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Please note – this post contains descriptions of PMDD that some may find distressing. Please read with caution.
It’s well known that PMDD symptoms can include insomnia (difficulty sleeping) or hypersomnia (difficulty staying awake) and perhaps for a select few, there are no sleeping issues at all and if so, what a blessing that must be.
For the rest of us however, poor quality sleep is just another blow we add to our cyclical list of the problems we encounter monthly with premenstrual dysphoric disorder.
It’s one I know all too well so I want to focus on my experience and the correlation I’ve found between my sleep pattern and the symptoms I experience.
This will include something I’ve never really seen discussed or discussed myself previously which makes me wonder – could it be just me?
I wish to speak on it regardless especially if it helps another woman.
I speak of the onset of nightmares during PMDD days.
Yes, for me it’s a real thing which causes me to believe it may be for others too.
On my ‘good’ (PMDD-free) days, I barely dream or remember any, if I do. During PMDD however, although the usual symptoms don’t cause me so much concern these days, the nightmares remain a consistent feature.
How badly they affect me, depends on the type of sleep I’ve been getting.
Such nightmares only occur during PMDD days – how strange, right?
So, before I get into this bizarre phenomenon that is PMDD nightmares, first I want to discuss sleeping patterns and the condition.
PMDD Insomnia/Hypersomnia
I was unfortunate enough to experience insomnia during my bad weeks in the past and if any of my readers experience the same, nothing I say next will come as a surprise.
Of course, in present day, my sleeping pattern has changed for the better with my regular gym activity etc and I’ll get into that a bit later.
For now, I want to focus on my past when the condition was a horrific 14 day experience each month.
Even without PMDD, if you struggle to sleep or struggle to stay awake, your mental health is likely to be affected (just read this article on the effects of sleep deprivation on otherwise healthy people).
So, what does life look like when like us, you’re already struggling mentally on a cyclical basis, and you combine an absurd sleeping pattern?
A walking wreck seems fitting – well, this was me.
I’d struggle to concentrate; my fatigue symptoms would intensify (as if they weren’t bad enough), and I’d be trying to hold my life together on a thread and prayer.
I don’t believe there are words available for how disruptive this combination of poor wellbeing and poor-quality sleep can be.
It all leads to dark thoughts
For my readers without PMDD, hopefully the above sheds light on why suicidal thoughts play a common feature with the condition.
Let me however, provide more context.
We feel depressed, we’re anxious about everything, we’re drained and severely fatigued – spent of all energy.
Our patience runs excessively thin, we become easily and unusually enraged, we can’t take loud noise and socialising with other people becomes particularly uncomfortable.
We crave and eat foods that aren’t good but provide short-term comfort, we feel unattractive, disgusted by how we look in the mirror despite the absence of any change.
We can’t sleep or it may be that we can’t stop sleeping. We’re at wits end and we just want it all to end.
We feel hopeless, sad and traumatised from going through this monthly fiasco – it’s draining.
We fight back tears when we’re amongst others but it’s tough. We want the ground to open and swallow us whole never to return. Our confidence sinks to an impossible low.
We hate this condition, we hate ourselves, we hate life.
As extreme as it may sound to others, to a woman who’s struggling with PMDD in this way, death can be a very appealing concept.
The above statements won’t be an accurate account for all women who have the condition of course, although, there will be stark resemblances.
The above depiction is actually what my life previously looked like – for many, many years.
Here’s a video diary entry I filmed years ago when I was at this point in my life which I later shared on my YouTube channel.
Even now, it’s difficult for me to watch but it also reminds me of how far I’ve come and is why I actively seek the mental welfare of others be it PMDD or any other mental health condition.
Why sleep is crucial to PMDD
So, you may be wondering – how does sleep play into all this?
As I mentioned earlier, the emotional symptoms of the condition can already be significantly challenging to handle and for many, it’s completely debilitating.
When we add sleep problems, it becomes a recipe for disaster.
I’ve experienced both insomnia and hypersomnia with PMDD and their effects on the symptoms aren’t much different when it comes to the severity of impact.
What tends to be different however, is the way in which they impact the symptoms.
Insomnia for me, intensifies the symptoms I experience tenfold. Particularly, anxiety.
Those feelings of being on edge become so heightened, I’d barely be able to sit still. I’d fidget and be frantic about everything.
I’d then exhibit OCD behaviours because I’m so concerned the way I’m feeling will cause me to ‘drop the ball’ in some way, so I’d overcompensate by being obsessively meticulous.
I’d over-plan and plan some more, then check my plans, write my plans and go over my plans again proceeding to then send my plans to myself on WhatsApp to then check them all again but this time on my phone – this is an example.
Although I’d feel I’m doing myself a favour, my OCD behaviour would exhaust me further, adding to how horribly I feel.
To give an example of the sleep deprived heightened anxiety, I’ll use something as normal to me as my driving.
I’d feel so anxious, that on occasion I’ve had to stop and park to calm myself down as my legs would tremble uncontrollably.
For a new driver on the road, a certain level of anxiety is to be expected but when you’re practically a driving veteran as myself, it’s difficult to fathom. I’ve been driving for over a decade and consider myself a very confident driver.
The point I’m making, is to demonstrate how much more heightened the anxiety can be because of the lack of sleep.
PMDD related anxiety minus issues with sleep is problematic in itself, but once insomnia is thrown into the mix it can become gut-wrenching.
