A Woman’s Guide to Getting Over Insomnia

A couple of years ago, experts hypothesized that women need more sleep than men. As director of the Sleep Research Center Jim Horne explained, “Women’s brains are wired differently … so their sleep need will be slightly greater.”

He also outlined how women are more strongly affected by poor sleep or lack of sleep than men, with a higher likelihood of mood instability and psychological distress as a result. Horne went on to explain that women need an extra 20 minutes in the “recovery mode” provided by sleep compared to men. (Important note: his study shouldn’t be used by men to justify skimping on sleep! Sleep deprivation is a problem that affects all people, and everyone should take it seriously.)

It’s fun to see the research that acknowledges our hard-working brains. And it’s wonderful to have “expert permission” to sleep a little more…that is, if we can sleep more. 

Sleep deprivation is tragically common in the United States. One in three people in the United States do not get enough sleep on a regular basis, according to the CDC, and many women with hormone imbalances encounter extra obstacles when it comes to healthy sleep. Hormone fluctuations after giving birth can interfere with sleep for many women (not to mention getting up often with baby), so can pregnancy itself. Hot flashes during perimenopause and menopause can also throw a wrench in good sleep.

But getting enough high-quality sleep helps women balance their hormones, erase period problems, and look and feel their best. Sleep matters. In this post, I outline why good sleep matters for your menstrual cycle and how you can get more of it. 

The 4 Hormone-Related Causes of Insomnia

Getting enough healthy, high-quality sleep is important for so many reasons, from helping your brain detox to being able to perform your best at work the next day. Here are some key things get in the way of good sleep for women:

Cause #1: Adrenal Dysregulation

The adrenal glands control our stress response, and dysregulation in the adrenal system can mean an imbalance of the fight-or-flight hormone cortisol. You are supposed to get surges of cortisol during the day, but none at night. When the adrenal system is out of balance, the opposite happens: you have low cortisol in the morning, but then it peaks in the evening, leaving you with that wired-but-tired feeling when you’re trying to fall asleep — and feeling groggy and unable to get out of bed in the morning. 

Cortisol is one of the body’s master hormones and when it is dysregulated, the body’s other master hormones, like insulin, estrogen, and progesterone, will be dysregulated, too. If you hope to heal your hormone imbalances and erase period problems like acne, bloating, heavy or irregular periods, and severe PMS, you need to address adrenal fatigue, and that means making sleep a priority. 

How You Know If You Have Problems with Your Adrenal Glands

If you get a really good night’s sleep — say, you’re in bed by 10pm and sleep a full, uninterrupted 8 to 10 hours — but you still feel hungover in the morning, you might be experiencing the start of adrenal problems. 

Other symptoms of early-stage adrenal dysfunction include:

• Low libido
• Inability to deal with stress
• Problems with concentrating and memory
• Getting sick often
• Feeling depressed

The Root Causes of Adrenal Dysfunction

Several common factors fuel adrenal problems. One of the main ones is not listening to the body’s internal clock when it tells us we’re tired (more on that below). Another contributing factor is imbalances in the gut microbiome. That’s because the gut microbiome is in conversation with the adrenal glands (which produce cortisol) and when the gut flora is imbalanced it can fuel problems with the adrenal system. In the case of leaky gut syndrome, for example, toxic substances leak from the gut to the rest of the body (where they shouldn’t be) and trigger inflammation — and that inflammation stresses the adrenal glands, which start to act erratically.

But one of the biggest root causes of an overtired (and poorly functioning) adrenal system is not listening to our bodies when they send us the signals that it is time to rest. 

Culturally, we’re trained to think that we’re supposed to feel tired all of the time. We keep ourselves overbooked and overextended, we stay BUSY, in order to achieve everything we set out to achieve. For the most part, our brains can handle this. They can juggle work tasks, child care, meal planning, socializing, and studying and succeed. But our adrenals are more primitive than our brains and they cannot handle this. They get burnt out very quickly by the modern way of life.

This way of life also means that, all too often, we skimp on sleep, which makes adrenal imbalances —and all hormone imbalances — worse.

Cause #2: PMS-Related Insomnia

In order to improve the quality of your sleep, it’s critical to adopt lifestyle strategies that help balance your hormones. That’s because imbalanced hormones can affect the quality and quantity of your sleep. 

Take PMS-related sleep problems, which is driven by hormone imbalances. When PMS strikes, you’re already feeling bloated, cranky, tired, and moody the week before your period. Now add insomnia to the list, which makes the PMS symptoms you’re experiencing even worse. 

It’s a vicious cycle, one I know firsthand. When my period problems were at their worst in my early 20s, I was always tired but could never fall asleep. 

But PMS-related insomnia doesn’t discriminate based on age. It can strike every menstruating woman, and it can be especially bad for women over age 35 when the hormonal shifts that happen during perimenopause start to kick in.

What Causes Insomnia the Week Before Your Period?

The week before your period (when PMS strikes) is called the luteal phase. During the luteal phase, you have a big surge and then a rapid decline in estrogen and progesterone. When your estrogen and progesterone are balanced in relation to each other, this rise and fall shouldn’t trigger any symptoms. 

