| Q: |
How does the menstrual cycle affect sleep?
| | A: |
The hormones estrogen and progesterone play a role in regulating
the menstrual cycle and also, through their additional functions
relating to the brain, influence other processes like sleep and
circadian rhythms. Changes that occur in women’s bodies during the
menstrual cycle can affect sleep. Many women report 2–3 days of
disrupted sleep during each cycle. Some report more sleep in the
premenstrual period, while others report insomnia. Factors like stress,
mood, illness, medication, diet, and sleep environment can also affect
sleep at this time. Menstrual cycles are usually 25–35 days long.
|
| Q: |
What is sleep like before ovulation?
| | A: |
Day 1 of the menstrual cycle is identified as the first day of
bleeding (menses). Bleeding usually continues for about 5 days. During
this time, many women sleep less and feel less comfortable during their
sleep time. Those who suffer from menstrual cramping and pain obviously
spend more time awake due to pain than those who don–t, have greater
movement activity during sleep, and experience more stage 1 (lighter)
sleep and less REM sleep. When bleeding stops and estrogen levels start
to rise, women may experience more REM sleep.
|
| Q: |
Does sleep change at the time of ovulation?
| | A: |
Around day 14, ovulation (release of an egg from the ovary)
occurs. Estrogen levels in the blood peak just before ovulation. During
this time, there are no real changes in sleep quality or quantity, but
there may be subtle differences in the amount of REM and slow wave sleep
in women who have ovulated successfully.
|
| Q: |
What happens to sleep after ovulation?
| | A: |
If the egg is fertilized after its release, pregnancy will ensue.
Otherwise, this stage of the cycle is dominated by the hormone
progesterone. If fertilization does not occur, hormone levels drop
dramatically and menstruation occurs. Some women may find it difficult
to sleep during this time. Others suffer from premenstrual syndrome
(PMS), with bloating, irritability, headaches, moodiness, and abdominal
cramps. All of these may affect the quality of sleep. Some women may
experience drastic changes to their sleep including excessive sleep,
insomnia for a couple of nights prior to their period, or significant
daytime sleepiness. Depending on the severity and whether the problem is
long– or short-term, this can be classified as a sleep disorder.
|
| Q: |
What can I do to improve my sleep, especially premenstrually?
| | A: | If you suffer from premenstrual syndrome or have
severe mood changes (depression, anger, and irritability that affect
normal functioning), you should seek medical advice. Apart from
modifying lifestyle factors, there are some effective medications that
can be very useful in controlling symptoms. Sometimes going on an oral
contraceptive may help considerably.
|
| Q: |
How do oral contraceptives affect ovulation?
| | A: |
Many women take oral contraceptives for long periods of time to
regulate their menstrual cycles and to control fertility. Oral
contraceptives are combined formulations of low-dose progestin and
synthetic estrogen and suppress the body’s own production of these
hormones. They, thus, prevent ovulation (production of an egg from the
ovaries), interrupting the normal course of the cycle.
|
| Q: |
Can oral contraceptives have an impact on sleep?
| | A: |
Oral contraceptives affect body temperature regulation and can
affect sleep. Body temperatures are consistently raised throughout the
cycle, unlike in women who are not on the pill. Secretion of melatonin
may also be affected although the research evidence is currently still
under review. Women on oral contraceptives have more stage 2 sleep and
less slow wave sleep, the deep sleep that is thought to be restful and
restorative. They are likely to have more REM sleep than women not on
oral contraceptives.
|
| Q: |
What is polycystic ovarian syndrome and how does it affect sleep?
| | A: |
Polycystic ovarian syndrome (PCOS) is a disorder in hormone
production in which some of the ovarian cells produce too much androgen
(male hormones). PCOS affects up to 4 in 100 women of child-bearing age
and results in disrupted and irregular periods, weight gain, a tendency
to develop diabetes, and excessive body hair. The risks for developing
high blood pressure and heart problems are also increased. With regard
to sleep, women with PCOS have a higher risk of developing
sleep-disordered breathing and sleep apnea (probably due to weight gain)
and are more likely to report symptoms of excessive daytime sleepiness.
PCOS is usually treated by a specialist in hormones (endocrinologist).
|
| Q: |
Does shift-work affect the menstrual cycle?
| | A: |
Shift-work can disrupt circadian rhythms in hormone production.
The reproductive/sex hormones are also affected. Studies show that women
shift-workers have more irregular menstrual cycles, painful
menstruation, and longer menstrual cycles than women who are non-shift
workers. Stress probably plays a large part in affecting the secretion
of hormones from the pituitary gland that then regulate the production
of sex hormones.
|
The menstrual cycle
By convention, the
menstrual cycle is represented as lasting 28 days to show the changes
that occur throughout the cycle. The first day of bleeding (menses) is
day 1. Ovulation (release of the egg from the ovary) is day 14.
The cycle is thus
divided into 2 phases. The first phase of the cycle (prior to ovulation)
is the follicular phase. During this stage, as the egg starts to grow
in the follicle, the levels of estrogen are high. The high estrogen
levels cause a surge in luteinizing hormone (LH), which controls
fertility and is the trigger for ovulation.
During the second half
of the cycle (the luteal phase), the levels of progesterone are much
higher than estrogen levels and resting body temperature may rise by as
much as 1°F (1/2°C). If there is no fertilization and implantation of
the egg during the luteal phase, the hormonal levels eventually drop
drastically and bleeding commences.
|
