Subjective Sleep Disturbance and Psychological Distress are Associated with Menstrual Problems

Objective: Several studies have investigated subjective sleep quality during the menstrual cycle. For example, subjective sleep quality is reportedly worse at the premenstrual phase and during menstruation. However, the influence of sleep quality on menstrual symptoms has not yet been elucidated. The aim of this study was to investigate the association between self-reported sleep quality, psychological distress, and menstrual symptoms. Methods: Participants were female university students (n=150; mean [SD] age 18.8 years). They completed the Pittsburgh Sleep Quality Index (PSQI), the Menstrual Distress Questionnaire (mMDQ), and Kessler’s Psychological Distress Scale (K6). We also collected demographic data. Results: Participants were categorized into good sleepers (PSQI total score <5.5, n=74) or poor sleepers (PSQI total score ≥ 5.5, n=76). Poor sleepers experienced significantly more severe menstrual symptoms (p<0.01) and tended to have a less regular or more variable length of their menstrual cycle (p=0.06) than good sleepers. Multiple regression analysis revealed that subjective sleep disturbance (PSQI ≥ 5.5) and psychological distress (K6 ≥ 9) were significantly positively associated with the mMDQ score. Conclusion: Subjective sleep disturbance and psychological distress in daily life are associated with menstrual problems, including severe menstrual symptoms and menstrual cycle irregularity.