Are Your Hormones Affecting Your Sleep?

Quick Answer: Yes, hormones can affect your sleep, and changes in hormone levels are a common reason for insomnia. Melatonin helps you fall asleep, while cortisol helps you wake up. Estrogen and progesterone also influence how well you sleep. Sleep often gets worse when these hormones change, like during your menstrual cycle, pregnancy, perimenopause, menopause, thyroid issues, or stressful times. Addressing the root cause and sticking to healthy sleep habits usually makes a difference.

If you notice your sleep gets worse at certain times of the month, during pregnancy, or as you go through menopause, hormones could be to blame. Hormones help decide when you feel sleepy or awake. When their levels go up, down, or out of balance, your sleep often changes too.

This is sometimes called hormonal insomnia. It happens more often in women because the hormones that change during the menstrual cycle, pregnancy, and menopause also affect sleep. 

This guide will show how hormones influence sleep, when they tend to cause problems, and what you can do to help.

How Hormones Control Your Sleep

A few hormones set the rhythm of your sleep and wake cycle.

Melatonin is the main hormone that helps you sleep. Your body makes it when it gets dark, telling your brain it's time to relax. Cortisol does the opposite. It goes up in the morning to help you wake up and should be lowest at night.

Estrogen and progesterone also play a role in sleep, so changes in their levels can affect how well you rest. Progesterone helps you feel calm and supports melatonin. Estrogen helps control your body temperature and sleep cycle, and it supports serotonin, which your body needs to make melatonin. When these hormones drop or change, sleep often gets worse.

Signs Your Sleep Problem Might Be Hormonal

Hormonal insomnia feels like regular insomnia, but the timing can be a clue. Your sleep issues might be related to hormones if you:

• Have trouble falling asleep or staying asleep at certain points in your menstrual cycle

• Started sleeping poorly during pregnancy or perimenopause

• Wake up with night sweats or feel too warm to sleep

• Notice that your sleep gets worse during stressful periods

• Have other symptoms of a hormone change, such as mood shifts, fatigue, or irregular periods

If your sleep problems follow a pattern connected to your cycle or a certain stage of life, it could be a sign that hormones are involved.

Also Read: Sleep Supplements for Menopause: Which Ones Are Worth Trying

Why Does Sleep Change During Your Menstrual Cycle?

Many women notice their sleep changes at different times in their cycle, mostly because progesterone and estrogen levels go up and down.

During the second half of your cycle, called the luteal phase, progesterone goes up. This is usually a calmer time for sleep. However, progesterone also makes your body a bit warmer, which can make deep sleep harder. In the week before your period, progesterone drops quickly. This drop is one reason many women feel restless, anxious, or have trouble sleeping before their period starts.

This effect is even stronger for women with premenstrual syndrome (PMS). A review of 35 studies found that sleep problems like poor sleep quality, shorter sleep, and feeling sleepy during the day are common in the late luteal phase. Women with PMS or the more severe premenstrual dysphoric disorder (PMDD) often have the most trouble sleeping. Sleep also tends to be lighter during your period, when both hormones are at their lowest.

What helps: Keep your bedroom cool, especially in the second half of your cycle when your body temperature is higher. Track your cycle and your sleep to spot patterns, and plan relaxing evenings on the days you usually sleep worst. Keeping a regular sleep and wake time helps your body adjust to hormonal changes.

Why Is It Hard to Sleep During Pregnancy?

Sleep problems are common during pregnancy, and hormones are one reason why. Estrogen and progesterone levels rise quickly, especially early in pregnancy, which changes sleep and affects other parts of the body too.

But hormones aren't the only reason. As pregnancy goes on, several physical changes can also make sleep more difficult:

• Needing to urinate more often, including overnight

• Back pain, leg cramps, and general discomfort

• Heartburn

• Anxiety about the pregnancy or birth

Sleep is often hardest in the third trimester, when physical discomfort is at its peak.

What helps: Try sleeping on your side, especially the left side, as it's usually more comfortable and better for circulation later in pregnancy. Use pillows to support your belly and place one between your knees. Drink plenty of fluids during the day, but cut back in the evening to reduce nighttime bathroom trips. If anxiety is making it hard to sleep, talk to your provider for support.

Why Does Menopause Cause Insomnia?

Menopause is a common time for sleep problems, and the hormone changes are a big reason. About 40% to 60% of women have trouble sleeping during menopause.

During perimenopause, the years before your periods stop, estrogen and progesterone levels go up and down and then drop over time. Each drop affects sleep. Less progesterone means you lose a calming hormone that helps you sleep. Less estrogen makes it harder for your body to control temperature, leading to hot flashes and night sweats that can wake you up at night. Lower estrogen also means less serotonin, which your body needs to make melatonin.

Cortisol can make things worse. Stress and cortisol levels are often higher during this time, and having more cortisol at night makes it harder to fall asleep and stay asleep.

What helps: Keep your bedroom cool and wear light, breathable clothes to help with night sweats. Try to avoid alcohol, caffeine, and spicy foods in the evening, as they can trigger hot flashes. Stick to a regular sleep schedule and create a calming bedtime routine. For some women, hormone therapy can help, especially if hot flashes are the main issue, so talk to your provider about it. Cognitive behavioral therapy for insomnia (CBT-I) is also effective and doesn't require medication.