My experience with hypersomnia has been just as severe in a different form specifically when it comes to depression.
If I’m sleeping constantly, the fatigue I’m already experiencing is intensified. It’s never a refreshing sleep and I also feel guilt for sleeping so much.
The depression becomes heightened, and I’d become almost paralytic to my daily duties whilst thoughts of self-disdain circulate.
I’d feel I’m letting myself down but don’t have energy to do much. And so, I’d just keep sleeping any chance I get because in a weird twist, the sleep is also an escape from reality.
When you’re dealing with premenstrual dysphoric disorder, the way you’re sleeping can influence the severity of how the symptoms affect you – for better or worse and I’ll share what I do shortly.
PMDD Traumatic Dreams
Before I do, I wanted to revisit something I mentioned earlier – PMDD nightmares.
The reason I’ve chosen to draw attention to this is because of a recent experience I had in 2024.
I wouldn’t know how to explain what I dreamt as it’s inexplainable for the most part and didn’t make much sense.
The part I can remember however, were three ladies who I didn’t know being extremely savage in their behaviour towards me. I’ll spare you the details, but it was extremely frightening.
I was in tears within this nightmare but then, I also woke up in floods of tears – in real life. My hysterical crying woke me out of my sleep only for me to continue crying as I sat up on my bed.
The frustrating thing, if you’ve seen one of my more recent YouTube videos where I spoke on ‘How I use to Struggle’ is, I’ve actually been doing well despite PMDD.
This nightmare caught me off guard and what I was experiencing within the dream itself, filtered into my reality which had me particularly worried.
The worst part being the emotional pain I felt in the dream is how I felt once I’d woken up and this incident wasn’t the first time.
In fact, this has been a consistent pattern I haven’t been able to break free from – yet.
Each month with the onset of the condition, these nightmares will plague my sleep for several nights inducing the very symptoms I work so hard to fight.
Once my bleed appears however, the nightmares vanish along with anything else I may have been experiencing.
The one factor that caught my attention?
The severity and impact of these nightmares are worse if I’m not sleeping enough or if I’m sleeping too much.
Good sleep doesn’t guarantee I’ll be nightmare free, but I’ve noticed when I’m sleeping well, the nightmares however unpleasant, don’t affect my wellbeing much.
This brings me unto the last most important part of this post.
The Importance of Sleeping Well during PMDD
So, what does good sleep look like anyway and how does it benefit the condition?
This is going to differ from one woman to the next but to start, the recommended hours of sleep for adults is between 7-9 hours per night and for those of us with premenstrual dysphoric disorder, adhering to this recommendation is crucial.
To be able to perform at my optimum capabilities, I sleep for a minimum 7-8 hours a night.
No less and no more.
I continue this practice during PMDD weeks despite how enticing it may be to stay awake and watch another episode of Netflix.
I’m regimented and why?
My mental health as pertains to this condition is already at a compromise compared to those without such conditions. I must be vigilant for the sake of my mental state.
We experience the condition because of our brain’s sensitivity to the changes in our hormones.
This made me realise that my brain will likely be just as sensitive to disruptions in sleep, which may throw it off balance even further and explained, why I’d experience a higher severity of certain symptoms when my sleep was disrupted.
To give our minds the best opportunity to function well, we must play an active role and that includes ensuring we’re adequately resting.
An extreme level of sleep or the lack thereof are both going to have detrimental consequences on how severely the condition affects us.
I’ve been disciplined with my sleep for approximately 2-3 years at the point of writing this post and have noticed a distinct difference in how the condition affects me when I’m sleeping well and when I’m not.
Insomnia was my Achilles-heel for years so I had to find a routine that would work in my favour to help me fall asleep – and sleep well.
Committing to working out first thing in the morning eventually fixed my problem. To wake up at 6am, I’d have to be in bed by 10-10.30pm to achieve my required hours.
My workout activity would boost my energy levels and endorphins but similarly, in addition to all my day’s activities, it’d ensure that when bedtime approached, I’d be ready to sleep without issue – and deeply.
It was difficult to implement at first and it took serious getting use to, but I kept doing it anyway.
I knew I had to force my body to adjust and get use to this change so despite how difficult it was at first, it’s now my lifestyle.
The nightmare I described in which I woke up distraught, followed a consecutive number of late nights and inadequate sleeping hours.
I had briefly fallen back into an old pattern of sleeplessness. The way that dream affected my mood and for which PMDD began to feel like it had in the past, quickly got me back on track.
In doing so, the spiked symptoms eased, and I immediately felt a great deal of emotional relief and more like my usual self.
I’m aware the last few days before my bleed will come with their woes as discussed in my blog ‘Closer the Bleed, the worse the PMDD’.
For the majority of my PMDD days however, I don’t experience the symptoms in the way I use to.
I do everything possible as discussed across my blogs and YouTube to ensure I live a reasonably enjoyable and you can too.
To hear more about what I discovered when it comes to sleep and mood generally, I previously published a YouTube video on this very topic you can watch here.
How you sleep may not seem like a big deal to you, or it’s possible you may not have considered it when it comes to the condition, but it matters.
If anything I’ve mentioned is reflective of your own experience with PMDD, then believe me when I say that you shouldn’t take your sleep for granted – it can be detrimental.
Begin prioritising your sleep, it’s a method of self-care for the brain and when it comes to PMDD our brain health is everything.
