There are many great benefits to being on birth control pills: safe and effective protection against pregnancy, lighter and less painful periods, clearer skin—and the list goes on. But just like all forms of medication, hormonal birth control can have some unwanted side effects. Although sleep issues aren’t one of the most common side effects, some people have anecdotally experienced changes in their sleep.
Below, we asked experts to explain whether birth control pills can affect sleep and what you can do to promote better sleep habits to ensure a good night’s rest.
Can birth control cause sleep problems?
There are some small studies that show birth control pills can affect sleep. For example, according to a widely cited online survey in the Journal of Sleep Research, women who used oral contraceptives, whether progestin-only or combination pills, reported more insomnia symptoms and experienced excessive daytime sleepiness compared to women who weren’t using any birth control pills.
The same study found that progestin-only pills were associated with lower sleep duration. Additionally, a small study in Psychoneuroendocrinology found that oral contraceptive use was associated with severe insomnia symptoms.
That said, there’s also some research that hormonal birth control pills can improve sleep. A population-based survey in the International Journal of Gynecology & Obstetrics found that women taking oral contraceptives tended to have increased sleep efficiency compared to women in the follicular (starts the first day of their period) or luteal phases (the start of ovulation) of their menstrual cycle.
“Some research has found hormonal contraception to improve sleep efficiency and decrease sleep apnea, while other research shows increased daytime sleepiness and insomnia symptoms,” says Stephanie Hack, MD, an obstetrician-gynecologist and host of the Lady Parts Doctor podcast. “The sample sizes in the studies I reviewed were small—less than 1,500 participants. More research is needed to fully understand.”
One possible reason you may have trouble sleeping at night is that taking hormonal birth control suppresses your natural production of estrogen and progesterone, says Alisa Vitti, founder and CEO of FLO Living and creator of the Cycle Syncing Method®.
“Progesterone is a hormone that helps you sleep,” explains Vitti. “Perimenopausal women who start making less of this hormone often experience insomnia due to falling levels of it—and so it can absolutely affect women’s sleep earlier if they are on the Pill.”
There’s also a relationship between melatonin (sleep hormone) production and progesterone that supports a healthy cycle, adds Vitti. “Melatonin rises in the luteal phase and falls a bit before ovulation, which modulates cyclicity,” she says. “Disturbing this process can impact cortisol and progesterone levels, and depending on the type of pill you are taking and the time of day you take it, it can interfere with this melatonin/progesterone interaction further and disrupt sleep and daytime energy levels.”
There are two main types of birth control pills: Combination pills, which contain both estrogen and progestin, and progestin-only pills. But again, more research is needed to fully understand the relationship between the hormones in birth control and how they may affect sleep.
How to sleep better on birth control
Speak to your gynecologist about switching to a non-hormonal form of contraception or a hormonal IUD if you’re having sleep issues and think that it’s related to your birth control, Hack says.
“If you’ve only been put on this medication to deal with period problems, then finding a more systemic solution to your hormone problems would both address the root causes of those issues and eliminate the cause of your sleep disruption, aka that medication,” adds Vitti.
In the meantime, here are some ways you can try to get better sleep at night. Many of these tips are used to promote better sleep in general, whether you’re on the Pill or not.
1. Set a consistent sleep schedule
Following a sleep routine, in which you go to bed at the same time or around the same time every night, can help your body get into a regular rhythm with sleep and waking up, Hack says. Experts encourage you to follow this schedule even on weekends, when you may want to stay up later and sleep in.
2. Exercise during the day
Incorporating some physical activity during the day promotes better sleep at night, Hack says. According to a 2017 review in Advances in Preventive Medicine, exercise helped improve sleep quality and duration, particularly among middle-aged and older adults.
Just make sure to avoid working out right before bedtime because the endorphin release can make it harder for you to fall and stay asleep, per Johns Hopkins Medicine.
3. Limit your caffeine and alcohol intake.
Drinking too many caffeinated drinks, such as coffee, tea, soda, and energy drinks, can make it difficult for you to sleep at night, Hack says. The Food and Drug Administration recommends sticking to no more than 400 milligrams of caffeine daily—that equates to about four or five cups of coffee.
Consuming too much caffeine during the day can cause an upset stomach and the jitters, and heighten anxiety, which all can affect your ability to fall asleep.
Similarly, aim to limit your alcohol consumption before bedtime. A review in the Handbook of Clinical Neurology found that alcohol had a sedative effect initially, but after a few hours, it caused fragmented and disturbed sleep. In fact, about 36%-91% of people with alcohol use disorder report insomnia either while drinking or within several weeks of stopping.
4. Consider wearing blue light-blocking glasses
It may be tempting to scroll through social media and check emails until late into the evening, but blue light from electronics can be one of the reasons keeping you up at night.
According to a small study in the Journal of Psychiatric Research, devices that emit blue light may affect sleep by suppressing melatonin. In the study, 14 people with insomnia symptoms wore blue light-blocking amber glasses for two hours before bed for a week and found that it helped improve their symptoms as well as their total sleep time and quality of sleep.
It’s best to avoid blue light devices by 7 p.m. and instead focus on reading a book, listening to soothing music, taking a warm bath, or even doing some light Yin yoga or stretching, Vitti says. Basically, you want to do things that will help you relax and unwind—not rattle you—before bed.
When is the best time to take birth control pills: morning or night?
The best time to take your pills is whenever you can consistently take them, Hack says. “Morning or evening doesn’t matter, but consistency does,” she says. That said, if you suspect that your pill might be affecting your sleep, you can try switching what time of day you normally take it—but again, stay consistent.
“If you take them in the morning, that dose of progestin can increase your melatonin production during the daytime and make you feel sleepier,” says Vitti. “It’s possible that if you take them after dinner, you’ll have your peak overnight, which might help with sleeping.”
Is it OK to take melatonin with birth control?
They’re generally safe to take together, but you should always talk to your healthcare provider before starting a new medication or supplement, Hack says.
Does the Pill make you sleep more?
There isn’t consistent evidence that shows that birth control pills can help you sleep better at night or make it more difficult to sleep. Larger studies and more research are needed to understand the relationship between the hormones in birth control pills and how they might affect sleep. If you have any concerns about taking your birth control pills, reach out to your doctor.
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