PMDD Insomnia: The Sleep Disturbances Explained

Rishabh Mehta
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Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
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PMDD Insomnia

PMDD is an endocrine disorder, which is a more severe form of Premenstrual Syndrome (PMS). 

Besides, it is also a mental disorder that can cause emotional distress and sleep problems. 

In fact, sleep problems account for one of the most common symptoms reported by 66 percent of women having PMDD. 

While milder problems can be dealt with, what about insomnia? 

Is PMDD insomnia a big concern that can affect the quality of life of several women? 

Read this article to find out the answer to these questions and also explore ways for management. 

PMDD and insomnia

It is true that, just like PMS, even PMDD can affect sleep quality, leading to insomnia. 

Mostly, the symptoms start appearing a week before starting the periods. 

They are at a peak one to two before the periods. 

Eventually the symptoms get mild or resolve a few days after periods. 

Women with PMDD have severe insomnia in both premenstrual and follicular phases (day one to day of ovulation of the menstrual cycle). 

However, it was higher in the luteal phase (second half of the menstrual cycle) than in the follicular phase. 

PMDD insomnia symptoms or associated sleep problems include:

  • Frequent awakenings
  • Non-restorative sleep
  • Unpleasant dreams or nightmares
  • Poor sleep quality
  • Daytime disturbances like sleepiness, fatigue, decreased alertness, and an inability to concentrate
PMDD can significantly affect mental health, as women with PMDD have a higher suicide rate with an odds ratio of 4.4 in comparison to women without PMDD. 

Many other sleep parameters that can be affected by PMDD are:

  • Bedtime
  • Sleep-onset latency
  • Sleep maintenance
  • Wake time

To know about all the PMDD symptoms you can experience alongside insomnia, read PMDD symptoms

PMDD insomnia treatment

Woman holding birth control pillsSource: Signature_images
Woman holding birth control pills

PMDD symptoms are mostly treated with Selective Serotonin Reuptake Inhibitors (SSRIs) and birth control pills. 

Besides, options like surgical removal of ovaries and uterus are the last option if symptoms are severe and unresponsive to other treatments. 

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When it comes to insomnia, managing it alongside other PMDD symptoms, such as pain and fatigue, can be challenging. 

However, you can achieve it by practicing sleep hygiene. 

It involves practices such as sleeping and waking up at the same time daily, giving up on smoking and caffeine, and relaxation exercises. 

Besides, Melatonin can also restore sleep in case of PMDD while restoring the balance of reproductive hormones. 

Some other ways to deal with insomnia can also help, which include medications like Benzodiazepine receptor agonists such as Zolpidem. 

PMDD is a disabling form of PMS and cannot be left untreated. In case of any discomfort, you must consult a doctor and immediately seek treatment to avoid issues such as depression and suicidal thoughts. 

Cognitive Behavioral Therapy for Insomnia (CBT-I) is another treatment plan which continues for 6-8 weeks. 

It involves sleep education, relaxation or meditation, and cognitive therapy to reduce the nervousness about sleeping. 

For detailed information about treatment options, read PMDD treatment. 


Just like PMS causes insomnia, so does PMDD by affecting the quality and time of sleep. 

About 66 percent of the women with PMDD encounter sleep-related problems such as fatigue, poor sleep quality, time, and daytime sleepiness. 

These symptoms are higher in the second half of the menstrual cycle, peaking a day or two before periods. 

Techniques such as sleep hygiene and CBT-I therapy can help manage them. 

Additionally, supplements like Melatonin or medications like Benzodiazepine receptor agonists can help. 

However, it is important to consult a doctor before using medications. 

Timely reporting of symptoms and discomfort can help relieve them, prevent severity and preserve quality of life. 

Frequently Asked Questions

How to manage PMDD and insomnia?

For managing PMDD symptoms, doctors mostly prescribe SSRIs or oral contraceptives for treatment. Sometimes, removal of the uterus and ovaries is required for severe symptoms unresponsive to other treatments. Besides, for better sleep, you can practice sleep hygiene and relaxation techniques and ask your doctor for medication. 

Can PMDD cause insomnia?

Yes, PMDD can cause insomnia. About 66 percent of the women having PMDD have some trouble sleeping. In a few cases, it can develop into insomnia. It is most likely to hit a week before periods, and the symptoms get milder a few days after. 

Does insomnia worsen the PMDD?

Women with PMDD report insomnia or at least some sleep problems. Insomnia can not only disrupt the night cycle but also worsen other PMDD symptoms during the daytime. It includes poor concentration, daytime sleepiness, poor performance, and decreased alertness. 

Is insomnia a condition in PMDD?

Insomnia is a condition related to PMDD. Many women experience insomnia along with other symptoms like depression, fatigue, headache, and bloating due to PMDD. These symptoms mostly appear a week before periods and peak one or two days before periods. 

How to sleep properly with PMDD?

Sleep management techniques for PMS/PMDD can help you enjoy a better nighttime. These include sleep hygiene, which involves healthy sleeping practices like sleeping and waking up at the same time daily, avoiding naps, caffeine, etc. Moreover, Melatonin and other medications, like Benzodiazepine Receptor Agonists, can help. 

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