When you Google “women’s sleep,” you’ll mostly be served ads for pyjamas. You’ll have to search a bit harder to find out about the very real, biologically rooted, and often socially dismissed sleep problems that affect millions of women across their lives.
That’s a problem. Because women’s sleep is not a niche issue — it’s a public health issue. For too long, male physiology has been the default in sleep research. Sleep has been studied with men as the baseline — and women, with our hormone fluctuations and complex lives, have often been left out of the picture.
But here’s the truth:
Women are not small men.
We are not the anomaly.
Bad sleep is not inevitable.
From puberty to pregnancy, from menopause to motherhood, sleep changes dramatically. In this article I’ll break down what we know about how and why women sleep differently — and what you can do about it.
How Sleep Differs in Women: A Biological Starting Point
Hormones: The Sleep-Shaping Chemicals
Recent research highlights the fundamental role of sex hormones on sleep. These studies suggest that hormonal changes at various life stages impact women’s sleep quantity and quality. For example:
- Estrogen and progesterone play roles in temperature regulation, breathing, mood, and arousal — all of which impact sleep.1
- Pregnancy (especially in the third trimester) can bring physical discomfort, restless legs syndrome (RLS), and fragmented sleep.1
- After menopause, falling estrogen levels can disrupt sleep architecture and increase the risk for sleep apnea.1
The science is clear: these hormonal changes influence women sleep, and we need to pay attention to them.
The Circadian Clock: Gender Differences
You may know that we all function on a roughly 24-hour circadian rhythm. However, women tend to have shorter circadian cycles and earlier sleep-wake preferences than men. That means more of us are early birds.2
Girls’ circadian rhythms may also mature earlier than boys’, but that advantage is lost at puberty, when girls’ risk of insomnia rapidly increases.3
The Great Sleep Paradox: Do Women Get More Sleep Than Men?
When researchers use objective measures of sleep, like polysomnography (PSG), women actually tend to sleep longer than men and experience more deep sleep.
But these findings are misleading. The difference in sleep duration between the sexes is small, and if we look at other sleep measures we see a different picture.4 Women are more likely to:
- Take longer to fall asleep
- Have trouble staying asleep
- Experience sleep disorders like insomnia and Restless Leg Syndrome (RLS)
Sleep is never just about sleep. For women, it’s woven into a broader context of mental load and invisible work.
Sleep Disorders: Gendered Risks and Realities
Insomnia: The Most Gendered of All Sleep Disorders
Insomnia affects up to 28% more women than men, and that risk nearly doubles in older age.4 For many, it begins around puberty, when hormonal changes and mood instability emerge together. It often intensifies during:
- Pregnancy and postpartum, when hormonal shifts, physical discomfort, and caregiving demands collide
- Perimenopause, when night sweats and hormonal changes make sleep lighter and more fragmented
While hormonal and physiological changes can trigger poor sleep, many women develop what’s called conditioned arousal: the bed becomes a place of frustration, not rest. This is when poor sleep can become insomnia.5
Restless Legs Syndrome (RLS)
RLS is an overwhelming urge to move the legs, often with creepy-crawly sensations that worsen at night and disrupt sleep. RLS is twice as common in women as men.4 It often emerges in:
- Pregnancy — affecting up to 30% of women6
- Middle age — the risk increases two-fold from pregnancy to menopause4
- Women who have had multiple pregnancies4
Sleep Apnea: The Underdiagnosed Female Condition
Sleep apnea has long been seen as a “man’s disease” — think overweight, middle-aged snorers. But we now know that:
- Postmenopausal women are at sharply increased risk because of a decrease in progesterone6, anatomical changes in the upper airways, and weight gain.6
- Symptoms can be subtler in women. Men tend to report snoring and gasping, whereas women tend to report unrefreshing sleep and daytime fatigue.4
- Women often get missed or misdiagnosed because screening tools are biased toward male symptom profiles.4
Untreated sleep apnea can lead to chronic sleep deprivation – making proper diagnosis and gender-sensitive screening essential.
Women's Sleep Across the Lifespan
Adolescent Sleep
Teen sleep is notoriously tricky, with social, academic and biological changes making it hard for adolescents to get the recommended 7-10 hours of sleep. It’s during adolescence that girls start to report more difficulty falling asleep than boys. Teen girls are also at higher risk for insomnia and sleep disturbance related to menstrual-related discomfort.1
Sleep and Motherhood
Around 30% of pregnant women, and 42% of postpartum women report that they rarely get a good night’s sleep.7
Pregnancy often comes with physical discomfort, circadian fragmentation, emotional stress, and increased risk of RLS and sleep disordered breathing.
Mums tend to have more interrupted sleep than dads beyond pregnancy too, as the bulk of caregiver responsibilities often fall to them. Mums who are able to, catch up on sleep via naps, but when mums are in paid employment for the same number of hours as dads they lose the opportunity and actually get less sleep than dads.8
Perimenopause and Menopause
This stage is a sleep storm for many women, with up to 42% of women experiencing chronic insomnia by the end of their menopausal transition.1 Some of the reasons for this could include:
- Hot flashes and night sweats cause an increase in night-time awakenings6
- Melatonin secretion decreases significantly during the menopause transition1
- A reduction in progesterone increases the risk of sleep disordered breathing1
But poor sleep is not inevitable.
