Insomnia Around Ovulation: Cause and Treatment

Ovulation itself isn’t known to cause insomnia, however, insomnia during PMS or during a period is common.

The exact timing can vary significantly among women, which is why some women have trouble sleeping during their periods, while others have issues before them.

Regardless, recurring insomnia is a serious condition that can result in life-altering side effects if not treated.

Sleep Issues During Ovulation vs. PMS

The root cause of sleep issues for many women is their menstrual cycle.

Most women experience a wide variety of symptoms during their luteal phase (PMS), which immediately follows ovulation. Symptoms like depression, anxiety, and physical discomfort can all directly cause sleep trouble.

While it’s less common, some women do experience insomnia during their menstrual phase. Research has shown that menstruation affects stage 2 and REM sleep in women (1).

Some degree of symptoms around the luteal or menstrual phase is expected, but up to 5% of women get a more severe form of PMS called Premenstrual dysphoric disorder (PMDD), which is known to lower sleep quality (2):

The common sleep problems associated with PMDD are sleep onset insomnia, frequent night time awakenings, and non-restoration of sleep. These sleep related problems also have daytime consequences in the form of poor concentration, daytime sleepiness, decreased alertness and poor performance at work

Finally, note that menstrual cycle phases aren’t always fixed. While there is some degree of consistency, certain foods or supplements can influence timing.

For example, if a woman is having sleep issues, she might try a natural sleep aid like melatonin. Some studies have shown that melatonin can inhibit ovulation, which can have unintended side effects on sleep quality (3).

SummaryInsomnia is most common after ovulation as a result of PMS symptoms or menstruation, however, it varies among women.

What Causes These Types of Sleep Problems

The main root cause behind irritability, depression, anxiety, and all those other potential menstrual cycle symptoms that women can get are fluctuating hormone levels.

Again, these vary from person to person, but in general, hormone levels are highest during the luteal phase.

The main hormones of concern here are estrogen and progesterone, which have different effects on sleep (4):

• Estrogen - Typically, high levels of estrogen improve sleep quality. Estrogen peaks during ovulation, but remains high during the luteal phase for most women. If estrogen gets too low, it can cause a body temperature increase (i.e. hot flashes).
• Progesterone - There is an association between high levels of progesterone and lower sleep quality. It remains low for all stages of the menstrual cycle except the luteal phase. However, it starts to rise during ovulation, which may trigger sleep troubles.

Treatment Options for Luteal Phase Sleep Issues

Treatment for this particular type of insomnia needs to be supervised by a doctor.

On top of the typical treatment methods for insomnia, there are a few specific considerations here.

First, in the case of PMDD causing sleep trouble, research has shown that bright light therapy is an option (5,6):

Bright light therapy is an effective treatment during the late luteal phase of the menstrual cycle; studies showed it reduces depression, premenstrual tension and stress in women with PMDD.

The more traditional approach to treating both PMS symptoms and insomnia would be medication.

There is medication that treats both insomnia and medication when application. Most commonly, SSRIs (a class of antidepressant) are prescribed alongside benzodiazepines (7).

Other drugs like Zalplon and Zolpidem have been shown to be effective in treating primary insomnia, but come with side effects and safety concerns long term (8).

It’s a complicated situation that needs to be assessed by a doctor who can take in a woman’s individual situational factors.

Summary of Insomnia Around Ovulation

It’s not common for ovulation itself to trigger insomnia.

However, women often get insomnia symptoms during their luteal (pre menstrual) phase that directly follows ovulation, so the two can get confused.

Regardless, there are treatments options available, including unique methods like bright light therapy. Treatment should always be prescribed and monitored by a licensed health professional.

References

1. Sleep and Premenstrual Syndrome
2. Clinical diagnostic criteria for premenstrual syndrome and guidelines for their quantification for research studies
3. Melatonin
4. Evaluation and Management of Sleep Disturbance During the Menopause Transition
5. Morning versus evening bright light treatment of late luteal phase dysphoric disorder
6. A controlled study of light therapy in women with late luteal phase dysphoric disorder
7. Influence of 17-beta-estradiol on cerebrovascular impedance during menstrual cycle in women
8. Eight weeks of non-nightly use of zolpidem for primary insomnia