But when you have too much estrogen relative to progesterone—a condition called estrogen dominance—you can experience PMS symptoms, including insomnia. Estrogen dominance is triggered by a long list of common factors, including stress, lack of self-care, poor diet, sedentary lifestyle, and exposure to environmental toxins. 

This hormone imbalance is made worse if your progesterone levels are low overall—which can affect women of every age, but which happens more often to women over age 35. That’s because overall progesterone levels start trending downward during perimenopause, and lower progesterone negatively impacts the production of melatonin, which is required to fall asleep and stay asleep. Progesterone also promotes relaxation, and without enough of it, you will have trouble falling asleep easily. Progesterone is good for sleep. 

Some common environmental factors make the situation even worse. Drinking caffeine is one, using alcohol to unwind is another. If you have adrenal fatigue, you may experience PMS-related insomnia as feeling “tired-but-wired,” where you lay in bed exhausted but can’t fall asleep. Micronutrient deficiencies, including low levels of magnesium, zinc, and/or selenium can also fuel the problem. Magnesium helps promote relaxation; selenium may help boost progesterone and bring your reproductive hormones back into balance; studies show that zinc can help improve sleep quantity and quality. 

Cause #3: Perimenopause

The hormonal fluctuations that accompany perimenopause, the years preceding menopause, can cause sleepless nights. 

Perimenopause is when a woman’s ovaries begin to move from ovulating like clockwork to not ovulating anymore.  This is accomplished by the slow and steady rise of follicle-stimulating hormone (FSH) and fluctuating estrogen levels. Over time, these fluctuating hormone levels become waning hormone levels and they stop signaling the process of ovulation all together (menopause). Think of this as a kind of reverse-puberty.

Levels of melatonin, the sleep-promoting hormone, also drop as we get older. Experts suspect that it is the decreases in both estrogen and melatonin (and the complex interactions between these and other hormones) that give rise to perimenopausal (and menopausal) sleep complaints.

I recommend three top strategies for having symptom-free perimenopause. First, you’ll want to practice phase-based eating, which means changing what you eat in each phase of your cycle to support optimal hormone balance and metabolism. This approach to eating provides the most variety of micronutrients to support overall hormonal balance. It also ensures that you’re getting key foods at critical times to break down the excess levels of estrogen that can cause breakouts and PMS. Not to mention that this approach will improve the quality of your bleed, support fertility, and boost sex drive, energy, and mood. Phase-based eating is the true differentiator for the FLO protocol. Everything about your diet and lifestyle should be relevant to your female biochemistry, and the FLO protocol ensures that.

Second, you’ll want to engage in phase-based exercise. The cyclical nature of your 28-day menstrual cycle provides the perfect architecture for planning how to work out and when to work out. During each phase of your menstrual cycle, your body is primed for different kinds of exercise. At certain times—during the luteal phase and during menstruation, for example—the nutrients and hormones in your body are directed toward building up the lining of your uterus, so you won’t have all the internal resources you need to work out at full capacity. During the other phases, however, your body can channel all its resources into a really strong workout. By engaging in phase-based exercise, you will save yourself from exhaustion, burn-out, and unpleasant perimenopause symptoms. 

Third, you’ll want to maximize your micronutrients. Supplements are non-negotiable for keeping hormones balanced and stable as you enter perimenopause. Supplementing with specific micronutrients gives the body the extra support it needs during times of hormonal transition. For women in perimenopause, I specifically recommend a B-complex to help with energy and fatigue; magnesium for regular ovulation and thyroid function and healthy, high-quality sleep; probiotics to help metabolize estrogen; and a vitamin D3-Omega-3 blend to support overall hormone balance and fertility. 

Cause #4: Postpartum

Your hormones are on a roller coaster after giving birth, so this can throw off your sleep. So, of course, does having a baby to take care of! One of my key pieces of advice, in the first months after giving birth, is to try to sleep when your baby sleeps. In addition, you’ll want to engage in phase-based eating when your period returns. Supplement with a prenatal vitamin, probiotic, and fish oil, if you are breastfeeding and take Balance Supplements when you are done breastfeeding. Focus more on sleeping than on making time for exercise in the first months after pregnancy. When your period returns, start to return to exercising in sync with your cycle. 

Not Paying Attention to Sleep Cues

One of the biggest issues we face in getting to sleep is ignoring the signs that we are tired. We’re trained from an early age to push right past them, and we do. We might start yawning around 8:30 or 9:00pm, but in our push to be productive or sneak in one more episode of our favorite streaming show, we dismiss the signs that we’re tired and stay awake — often until much later than 9:00!

When we’re young, we follow the cues our bodies give us that tell us we’re tired. I see this with my daughter now.  She gets tired, rubs her eyes, wants a bit to eat, a cuddle, and then she’s out. There’s no fighting it, it’s a routine and she sleeps often!

As we get older, we often ignore the cues our bodies send us that tell us we’re tired. We may start yawning, but we ignore it to keep on working or reading or binging Netflix. Our eyes start to feel heavy but we push through, intent on playing one more round of cards with friends or finishing the chapter we’re on in our book (we’re so close, after all!). 

So your first step in the quest to get more sleep is to simply start tuning into your body, paying attention to signs that you’re tired, and then following those signs to bed!

Your next step is to uncover your sleep story and make specific, targeted changes to address your unique sleep dysregulation.