Is severe PMS associated with insomnia risk in working women?

Sleep disturbance carries a substantial global burden, and insomnia stands out as the most prevalent manifestation, affecting between one-third and one-half of the adult population. Women bear a disproportionately greater burden, largely owing to cyclical reproductive hormonal changes throughout the menstrual cycle. Premenstrual syndrome (PMS) is hypothesized to impair sleep via three converging pathways: reduced luteal-phase serotonin synthesis, aberrant allopregnanolone modulation of GABA-A receptors, and circadian pacemaker disruption. A cross-sectional observational study enrolled 62 female employees from two financial-sector companies in Jakarta during September–October 2018. Instruments included a sociodemographic questionnaire, a validated PMS severity scale, and the Insomnia Severity Index (ISI). Fisher exact test was used for bivariate analysis (p < 0.05). Young adults aged 18–35 years comprised 85.5% of participants. Premenstrual symptoms were universal; 92.7% reported mild-to-moderate and 7.3% severe-to-very-severe intensity. ISI-defined insomnia was detected in 48.4% of participants. Neither age (p = 1.000) nor PMS severity (p = 0.189) reached statistical significance; however, the odds ratio for insomnia in the severe PMS subgroup was 4.77 (95% CI: 0.49–46.3). No significant associations were demonstrated, most likely because an underpowered severe-PMS subgroup precluded reliable detection. The magnitude of the odds ratio signals a clinically meaningful trend warranting prospective investigation with objective sleep measurement and systematic confounder control.

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