Premenstrual Dysphoric Disorder and Sleep Quality: A Systematic Review

Abstract

The prevalence of Premenstrual Dysphoric Disorder (PMDD) is estimated at 3-8% among menstruating women, with recent large meta-analysis confirming a 3.2% rate for diagnosed cases. This review investigates the relationship between PMDD and sleep quality, highlighting how disrupted sleep-wake cycle can exacerbate symptoms like fatigue and insomnia, ultimately affecting daily functioning. Following PRISMA guidelines and registered with PROSPERO, a literature search across OVID, Embase, and the Cochrane Library identified 151 articles, which were narrowed down to 7 studies, published between 2015 and 2023, involving 1,579 PMDD participants from Taiwan, India, Canada, and the USA. Findings revealed significant impairments in emotional regulation and sleep quality, underscoring a bidirectional relationship where poor sleep worsens PMDD symptoms and vice versa. Additionally, lifestyle factors and comorbid conditions, such as bipolar disorder, were found to impact PMDD symptoms, emphasizing the need for integrated treatment strategies. Improving sleep management can enhance mood stability and cognitive function, with inadequate sleep linked to decreased positive mood, particularly during menstruation. The review advocates for targeted sleep interventions as crucial for better mood regulation and cognitive performance in individuals with PMDD, reinforcing the importance of prioritizing sleep in the management of menstrual-related disorders for improved mental health outcomes.