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Please note – this post contains descriptions of PMDD that some may find distressing. Please read with caution.
Is it a Thing?
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 addition to the list of problems we encounter with premenstrual dysphoric disorder.
It’s something I know all too well, which is why I want to focus on my own experience and the connection I’ve noticed between my sleep patterns and my symptoms.
This will include something I’ve never really seen discussed or discussed myself which makes me wonder — could it just be me?
Due to the complexities of PMDD, I felt to address it regardless in case other women have noticed the same.
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In discussing PMDD and sleep, I’m specifically speaking on the onset of nightmares during PMDD days.
On my ‘good’ days, I very rarely dream at all, or perhaps it’s that I don’t remember them when I do. Either way, my dreams pose no issues otherwise.
During PMDD however, although the usual symptoms no longer cause as much disturbance as they did previously, the nightmares have remained a consistent feature.
How badly they affect me, depends on the type of sleep I’ve had — not sleeping enough worsens that effect.
It’s a pattern I noticed because the timing of such nightmares only ever occurs during PMDD days — strange, right?
So, before I get into this bizarre phenomenon, I first want to discuss sleeping patterns in relation to the condition generally.
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PMDD Vs Sleep
In the past, I would experience insomnia during my bad weeks, and if any of you experience the same, nothing I say next will come as a surprise.
Of course, in present day, my sleeping patterns have changed for the better with my regular workout activity etc, and I’ll get into that a bit later.
Even without PMDD, if you struggle to sleep, or struggle to stay awake, your mental health is likely to be affected (this article highlighting the effects of sleep deprivation on otherwise healthy people says it all).
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So, what does life look like when you’re already struggling mentally on a cyclical basis, and you combine that with a severely disruptive sleeping pattern?
Whether you’re not sleeping enough, or you’re sleeping too much, a walking wreck seems fitting — and that was me.
I’d struggle to concentrate; my fatigue symptoms would intensify (as if they weren’t bad enough), and I’d try to hold my life together on what felt like a thread and prayer.
There are no words that truly capture just how disruptive the combination of poor wellbeing and poor-quality sleep can be.
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An Account of PMDD
For my readers without PMDD, hopefully the above sheds light on why suicidal thoughts play a common feature with the condition.
To 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’re unsettled by loud noise, and socialising becomes particularly uncomfortable.
We crave and eat foods for short-term comfort, and we feel unattractive, upset by our appearance despite the absence of any change as our confidence sinks.
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We feel hopeless and sad, traumatised from going through this monthly fiasco.
When we’re amongst others, we’ll be fighting back tears. We hate this condition, we despise ourselves, and we certainly dislike life.
The added disruption to our sleep brings us to wits end as the desire for it to all end mounts.
As extreme as it may sound, to a woman who’s struggling with PMDD, death can become a very appealing concept.
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Although the above statements aren’t an accurate account for all women with the condition, there will be stark resemblances.
What I described is exactly how my own life looked — for many, many years. Here’s a video diary entry I filmed years ago that bears witness.
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 welfare of others be it PMDD, or any other mental health related condition.
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PMDD Vs Insomnia
So, you may be wondering — how does sleep play into all this?
As mentioned earlier, the symptoms we face can already be significantly challenging.
When we add sleep problems, it becomes a recipe for disaster.
I’ve personally experienced both insomnia and hypersomnia with PMDD, and when it comes to the severity of their impact, their effects on symptoms are equally significant.
What tends to differ, however, is the way each one impacts the symptoms — at least that has been my observation.
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For me, insomnia intensifies my symptoms tenfold — particularly, anxiety.
That constant sense of being on edge becomes so heightened that I can barely sit still, fidgeting and feeling frantic about everything.
I would begin to exhibit OCD behaviours driven by a fear that the way I was feeling might cause me to ‘drop the ball’ in some way. To compensate, I became obsessively meticulous.
I’d over-plan then plan some more — checking, rewriting, and re-reading everything.
Although it felt as though I was helping myself at the time, these OCD behaviours only exhausted me further, compounding how I unwell I already felt.
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To give a real example of how sleep deprivation heightens PMDD anxiety, I’ll use something as familiar to me as driving.
I’d feel so anxious that, on occasion, I had to pull over and park just to calm myself down, as my legs would begin to 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 full-time for over 15 years and consider myself a very confident driver but I’m making this point to demonstrate how significantly a lack of sleep can heighten PMDD anxiety.
