You fall asleep exhausted, then your eyes open at 3 a.m., your heart beating too fast, impossible to go back to sleep. Sometimes the day before your period, sometimes in the middle of menopause, and you feel like your body has taken control of your nights. The hormones that regulate the menstrual cycle, pregnancy, menopause or the thyroid constantly interact with those of sleep, such as melatonin and cortisol. When this balance is disrupted, the brain receives contradictory signals: to sleep or stay alert. Certain specific signs can help identify this “hormonal insomnia”.
When hormones disrupt sleep
Asked by HuffPost UKdoctor Giuseppe Aragona, general practitioner, explains that hormonal insomnia “refers to sleep difficulties that occur as a result of changes or imbalances in hormones in the body“, and specifies that melatonin signals to the brain that it is time to sleep while cortisol promotes alertness when its level remains high in the evening.
Menstrual periods, pregnancy, perimenopause, menopause, but also thyroid diseases or other endocrine disorders are times when these hormones move a lot. “These hormonal fluctuations can disrupt body temperature regulation, circadian rhythm and mood, all of which contribute to sleep disorders“, continues Dr. Giuseppe Aragona. This is where the nights often begin to become fragmented.
Signs that suggest hormonal insomnia
According to the doctor, the symptoms are very similar to those of so-called classic insomnia. “People with hormonal insomnia often have trouble falling asleep at first, wake up during the night and struggle to get back to sleep, or wake up too early in the morning“, describes Dr. Giuseppe Aragona. Sleep then seems fragmented, not very restorative, with fatigue, irritability, difficulty concentrating and low mood during the day.
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Frequent awakenings;
- Waking up very early and unable to go back to sleep;
- Non-restorative sleep, fatigue, irritability during the day;
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Night sweats and hot flashes;
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Urge to urinate at night;
- Pain or pauses in breathing noticed by the partner.
When these signs almost always return at the same time of your menstrual cycle, the hormonal track strengthens. At the end of the luteal phase, many women describe the same symptoms: painful or swollen breasts, cramps, severe fatigue and mood swings, with broken nights. During periods, pain and heavy bleeding, but also the fear of staining the sheets, further shortens sleep. The hot flashes and night sweats of menopause create the same vicious cycle of repeated awakenings.
When to consult for possible hormonal insomnia
When sleep problems last more than three nights a week for at least three months, specialists advise consulting. Dr. Giuseppe Aragona indicates that a doctor will then be able to “explore a person’s general health, hormonal history, and the timing and pattern of symptoms“. He adds that it is important to look “mood changes, night sweats or bladder problems” and to rule out other possible causes.
Doctors then check whether stress, poor sleep hygiene, sleep apnea or chronic pain alone do not explain the insomnia. When a hormonal imbalance is suspected, a gynecologist or endocrinologist may suggest blood tests for thyroid, sex hormones or cortisol. Dr. Giuseppe Aragona also recommends “maintain a regular sleep routine, avoid stimulants and screens in the evening, and keep the bedroom cool, dark, and quiet“, focusing on relaxation, physical activity and a balanced diet.