability to regulate body temperature.
While balanced estrogen can support restful sleep, declining estrogen during menopause can lead to night sweats and hot flashes. The result is often lighter, more fragmented sleep. Rather than making you sleepy, low estrogen often makes it harder to stay asleep through the night.
Sleep Aids, Melatonin, and Hormone Balance
Some women who have trouble sleeping may use over-the-counter sleep aids like melatonin supplements. Others use prescription medicines to help them get more sleep. Be sure to speak with a doctor before taking any type of sleep aid, especially if you are pregnant. These medications might help for a short period of time, but medicine is not a cure for insomnia.
Developing healthy habits during the day and at bedtime can help you get a good night’s sleep on a regular basis.
How to Improve Sleep When Hormones Are Working Against You
Now that you know when to expect hormone-induced periods of difficulty sleeping and staying awake, you can develop sleep habits that will help you navigate those periods. Remember that we can’t place all the blame on hormones for poor quality of sleep. Many other life and lifestyle factors contribute.
Luckily, there are some things we can control. Here are some tips for improving your sleep habits:
Try to stick to a regular sleep schedule
Your body loves consistency! Going to bed around the same time each night and not sleeping in more than one extra hour on weekends will help improve sleep quality.
Avoid eating close to bedtime
This can be a tough one because hunger hormones tend to rise at night. Meanwhile, hormones that make you feel satiated tend to decrease throughout the evening. The issue is that eating late at night can affect your quality of sleep. It can also put you at higher risk for developing diabetes and obesity.
Avoid cell phones and other screens at bedtime
Melatonin is a sleep-inducing hormone that helps regulate your sleep-wake cycle. During the day, sunlight prevents your body from producing melatonin, helping to keep you awake. Light from cell phones and laptops can also suppress melatonin, so using these screens at night can make it harder to fall asleep.
If you do use your phone before bed, use the nighttime setting that changes the screen color and minimizes melatonin-suppressing light. And remember that falling asleep should be a peaceful, relaxing experience, not a time for engaging your mind, taking in new information, and eliciting emotional responses that could keep you awake much later than you need to be.
Limit caffeine intake
Adenosine is another hormone impacting sleep that naturally increases at night. Caffeine blocks adenosine receptors and can affect your sleep, even when consumed several hours before bed. Opt for decaf or herbal tea at bedtime.
Don’t drink alcohol within 3 hours of bedtime
Alcohol may make you feel sleepy at first, which seems like a good thing. However, odds are good that you will wake up, and it’ll be difficult to go back to sleep. Try to abstain for three hours before bedtime whenever possible.
Create an optimal sleep environment
Sleep in a location that is quiet, dim, and at an appropriate temperature. Try using a white noise device or app. Also, consider turning off lights and screens before you get into bed.
Remember, a bedroom should be a sleep environment. If possible, use your bed primarily for sleep. Avoid working in bed.
Exercise earlier in the day
Exercising can do wonders for getting deep sleep that gives your body a chance to rejuvenate. Endorphins are hormones that your body releases in response to pain or stress. Endorphins that are released during exercise can increase brain activity that causes people to feel more awake. Exercising at least a few hours before bedtime will give your mind time to wind down.
Try relaxing or meditating before bed
Mindfulness relaxation practices, yoga, breathing techniques, and even taking a warm bath can calm you and help you manage the stress hormones cortisol and adrenaline that contribute to anxiety, irritability, and sleep problems.
If you do wake up in the middle of the night, try to avoid doing anything that will stimulate your brain. For example, skip scrolling on your phone, reading a book, or watching the clock.
Instead, try meditation or repeating a word over and over until you nod off. That’s something I grew up doing in my Indian culture: repeating the name “Rama,” the protagonist of the Indian epic Ramayana. Rama is the incarnation of the Lord on earth. Repeating these two syllables is a bit like mindless prayer.
Counting sheep is a Western version of this repetition technique meant to de-stimulate your brain. It works!
Track your sleep along with your menstrual cycle
Many women find predictable patterns between hormone fluctuations and sleep quality.
Consider menopause hormone therapy (MHT)
For women experiencing symptoms of perimenopause like hot flashes and nigh sweats that disrupt their sleep, balancing estrogen and progesterone with menopause hormone therapy may improve both mood and rest. Talk to your gynecologist about this option.
FAQs about Hormones Impacting Sleep
How do hormones impact sleep throughout a woman’s life?
Hormones such as estrogen and progesterone affect sleep quality, duration, and timing. During puberty, menstrual cycles, pregnancy, and menopause, changing hormone levels can alter brain chemistry and body temperature, influencing when women feel sleepy and how deeply they rest.
Why do I feel more tired before or during my period?
Many women experience fatigue before menstruation because progesterone levels drop during the luteal phase. This change can make it harder to get deep, restorative sleep and may cause daytime drowsiness. Maintaining good sleep hygiene can help minimize these effects.
Is it normal to feel extra sleepy during pregnancy?
Yes. High progesterone levels in early pregnancy make many women feel more tired than usual. This is a normal hormonal response to the body’s increased energy needs. Practicing relaxation, staying hydrated, and resting when needed can improve sleep during pregnancy.
Can low estrogen cause insomnia?
Low estrogen can disrupt serotonin production and body temperature regulation, both of which affect sleep. This is why many women experience hot flashes, night sweats, and insomnia during perimenopause and menopause. Balancing estrogen levels through lifestyle changes or hormone therapy may help.
When should I talk to my doctor about hormone-related sleep problems?
If you consistently have trouble falling or staying asleep, experience night sweats, or notice changes in your sleep that align with your menstrual cycle or menopause, it’s time to talk to your OB/GYN. They can evaluate your hormone levels and discuss personalized treatment options.
When to Talk to Your Doctor About Sleep and Hormonal Changes
Getting the right amount of sleep can be critical for a woman’s immune system, physical and emotional health, and overall well-being. While hormones impacting sleep can cause issues, managing stress and other lifestyle factors is the best way to get better sleep. (See Dr. Adrianne Colton’s blog post for tips on managing stress and grief.)
Try practicing the different sleep habits above until you discover what works for you. If you’re still experiencing chronic insomnia or excessive daytime sleepiness, it may be time to see a sleep specialist. These physicians can help you get to the root of the problem and find a healthy way to improve your sleep.
To make an appointment with an OB/GYN provider at one of our Richmond, VA, locations, call VPFW at 804-897-2100 or message us to schedule online.