Can Thyroid Problems Affect Your Sleep?

Yes. Your thyroid makes hormones that control how your body uses energy, and if these hormones are out of balance, your sleep can be affected.

An overactive thyroid (hyperthyroidism) speeds up your body. It can cause a fast heartbeat, anxiety, night sweats, and trouble falling asleep. In research on people with Graves' disease, the main cause of hyperthyroidism, about 66% reported difficulty falling asleep. An underactive thyroid (hypothyroidism) slows things down. It often causes tiredness during the day and can lower sleep quality, even if you spend enough time in bed.

It often leads to significant daytime sleepiness and may reduce sleep quality even if you get enough sleep. Studies show that around 60% to 67% of patients experience poor sleep. 

Thyroid problems can also cause symptoms like anxiety, mood changes, and muscle aches, which can make sleep harder by themselves.

What helps: Sleep problems from thyroid issues usually improve once the thyroid is treated. If you have insomnia along with symptoms like unexplained weight changes, tiredness, a fast heartbeat, or feeling unusually cold, ask your doctor about a thyroid test. Treating the main problem is the most important step.

How Does Stress Affect Sleep Hormones?

Stress mainly affects sleep through cortisol. Normally, cortisol is high in the morning and low at night. If you are stressed for a long time, cortisol stays high when it should be dropping, making it hard to relax and stay asleep.

This can turn into a cycle. Stress raises cortisol and makes sleep worse, and poor sleep raises cortisol even more, making the next night harder. To break the cycle, you usually need to work on both stress and sleep. Since cortisol has a big impact on sleep, it helps to learn more about it. 

What helps: Create a calming routine before bed, such as dimming the lights, taking a warm shower, reading, or practicing slow breathing. Avoid screens during the last hour before sleep. Regular exercise during the day lowers stress hormones, and getting morning sunlight helps reset your cortisol rhythm.

Can PCOS Affect Your Sleep?

Yes. Polycystic ovary syndrome (PCOS) is a common hormone condition in women, and sleep problems often come with it. Women with PCOS are more likely to have insomnia and are at higher risk for obstructive sleep apnea, a condition where breathing stops and starts during sleep. About 35% of women with PCOS have sleep apnea, which is much higher than in women without PCOS.

Several aspects of PCOS can make sleep worse. Higher levels of male hormones (androgens) are linked to sleep apnea. Insulin resistance, which is common in PCOS, can get worse with poor sleep and also make sleep problems more likely. This often creates a cycle where PCOS affects sleep, and poor sleep makes PCOS harder to manage.

What helps: Good sleep habits are important, but since sleep apnea is common with PCOS, it is a good idea to get checked for it, especially if you snore, wake up gasping, or still feel tired after a full night's sleep. Treating sleep apnea can help both your sleep and PCOS symptoms. Managing insulin resistance with diet, exercise, and any treatments your doctor suggests can also improve both.

How Does Poor Sleep Affect Your Hormones?

The relationship goes both ways. Hormones affect your sleep, and poor sleep can also affect your hormones. This is one reason sleep problems can be hard to fix.

One clear example is appetite. Two hormones control hunger and fullness: ghrelin makes you hungry, and leptin makes you feel full. Not getting enough sleep changes both in the wrong way. In a large study, people who slept 5 hours had about 15% less leptin and 15% more ghrelin than those who slept 8 hours. This leads to more hunger and stronger cravings for high-calorie foods, which helps explain why poor sleep is linked to weight gain.

Poor sleep also raises cortisol and can make insulin resistance worse, which affects how your body handles blood sugar. Over time, these changes increase the risk of problems like type 2 diabetes. The main point is that taking care of your sleep also helps keep your hormones balanced.

How Do Sleep Hormones Change With Age?

As you get older, sleep often becomes lighter and more broken, and hormones play a role in this. Your body makes less melatonin as you age, so the signal to sleep gets weaker. Growth hormone, which is released during deep sleep, also drops, which is one reason deep sleep decreases over time.

These changes are normal, but they make good sleep habits even more important. Getting steady light during the day, keeping a regular schedule, and having a cool, dark bedroom all help support the sleep signals that naturally weaken with age.

When to See a Doctor

See a doctor if you regularly have trouble sleeping, or if your sleep problems come with other symptoms like irregular periods, unexplained fatigue, mood changes, or weight changes. A provider can check if a hormone change, a thyroid condition, or something else is causing your sleep trouble, often with simple bloodwork, and recommend treatment that fits your situation.

A melatonin-free way to wind down

If you want natural support to relax at night, especially during hormonal changes like menopause, Sip2Sleep® is a melatonin-free liquid sleep aid made with Montmorency tart cherry and Venetron® to help you ease into restful sleep. As with any supplement, check with your doctor first, especially if you are pregnant or take other medications.

About the author

Dr. Ruchir P. Patel, MD, FACP, is the Medical Director of the Insomnia and Sleep Institute of Arizona and the founder of Sip2Sleep. He is triple board-certified in sleep medicine, obesity medicine, and internal medicine. Dr. Patel is a multi-year Phoenix Magazine Top Doctor and holds the Inspire Excellence designation.

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