Do you struggle to fall asleep at night or find yourself waking up too early? Or, do you fall asleep during the day, no matter how much rest you get?

You are not alone. Many people with endometriosis (also called endo) experience sleep problems. Insomnia symptoms are twice as frequent in women with endo compared to those without the condition.

Sleep difficulties are frequently discussed on MyEndometriosisTeam. “I’m so exhausted,” said one member. “I’m usually awake till the early hours, but recently, I’ve been going to sleep before midnight and waking up at early hours! During the day, I’m literally falling asleep.”

Another member shared, “I had severe insomnia last night and barely got two hours of sleep. My endometriosis causes me bouts of insomnia and makes it difficult for me to tackle a day’s work.”

The good news is that you don’t have to accept insomnia as an inevitable part of your endo. There are steps you can take to improve your sleep and, ultimately, your daily life. Treating insomnia can even help alleviate other endometriosis symptoms.

What Causes Sleep Problems in Endometriosis?

Most of us experience loss of sleep at one point or another. However, for those living with a chronic condition like endometriosis, sleep problems can be much more common. Several endo-related issues can affect your quality of sleep.

Pain

Any condition that causes pain can affect sleep, and the chronic pelvic pain characteristic of endo is no different.

There is a word for this type of lack of sleep: “painsomnia,” or pain-induced insomnia. One member wrote, “I haven’t had a decent night’s sleep in a couple of weeks due to pain-induced insomnia. I've almost fallen asleep standing up at work but can’t sleep at night.”

Painsomnia is often a cyclical problem for people living with endometriosis. The sleep disruption resulting from pain can trigger the immune system to activate excessive inflammatory responses. This, in turn, stimulates pain and causes more sleep disturbance.

Discomfort

General discomfort often accompanies more severe or localized pain in people with endometriosis. Whether it’s due to something you ate, menstrual pain, or another symptom of endometriosis, discomfort at night can make it difficult to fall asleep. This can result in poor quality of sleep, which contributes to fatigue and sleepiness during the day.

Anxiety

Anxiety can seriously affect your ability to get a restful night’s sleep. One MyEndometriosisTeam member whose insomnia has improved with medication shared, “Still I have times, particularly when my anxiety is very high, that I still stay wide awake (but so, so tired).”

Anxiety about not being able to sleep is a common contributor to the inability to sleep. It’s important to let your doctor know if you’re experiencing anxiety, as chronic anxiety can affect your mental health and trigger depression.

Migraines

Like endometriosis, migraines are a common occurrence among women of reproductive age. Research has established a relationship between migraine and endometriosis.

Recent studies have shown that people who experience migraines have a higher prevalence of poor quality sleep than those without. Such sleep problems are common among people with migraines, affecting 30 percent to 50 percent of adults and children with the disorder. The relationship between sleep problems and migraines also seems to be reciprocal: sleep disruption can trigger migraine attacks, which, in turn, can affect your quality of sleep.

The Impact of Sleep Problems on People With Endometriosis

Poor sleep can make daily life challenging and can negatively affect quality of life. Sleep problems may have many different impacts on people with endo, ranging from physical to emotional.

Increase in Inflammation

Inflammation is a key factor in endometriosis. Not only are inflammatory chemicals involved in the development of the disease, but endometriosis also triggers inflammation. Inflammation, in turn, is one of the biggest causes of pain for people with endo.

Unfortunately, sleep deprivation can cause further inflammation. According to researchers, loss of sleep, even for a small part of the night, can prompt the immune system to produce tissue-damaging inflammatory chemicals.

Sensitivity To Pain

Lack of sleep can increase your sensitivity to pain by blocking the brain’s natural pain-relief chemicals, such as dopamine. When this occurs, pain signals become more intense and lower your pain threshold, even if nothing has happened physically to increase your pain.

Fatigue

Fatigue, or constant exhaustion, is a very common symptom of endometriosis. Lack of sleep can exacerbate fatigue related to endo.

Anxiety and Depression

Research has indicated that the relationship between lack of sleep and anxiety and depression is likely reciprocal.

Although anxiety and depression can contribute to lack of sleep, research has revealed that not getting enough sleep can also increase the risk of anxiety and depression and worsen their symptoms.

How You Can Improve Your Quality of Sleep

Managing your sleep problems is one step in taking care of yourself with endo. There are certain steps you can take to ensure your quality of sleep improves over time.

According to the Centers for Disease Control (CDC), the there are steps that can help you get started on your journey to easier sleep.

Follow a Sleep Schedule

Go to bed and get up at the same time each day, including weekends. Being consistent reinforces your body’s sleep-wake cycle.

Start a Sleep Routine

Get yourself in sleep mode before going to bed. Dim the lights and stop using screens an hour before bedtime. You can also use blackout curtains to block any light from outside.

Avoid Caffeine Late in the Day

Avoid drinking caffeinated beverages, such as coffee, tea, or soda before bed.

It’s also important to keep in mind that you shouldn’t try to sedate yourself or induce sleep with alcohol. Doing so interferes with the rapid eye movement (REM) portion of the sleep cycle, which is important for achieving restorative sleep.

Exercise During the Day

Physical activity during the day can help you sleep better at night. Exercise can be challenging if you’re struggling with endo pain or other related symptoms. Try to incorporate gentle activity whenever you can.

Don’t Force It

If you can’t sleep, get out of bed. You can read a book, meditate, or perform another quiet, relaxing activity until you feel the need to sleep. Once you start to feel sleepy, go back to bed.

Talk To Your Doctor

Talk to your gynecologist or other health care provider about your sleep difficulties. They can help you identify solutions to improve your sleep or refer you to a specialist in sleep disorders.

MyEndometriosisTeam Members’ Tips on Getting Better Sleep

Members of MyEndometriosisTeam frequently share tips that they have found to work for them. Be sure to talk to your doctor before starting any new supplements, treatments, or regimens for sleep problems.

Talk With Others Who Understand

You don’t have to accept sleep problems as part of your life. Part of proper endo management is by rest through sleep. On MyEndometriosisTeam, you can talk with more than 113,000 members from all over the world who come to offer and share support.

Have you experienced sleep problems with endo? Share your story in the comments section below, or start a conversation by posting on your Activities page.