Sweet Dreams & PCOS: Strategies for Restorative Sleep

Happy Sunday Loves!

Something I’ve been focusing on a lot is sleep. I’ll be honest, since getting back from Chicago I have not been getting great sleep and my recovery has just not gotten back to what it was before that trip. And that’s just how it is sometimes. Sleep and recovery is the compromise for giving yourself a fun experience. That said after a trip, a night or a busy week of work, it’s super important to get back on your sleep hygiene a-game. 

With PCOS sleep is a non-negotiable for me. Making sure to plan my schedule around the sleep and recovery I need is paramount. But why would your sleep me so important?

Sleep is one of the most crucial aspects of managing PCOS. When sleep is compromised, so is your recovery, mood, and overall well-being. This week, I’ve found myself struggling with sleep, which led me to dive deeper into understanding how I can get back on track. In this post, I’m going to explore the hormones that play a key role in sleep, how my Oura Ring supports my sleep journey, different sleep metrics to pay attention to, and why quality sleep is vital for improving PCOS symptoms.

Our bodies are regulated by a delicate balance of hormones, and sleep is no exception. The key hormones that influence our sleep patterns are melatonin, cortisol, progesterone and insulin. 

• Melatonin (1) is often referred to as the sleep hormone and is produced by the pineal gland in response to darkness. It helps regulate our sleep-wake cycle by signaling to our body that it’s time to rest. For us with PCOS, melatonin production can be disrupted due to hormonal imbalances, making it harder to fall and stay asleep.

• Cortisol (2) is making its way around the internet right now, and as many of you probably know it’s the stress hormone that plays a significant role in our sleep patterns. Typically, cortisol levels peak in the morning to help us wake up and gradually decrease throughout the day. However, chronic stress or hormonal imbalances in PCOS can lead to elevated cortisol levels at night, interfering with sleep.

• Progesterone (3) is known as the calming hormone, helping to promote sleep by reducing anxiety and encouraging relaxation. When you have PCOS, there’s often a lower level of progesterone, especially during the luteal phase, which can contribute to sleep disturbances. - I just so happen to be in the luteal phase right now, so I’m extra feeling this

• Insulin (4) - Insulin resistance, a common feature of PCOS, can also affect sleep. Poor blood sugar control can lead to nighttime awakenings and difficulty staying asleep.

Understanding these hormones and how they interact with each other is key to improving sleep quality. When one or more of these hormones are out of balance, it can create a vicious cycle of poor sleep and worsening PCOS symptoms. By improving sleep quality, these hormones can be better regulated, which helps reduce symptoms such as acne, weight gain, and irregular periods.

The most critical aspect of sleep is its ability to reduce stress, and while I’m sure you’re sick of hearing “you just need to get sleep, reduce stress and lose weight to improve PCOS, adequate sleep helps lower cortisol levels. When you lower your cortisol your body can get out of fight or flight and all the work you’re putting in finally starts to take effect. Improved sleep also enhances insulin sensitivity, which is particularly important for those with PCOS. Better insulin sensitivity helps control blood sugar levels and reduces the risk of insulin resistance, a common concern among women with PCOS. Quality sleep contributes to better mood and energy levels. Poor sleep can lead to mood swings, irritability, and fatigue, all of which are frequently experienced by those with PCOS. 

Okay, so by now you’re probably wondering how the heck do I know if my sleep is good or bad and how can I improve it?

One of the tools that have been instrumental in my sleep journey is the Oura ring, a smart ring that tracks the various aspects of sleep and provides detailed insights into sleep patterns and overall health. The Oura ring breaks down your sleep into different stages—light, deep, and REM sleep—helping you understand how much restorative sleep you’re getting and whether your body is cycling through the necessary stages for optimal recovery. It also tracks your heart rate and heart rate variability (HRV) during sleep, both of which are indicators of your body’s stress levels and recovery state. A lower resting heart rate and higher HRV generally signal good recovery, while elevated heart rates might suggest stress or poor sleep quality.

Another helpful feature of the Oura ring is the “readiness score”, which is based on factors like sleep, activity, and body temperature. This score gives you an overall picture of how ready you are to take on the day. When my readiness score is low, it’s a clear signal that I need to prioritize rest and recovery. Additionally, the ring provides a sleep score that summarizes the quality of your sleep by considering factors like total sleep time, sleep efficiency, and the balance between different sleep stages. A high sleep score indicates good sleep hygiene, while a low score can help you identify areas for improvement.

Tracking sleep metrics can provide valuable insights into your sleep patterns, allowing you to make adjustments to improve your sleep quality. One key metric to watch is total sleep time, which refers to the total amount of time you spend asleep during the night. As a person with PCOS, it’s essential to aim for at least 7-8 hours of sleep to support hormone balance and overall health.

Time in deep sleep is another critical metric. Deep sleep is the most restorative stage, where your body repairs tissues, builds muscle, and strengthens the immune system. Those of us with PCOS should aim to spend at least 15-20% of our total sleep time in deep sleep for optimal recovery. Lastly, sleep onset latency, which refers to how long it takes you to fall asleep after going to bed, is also worth monitoring. Ideally, it should take about 10-20 minutes to fall asleep. Longer sleep onset latency can indicate stress or poor sleep hygiene, signalling a need for adjustments to your bedtime routine or stress management strategies.

