What can help premenstrual insomnia?



Naturopath, Herbalist and Yoga teacher (BA, Dip Nat, Dip Herb)
@NerdyNaturopath
SiobhanTalksPeriods
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14 December 2023

From bedtime herbal rituals to dodging stress like a pro, we've got the lowdown on reclaiming your beauty sleep, no matter the time of the month. Ready to swap the tossing for tranquillity? Dive into our blog, where Siobhán spills the herbal tea on everything from mood-boosting munchies to bedtime bliss. Get set to trade those restless nights for a brighter, more energised tomorrow.

Hormonal fluctuations before our period can cause premenstrual insomnia for some women, an often-overlooked symptom of PMS. Eating complex carbohydrates, magnesium-rich foods and omega-3 fatty acids can help.  Stress management and sleep hygiene are important as well. Some herbs that can help are Lemon balm, Valerian, Hops, Passiflora, and even Lettuce!

Insomnia and sleep disturbances are not uncommon during the premenstrual phase, but given that it is not a commonly talked about symptom of PMS, we often don’t think to look to our hormones for why we cannot sleep before our periods come. Understanding the connection between hormonal fluctuations and sleep patterns can really help us get some insight into why this happens, and what we can do to help.
In this blog, I'll explore the role of PMS in disrupting sleep, and how adopting certain dietary and lifestyle changes, alongside the use of herbal medicines, can contribute to more restful nights.

4 reasons for premenstrual insomnia

1. Impact of hormones on neurotransmitters

The menstrual cycle is a delicate dance of hormones, and as we approach our period, there is a notable shift in oestrogen and progesterone levels. These hormonal fluctuations can influence neurotransmitters like serotonin and melatonin, which play pivotal roles in regulating sleep-wake cycles. Fluctuations in oestrogen can influence serotonin levels, potentially impacting mood and sleep. Progesterone, on the other hand, can affect melatonin, a hormone that regulates sleep-wake cycles. Changes in progesterone levels may disrupt the normal production and release of melatonin, which can also lead to sleep disturbances. There is some early research being done on supplementing with melatonin to help with PMS symptoms as well, which is interesting. Like so many things, when it comes to female health it seems to be cyclical, with hormone changes affecting melatonin levels and melatonin levels affecting hormonal symptoms. (1)  
When it comes to our bodies, it’s all connected!

2. Body Temperature Regulation:

Progesterone tends to elevate body temperature slightly. This increase in body temperature is a natural part of the menstrual cycle, as anyone who measures their temperature change to track their fertility knows. However, some women may be more sensitive to temperature changes, and disturbances in the normal temperature rhythm can affect sleep for some of us. If you find yourself throwing off your duvet for no obvious reason, you may find the answer in checking where you are in your menstrual cycle.

3. Water Retention and Discomfort:

Premenstrual shifts in our hormones can also contribute to physical discomfort, such as breast tenderness and water retention. Discomfort and bloating may make it challenging for some women to find a comfortable sleep position.

4. Stress Response:

Hormonal fluctuations can amplify the body's stress response as well, especially if we are not getting the rest we need. Elevated stress levels, particularly in the premenstrual phase, can contribute to anxiety and racing thoughts, making it difficult for many of us to relax and fall asleep.

5 tips to help premenstrual insomnia

Hormonal fluctuations can amplify the body's stress response as well, especially if we are not getting the rest we need. Elevated stress levels, particularly in the premenstrual phase, can contribute to anxiety and racing thoughts, making it difficult for many of us to relax and fall asleep.

1. Diet:

A well-balanced diet is the cornerstone of overall health, including our hormonal health, and it can significantly impact sleep quality. Incorporating nutrient-rich foods can help stabilise our blood sugar levels and support hormonal balance. Consider adding the following to your diet:

Complex Carbohydrates: Opting for whole grains such as brown rice, quinoa, and oats can significantly contribute to promoting steady blood sugar levels. These complex carbohydrates release energy slowly, preventing the rapid spikes and crashes associated with processed carbs like white bread, pasta, and pastries. Additionally, steering clear of sugary carbs like biscuits is crucial, as they can lead to fluctuations in blood sugar levels, potentially disrupting sleep patterns. By choosing nutrient-dense, whole-grain options, we can help premenstrual insomnia by stabilising energy levels throughout the day and fostering a more conducive environment for restorative sleep at night.

Magnesium-Rich Foods: Magnesium is a relaxing mineral, known for easing cramps, reducing anxiety and aiding sleep. It can also help with a variety of PMS symptoms that might also be contributing to your premenstrual insomnia. (2) Including magnesium-rich foods in your diet is a great idea, but due to depleted mineral levels in our soils I often find that women need to take a magnesium supplement as well. I usually recommend Magnesium glycinate which is quite easy to absorb, or Magnesium citrate if you are prone to constipation.   

But make sure to add in magnesium-rich foods anyway! Some of the best food sources of magnesium include leafy green vegetables like spinach, kale, and Swiss chard. Nuts and seeds like almonds, cashews, and pumpkin seeds are also excellent sources of magnesium. Other magnesium-rich foods to include in your diet are whole grains and legumes like lentils, chickpeas, and black beans. Avocados, bananas, and dark chocolate all contain magnesium too. You can see why the Mediterranean diet is also found to be a great help for PMS and for balancing hormones. So many of these foods are staples in a Mediterranean diet! (3

2. Lifestyle:

The premenstrual phase is a time when our bodies need more rest, and we often feel more introverted. I personally love the idea of retreating into a cosy premenstrual cave every month before my period, but unfortunately in this day and age our commitments don’t make it easy to give in to our cyclical desires and needs!