Anxiety related to the condition is already problematic in itself, but once insomnia is added it can become debilitating.
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PMDD Vs Hypersomnia
My experience with hypersomnia has been just as severe in a different form — particularly, with PMDD related depression.
If I slept constantly, the fatigue only intensified. The sleep was never refreshing, and I was often left feeling guilty.
At the same time, the depression deepened, leaving me paralysed by daily responsibilities as self-deprecating thoughts continued to circulate.
I felt I was letting myself down, but didn’t have energy to do much. And so, I kept sleeping because in a strange twist, sleep also became 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.
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PMDD & Nightmares
I’ll shortly share practices I implement for improved sleep but before I do, let’s revisit something I mentioned earlier — PMDD nightmares.
The reason why I chose to draw attention to it is because of an 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 do 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 very frightening.
Within the nightmare, I was already in tears, and I woke to the same flood of emotion in real life. My own hysterical crying had pulled me out of sleep, leaving me feeling utterly overwhelmed.
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If you’ve seen my ‘How I use to Struggle’ video, you’ll know the most frustrating part was that I had actually been doing well with PMDD.
This nightmare caught me off guard, but what truly concerned me was how it spilled into my waking reality.
The hardest part wasn’t just the emotional pain, but the realisation that this wasn’t an isolated incident — it was simply one of the worst, and it’s what helped me recognise the pattern.
In fact, this has been a consistent pattern I haven’t been able to break free from — yet.
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Each month, such nightmares plague my sleep for several nights, inducing the very symptoms I work so hard to fight.
Once my bleed appears, however, the nightmares vanish with all the other PMDD symptoms.
But one contributing factor has caught my attention.
The severity and impact of these nightmares is worse if my quality of sleep is disrupted.
Good sleep doesn’t guarantee I’ll be nightmare-free, but I’ve noticed that when I’m sleeping well, even unpleasant dreams don’t impact my wellbeing as deeply.
This brings us unto the last most important aspect of this post.
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Quality Sleep & PMDD
So, what does good sleep look like anyway, and how does it benefit this 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 us, adhering to this recommendation is crucial.
To perform at my optimum level, I aim to get a minimum seven to eight hours of sleep each night — no less, no more.
I continue this practice during PMDD weeks despite how enticing it may be to stay awake and watch another episode on Netflix.
We must be regimented and why?
Because our mental health is already more compromised than that of those without such conditions, we must be vigilant for the sake of our wellbeing.
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Remember, we experience the condition because of our brain’s sensitivity to the changes in our hormones.
This made me realise that my brain is likely especially sensitive to sleep disruption, something that can throw it even further off balance and helps explain, why certain symptoms intensify when sleep is affected.
To give our minds the best opportunity to function well, we must play a proactive role ensuring we’re adequately resting.
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An extreme level of sleep, or the lack thereof, can have detrimental consequences on how severely the condition affects us.
I’ve been disciplined with my sleep for approximately three years at the point of writing this post, and have noticed a distinct difference in how the condition affects me if I’m sleeping well, versus when I’m not.
Insomnia was my Achilles-heel for years so I had to find a routine that worked in my favour when it came to sleeping.
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Exercise & Quality Sleep
Committing to a workout first thing in the morning eventually helped fix my problem.
To wake up at 6am, I needed to be in bed by 10-10.30pm the night before — to also achieve the necessary hours.
My workout activity would boost my energy levels and endorphins, but similarly, in addition to the day’s activities, it’d ensure that when bedtime approached, I’d be desperate for rest.
It was difficult to implement at first, but I kept doing it until it felt normal.
I knew I would have to force my body to adjust and in the long run, it became my lifestyle.
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The nightmare I described in which I woke up distraught had followed a consecutive number of late nights and inadequate sleeping hours.
I had briefly fallen back into an old pattern of sleeplessness. However, the way that dream affected my mood — and how PMDD had began to feel as it had in the past, was what quickly brought 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.
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Summary
I’m aware that the last few days before my bleed will come with its woes as discussed in my blog ‘Closer the Bleed, the worse the PMDD’.
For the majority of my PMDD phase however, I don’t experience the symptoms in the way I used to because I do everything possible to ensure I live a reasonably enjoyable life and you can too.
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To hear more about what I discovered when it comes to sleep and mood generally, I previously published a YouTube video 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, then believe me when I say that you shouldn’t take your sleep for granted.
Begin prioritising your sleep because it’s a method of self-care for the brain, and when it comes to PMDD, our brain health is everything.
