Menstrual Cycle Fluctuations of Progesterone and the Effect on Sleep Regulation

Abstract
Women of reproductive age experience higher rates of sleep disturbance than their male counterparts, leading to lack of restorative sleep and increasing risk for chronic disease. The objective of this review is to overlay the menstrual cycle with sleep regulation to develop an evidence-based theoretical model that directs clinical interventions for improved sleep in affected women. Utilizing the basic mechanisms for sleep and the menstrual cycle, in addition to evidence for sleep and hormonal dysregulation, hormonal fluctuations are mapped to variations in gamma-aminobutyric acid (GABA), melatonin, and cortisol levels. Effective interventions that may be included in individualized treatment plans – varying based on the scope of practice for each practitioner – are presented, along with the impetus for future research to explore the relationship between the menstrual cycle and sleep regulation.