From waking up to winding down, I’ve made a list of the best tips I’ve found to improve your sleep that I’ll be using on this journey to getting back to my best sleep scores above 90.

Morning: Set the Tone for the Day

• Get Morning Sunlight: Exposure to natural light early in the day helps regulate your circadian rhythm, making it easier to fall asleep at night. Try to spend at least 10-15 minutes outside within an hour of waking up.

• Hydrate: Start your day with a glass of water to rehydrate your body. Dehydration can affect your energy levels and mood, both of which play a role in sleep quality. This is also where I sneak in my bone broth.

• Eat a Balanced Breakfast: Focus on a breakfast that includes protein, healthy fats, and complex carbohydrates. This helps stabilize your blood sugar levels, preventing energy crashes that can affect your mood and sleep later in the day.

• Move Your Body: Incorporate some form of exercise, whether it’s a brisk walk, yoga, or a full workout. Exercise helps reduce stress and promotes better sleep. For any intense workouts, make sure they’re done at least three hours before bedtime.

Midday: Keep Energy Levels Steady

• Limit Caffeine: If you drink coffee of any caffeinated beverages, try to do so before noon. Caffeine can stay in your system for several hours, potentially interfering with your ability to fall asleep at night.

• Eat a Nutrient-Dense Lunch: Choose a lunch that includes lean protein, vegetables, and whole grains. Avoid heavy, greasy foods that can make you feel sluggish and disrupt your sleep later on.

• Take Short Breaks: If possible, take short breaks during the day to stand up, stretch, and move around. This helps prevent stress buildup and keeps your energy levels balanced.

Afternoon: Set Up for a Calm Evening

• Manage Stress: Use stress management techniques like deep breathing, mindfulness, or a short meditation to keep your stress levels in check. Chronic stress can lead to elevated cortisol levels, making it harder to sleep at night.

• Avoid Long Naps: If you feel the need to nap, keep it under 20-30 minutes and avoid napping late in the afternoon, as this can interfere with your nighttime sleep.

• Wind Down Your Day: Start to slow down activities as you approach the evening. This means avoiding high-stress tasks and focusing on lighter, less demanding activities if that’s possible for you.

Evening: Prepare for Restful Sleep

• Eat a Light Dinner: Aim to have dinner at least 2-3 hours before bed, and keep it light. Heavy meals can cause discomfort and indigestion, making it harder to fall asleep.

• Limit Screen Time: Reduce exposure to blue light from screens (phones, tablets, computers) at least an hour before bed. Blue light can disrupt melatonin production, making it harder to fall asleep. - I personally find this the toughest but as mentioned in my prior blog, limiting to one screen at a time is a good compromise.

• Create a Relaxing Evening Routine: Engage in calming activities such as reading, taking a warm bath, or practicing gentle yoga. This signals to your body that it’s time to unwind and prepare for sleep. - I like to sip on tea while watching something easy to help my body know it’s time to wind down.

• Set a Consistent Bedtime: Try to go to bed at the same time every night, even on weekends. A consistent sleep schedule reinforces your body’s natural sleep-wake cycle.

• Optimize Your Sleep Environment: Ensure your bedroom is cool, dark, and quiet. Use blackout curtains, a sleep mask, earplugs, or a white noise machine if needed. A comfortable mattress and pillows also contribute to better sleep.

• Practice Mindfulness or Meditation: If your mind tends to race at night, spend a few minutes meditating or practicing mindfulness. Focus on your breath or use a guided meditation to help you relax and ease into sleep. - I’ve previously mentioned my love for the Balance app for meditation, they also have many sleep specific meditations perfect for calming your mind before sleep. It’s also free for your first year!

As we wrap up, I want to remind you that prioritizing sleep isn’t just about getting enough hours—it's about nurturing your body, mind, and spirit. Whether you’re bouncing back from a trip, a busy week, or just navigating the ups and downs of PCOS, the quality of your sleep can make a world of difference in how you feel. By taking small, intentional steps throughout the day, you can create a routine that not only supports your sleep but also your overall well-being. Remember, it’s okay to have setbacks, but what matters is how you choose to reset and take care of yourself moving forward. Wishing you all restful nights and rejuvenating days ahead!

REFERENCES

(1) Zisapel, N. (2018). "New perspectives on the role of melatonin in human sleep, circadian rhythms, and their regulation." British Journal of Pharmacology, 175(16), 3190-3199. Arendt, J. (1995). "Melatonin and the Mammalian Pineal Gland." Springer-Verlag. (2) Lightman, S. L., & Conway-Campbell, B. L. (2010). "The crucial role of pulsatile activity of the HPA axis for continuous dynamic equilibration." Nature Reviews Neuroscience, 11(10), 710-718. Adam, E. K., & Kumari, M. (2009). "Assessing salivary cortisol in large-scale, epidemiological research." Psychoneuroendocrinology, 34(10), 1423-1436. (3)Freeman, E. W., & Sherif, K. (2007). "Prevalence of hot flushes and night sweats around the world: a systematic review." Climacteric, 10(3), 197-214. Pruessner, J. C., et al. (2003). "Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change." Psychoneuroendocrinology, 28(7), 916-931. (4) Stenvers, D. J., et al. (2019). "Circadian clocks and insulin resistance." Nature Reviews Endocrinology, 15(2), 75-89. Spiegel, K., et al. (2005). "Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes." Journal of Applied Physiology, 99(5), 2008-2019.