Purpose To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods Sleep was assessed for a minimum of 25 nights (range = 25-31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results There was a significant relationship between sleep duration and the day of the menstrual cycle (P = .042) and total symptoms reported that day (P < .001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P = .004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P = .950), wake after sleep onset (P = .217), and subjective sleep quality (P = .080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P = .220), subjective sleep quality (P = .502), or sleep latency (P = .740) but did significantly relate to wake after sleep onset (P < .001), with a significant day × symptom interaction (P < .001). Conclusions Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics.
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