When we continue to power through, despite the very normal premenstrual fatigue that nudges us to rest more at this time, it can make us more sensitive to pretty much everything and anything. The things we normally get away with, like late nights, or evening stimulation from our phones or TVs, can really impact our sleep in the premenstrual days. So, focusing on sleep hygiene, reducing stress, and engaging in exercise routines that support a good night’s sleep is extra important in those premenstrual days.

If you are prone to insomnia throughout the month, these can be helpful tips to implement on an ongoing basis; but if that seems too daunting and if the only time you find it hard to sleep is before your period, then you can focus on implementing these just in that week before your period.

3.Exercise:

Synching your exercise routine with your circadian rhythm can be a game-changer for achieving a restful night's sleep. Research suggests that the late afternoon to early evening is an optimal window for physical activity, as this aligns with the body's natural circadian fluctuations. (4

Engaging in moderate exercise during this timeframe not only promotes the release of feel-good endorphins (which I know most of us could do with in those premenstrual days!), but also elevates the body temperature, which then gradually decreases, post-exercise. This decline in body temperature signals to the brain that it's time to prepare for sleep.

By strategically timing your workout in the late afternoon or early evening, you can harness the power of your circadian rhythm to enhance sleep quality and potentially alleviate the sleep disturbances associated with premenstrual symptoms. Additionally, the calming effects of exercise can help mitigate stress and anxiety, contributing to a more serene transition into the night.

4. Stress Management:

Stress is also a driving factor behind many cases of insomnia. Stress, as most of us have experienced, can lead to racing thoughts, worries, and anxiety, and a brain that refuses to jump off its hamster wheel and rest. So, of course, stress can make it difficult to fall asleep or stay asleep throughout the night.

Many women find that stress doesn’t affect their sleep most of the time but, in the premenstrual days, it can have an impact on their sleep. Find whatever works best for you in terms of stress-relieving activities – exercise, yoga, meditation, time in nature: there are so many options. All of the herbs listed below can also be taken during the day to ease stress, as well as aiding sleep when taken (sometimes in larger doses) at night. Always refer to the dosages on the product packaging.

5. Sleep Hygiene:

We are hearing more and more about sleep hygiene in the wellness industry these days, and for good reason! Maintaining a regular sleep schedule helps regulate the body's internal clock, optimising the natural circadian rhythm for more predictable and restorative sleep. But it also helps to regulate our hormones, which also run on a rhythm of their own – again it is all connected! Creating a calming bedtime routine further signals to the body that it's time to unwind, providing a mental transition from the demands of the day to the serenity of sleep. This routine might include activities such as reading a book, practising gentle stretches, or enjoying a soothing herbal tea – like Chamomile or Lemon balm. Minimising blue light can be a game changer, and I even recommend turning off your phone and wifi an hour before bed. If this seems too extreme, you can get really cool blue light-blocking glasses to help you wind down without having to turn everything off, as well as apps that help to reduce the blue light and warm the colour of your screens. Equally important is the sleep environment itself – ensuring it is conducive to rest. This involves minimising external disruptions, keeping the room cool and dark, and investing in a comfortable mattress and pillows.

5 Herbs to Help Premenstrual Insomnia

Herbal remedies are wonderful allies for supporting both sleep and hormones.  Diet and lifestyle tips are the foundation of health and good sleep, but herbal remedies can be a brilliant natural option to add to your sleep routine too, helping you nod off. Here are some of my favourite herbs to consider for aiding sleep in the premenstrual days.

  1. Valerian Root: Widely recognised for its sedative properties, valerian root can be effective in promoting relaxation and improving sleep. Valerian calms the nervous system and influences GABA receptors, working centrally at the level of the brain, and promoting both emotional and physical relaxation. It is also antispasmodic, so it can be helpful if cramps keep you awake at night before or during your period.
  2. Hops: With a history steeped in brewing, hops are often recognised for their role in beer production; but did you know that they can also help you sleep? Hops also contain compounds that interact with GABA receptors in the brain, fostering a sense of calm and tranquillity. It is a powerful sleep herb when taken in larger doses in the evening. It is said that King George III used a pillow of Hops strobiles to help him sleep in place of opiates! When taken in smaller doses throughout the day, hops do not cause drowsiness and can be a wonderful remedy for stress and to help alleviate symptoms of anxiety.
  3. Passiflora: Passiflora is a herb I almost always put into a sleep formula for insomnia. It is used by many herbalists to aid sleep, and Alfred Vogel, in his book The Nature Doctor, recommended Passiflora to be taken in addition to Valerian and Hops for the treatment of insomnia, if an even stronger effect was needed. It is particularly helpful for people who take a long time to get asleep, but then stay asleep without trouble. It should be taken throughout the day and at night to aid sleep, as its effect are cumulative.
  4. Lemon Balm: Known for its mildly sedative effects, Lemon Balm can be beneficial in promoting relaxation and easing insomnia. Lemon Balm is high in volatile oils, which are antiseptic, antispasmodic and calming for both the digestive and nervous systems. It contains caffeic acid, which contributes to the antiviral effect, and rosmarinic acid, which is a potent antioxidant that supports memory and longevity.
  5. Lettuce: I bet you didn’t know that the crisp lettuce that you eat in salads can also be used as a sleep remedy? It won’t work if you just munch loads of salad, though. For medicinal purposes, the lettuce plant is harvested at a later stage, once it has flowered and its seeds are present. The plant then produces a milky sap that is really soothing for the nervous system and can help aid sleep.

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Navigating the challenges of PMS-related insomnia requires a holistic approach that addresses both the physical and emotional aspects of well-being. By making mindful choices in diet and lifestyle, and incorporating herbal remedies known for their sleep-inducing properties, we can nurture restful nights and embark on the journey towards a more balanced cycle and a more harmonious, well-rested premenstrual week.

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