PMDD and sleep have a two-way relationship – they can both help or harm each other. PMDD can disrupt your sleep with problems like insomnia, waking up frequently at night, and feeling unrested even after sleeping. 1 Poor sleep can hurt your focus and make you drowsy, affecting your performance at work or school.2 Disrupted sleep can intensify PMDD symptoms like fatigue, irritability, and mood swings, creating a cycle that’s hard to break.