Ask the Sleep Doctor: Insomnia, Birth Control Pills, and Stress

This week's "Ask the Sleep Doctor" question is a little different from the usual Q&A I post on Fridays. It comes from Liz, who answered her own sleep question by looking closely at the issues in her life that might be causing her insomnia. I'm posting it here as a great example of how individuals can isolate the issues in their busy lives that may be disrupting their sleep.

Here's Liz's original letter:

Hello,

I ran across your excellent blog in an effort to fix my insomnia without serious drugs. I can generally get to sleep by using various herbs and melatonin (sometimes Tylenol PM too), but some nights, it just doesn't work. I've noticed that those are usually the nights after I go to work (I'm a waitress part-time, and naturally, a dinner shift lasts until 9 or 10 at night), so I blamed work stress. However, I realized this morning that those nights are also the nights when I don't take my birth control pills at the scheduled time (it's just too busy at 8 p.m., which is when I'm supposed to take them). I know from Internet research that female hormones can mess with your sleep --  including pregnancy hormones, which is what birth control basically is.

Insomnia isn't listed as a common side effect of birth control, but people on the internet do report it occasionally. Do you think that could be the case here? If it helps, I'm 28 and reasonably healthy in other ways. With permission from my doc, I'm going to try shifting the BCP back a few hours, maybe even to noon or 2 p.m. and see if that helps, but this struck me as a topic for your blog. Feel free to use this letter without my name.

Cheerio,
Liz

Unfortunately, Liz wrote to me during a busy time, and I wasn't able to answer her until a few weeks had passed.  This turned out not to be a problem, as she'd solved her own sleep problem in the interim:

Hi-

As it happens, I decided to just do this (after asking my doctor), and it had an effect, but what cured my insomnia was quitting my stressful waitress job. (Not a good cure for everyone!) Your site helped me through this insomnia, and I have recommended it to others.  Thank you very much!

Liz

Comments

[Penny]

Hi there,

Okay... I have had sleeping problems off and on for many years but, normally it will last a few days and be good for the rest of the month. But, I started taking birth control 4 months ago and have had problems falling asleep at night at all. I can take cat naps but nothing more than that. I have heard that birth control sometimes gives women insomnia. I need to take birth control and I REALLY don't like taking sleeping pills every night to aid in sleeping. What can I do?? Please help!

Thank you,
Penny

[Emily]

I'm very glad to have found Dr. Breus' site. I can relate to these posts. I'm a healthy 30 year old mom and I've suffered from insomnia for a little over a year. It began exactly one month after I weaned my one-year old daughter. Before that time, I had never had any chronic sleep difficulties. I have always been a good sleeper in the past, even in times of stress. I exercise moderately, live a low-stress life, and I have a healthy diet.
The only clue is that my insomnia occurs in relation to my menstrual cycle. I cannot sleep at all for a few days and then it goes away completely. The cycle generally repeats month after month. Other problems I have experienced during this time are hot flashes and spotting. So I have been convinced that I am having hormone-related insomnia. Also, I am suspicious of my birth control pills and I am considering stopping them. The handful of doctors I have seen have told me about sleep hygiene and given me sleeping pill subscriptions. I can survive this way, but I would rather get to the root of the problem.
I have also hesitated about going to a sleep clinic because of the expense. What to do??

[meredith]

Emily,

It could very well be your BC pills... I had the same issue a while back. I'm not on BC anymore but I still get insomnia during my period. I'm not sure if there's a way around if it's hormonal.

[Hilda Luna]

Hi I dont know where to begin lol well I'll start with my age Im 33 I was diagnose with hypothyroid 6 years ago. I had My thyroid remove due to an overactive benige tumor on my gland Im on thyroid medication now and my dosage has been set for now. well for the past year I cant sleep at night and when I do. I wake up trying to catch my breath and wet from heavy sweat also many times I am woken up by my husband scares saying I was gasping as if I could not breath. I snore sometime but not all the time. I also notice I urine alot more during the night. I sleep most of the day and always tired even if I have my 8 hour sleep at night. I have headaches in the morning and memory loss sometimes is hard for me to concentrate or my mind feel disoriented. There has been times where I have gotten dizzy and fainted or when I get out of the hot shower I taken I would feel dizzy. I also have a thick uterus that cause me to have heavy bleeding I get anemic so symptoms might be the cause of that. I have been to the doctor for my thick uterus and have had a biopsy for uterus cancer and Im fine. Got Birth control to control heavy bleeding. I still cant sleep at night I heard of sleep apnea but I dont snore alot actually I snore more less than often. I need answers I seen doctors and the keep telling me is anxiety and giving me lexapro but is has not been helping my sleep. There are days where I sleep and there are day where Im awake all night trying to go to sleep but cannot and there are those times where I do sleep and wake up short of breath sweaty and dry throat gulping down water to feel better. if there anyone that know what going on with me I love to hear ideas or advice thank you.