Premenstrual sleep problems are caused by either a drop in progesterone, sensitivity to progesterone, or a histamine or mast cell reaction.
Sleep problems are also a common feature of perimenopause and menopause.
Hormonal sleep problems
PMS and PMDD
Premenstrual sleep problems are caused by one or more of the following:
- the steep drop in progesterone at the end of the cycle,
- hypersensitivity to the ups and downs of progesterone or
- a premenstrual histamine or mast cell reaction.
The solution is to support GABA with magnesium, vitamin B6, and glycine, and to take steps to reduce histamine. Read The role of histamine and mast cells in PMS and PMDD.
How does progesterone affect sleep? Progesterone is good for sleep because it converts to a sedating neurosteroid called allopregnanolone or ALLO which soothes the GABA receptors in the brain. When progesterone is high such as just after ovulation, sleep is deeper with more “sleep spindles” or brain waves that indicate the onset of deep sleep. When progesterone is low or non-existent such as on hormonal birth control, sleep is shallower and less restorative with fewer sleep spindles.
Perimenopausal sleep problems are caused by losing progesterone which results in a recalibration of the brain and stress response system. Perimenopause can also be a time of mast cell activation or high histamine, which further worsens sleep.
The solution is to reduce alcohol to lower histamine and to take magnesium and progesterone to stabilise the nervous system. Read Rescue prescription for perimenopause.
Menopausal sleep problems are caused by the lack of both progesterone and estrogen. Estrogen deficiency causes sleep maintenance insomnia, which means waking at 2 or 3 am and is the single most distressing symptom of menopause.
The solution is to reduce or quit alcohol and to take magnesium, progesterone capsules, and possibly a transdermal estradiol patch like Estradot.
Menopausal insomnia typically occurs during the first twelve months after the final periods and then sleep goes back to normal.
👉 Tip: Hormonal sleep problems are also helped by the usual sleep-enhancing techniques of exercise, morning light, and sleeping in a dark room.