What Can Women Do to Improve Their Sleep?
Here’s where we flip the script. Poor sleep isn’t just something women have to put up with. While not all sleep problems can be fixed overnight, many can be treated, managed, or improved.
Sleeping Pills Might Not Be The Answer
Sleeping pills won’t necessarily address the issues outlined above, and sometimes aren’t even an option (they’re often not recommended for children and pregnant women5. However, if you’re keen to explore than route, make sure your prescriber is well versed in women’s sleep – disturbances and treatments. Some prescription pills are metabolised differently by women so require a different dosage.4
What else can you do?
1. Track your sleep — and your cycle
Apps, journals, or wearable tech can help identify patterns and triggers across your menstrual cycle, life stage, or stress levels. Understanding what’s normal for you is key.
2. Don’t dismiss your sleep concerns
If you wake feeling unrefreshed, feel sleepy during the day, or struggle with insomnia — even if your sleep study is “normal” — it’s valid. Women’s sleep symptoms are often subtle, misattributed, or ignored. Trust your experience.
3. Advocate for yourself in healthcare settings
If you suspect sleep apnea, RLS, or insomnia, seek out a professional who understands sex and gender differences. Ask whether your sleep treatment plan has been tailored to your physiology — not just copied from studies in men.
4. Consider cognitive behavioral therapy for insomnia (CBT-I)
CBT-I is the gold standard for chronic insomnia. It’s especially effective for women in perimenopause or postpartum, where hormonal and behavioral factors interact. Unlike medication, CBT-I offers long-term improvements and zero side effects.
5. Explore hormone therapy cautiously
HRT can reduce night awakenings in some perimenopausal women, and decrease the risk of sleep apnea in some postmenopausal women, but the results are mixed and it’s not a one-size-fits-all solution.1 Speak with a knowledgeable healthcare provider about risks and benefits based on your personal history.
6. Resist the myth that motherhood means no sleep
Yes, newborns wake at night. But the idea that tiredness is a badge of maternal honor — or that it’s selfish to care for your own sleep — needs challenging. Well-rested mothers are healthier, and more able to meet the challenges of parenting.
7. Have faith in the basics
Studies suggest that good sleep hygiene e.g. having a consistent sleep schedule, minimising alcohol in the evenings, and exercising regularly, can benefit sleep at all life stages. These strategies are simple and free, but if we believe poor sleep is inevitable we are far less likely to bother to make changes.3
A Final Word: Let's Prioritise Women's Sleep
Sleep is not a luxury, and it’s not something you’re failing at.
Sleep is the foundation for your mental health, physical wellbeing, and cognitive functioning. And for women, it’s also a lens through which we can view larger inequalities in medicine, caregiving, and culture.
The emotional labor, the night-time caregiving, the mental load, the gendered expectations — they all shape how women sleep, and how we’re expected to sleep.
Poor sleep is not an inevitability, or a personal flaw — it is a solvable, systemic issue.
It’s time to change the conversation. To demand research that includes us. To ask for treatment that works for us.
Want to Know More?
I regularly run workshops on women’s sleep issues. If you’re interested in joining one of my workshops, take a look at the schedule here. Or sign up below for updates about upcoming workshops.
References
- Pengo, M. F., Won, C. H., & Bourjeily, G. (2018). Sleep in women across the life span. Chest, 154(1), 196-206.
- Duffy, J. F., Cain, S. W., Chang, A. M., Phillips, A. J., Münch, M. Y., Gronfier, C., … & Czeisler, C. A. (2011). Sex difference in the near-24-hour intrinsic period of the human circadian timing system. Proceedings of the National Academy of Sciences, 108(supplement_3), 15602-15608.
- Phillips, B. A., Collop, N. A., Drake, C., Consens, F., Vgontzas, A. N., & Weaver, T. E. (2008). Sleep disorders and medical conditions in women. Journal of Women’s Health, 17(7), 1191-1199.
- Mallampalli, M. P., & Carter, C. L. (2014). Exploring sex and gender differences in sleep health: a Society for Women’s Health Research Report. Journal of women’s health, 23(7), 553-562.
- Nowakowski, S., Meers, J., & Heimbach, E. (2013). Sleep and women’s health. Sleep medicine research, 4(1), 1.
- Jehan, S., Masters-Isarilov, A., Salifu, I., Zizi, F., Jean-Louis, G., Pandi-Perumal, S. R., … & McFarlane, S. I. (2015). Sleep disorders in postmenopausal women. Journal of sleep disorders & therapy, 4(5), 212.
- Chasens, E. R., Twerski, S. R., Yang, K., & Umlauf, M. G. (2010). Sleepiness and health in midlife women: results of the National Sleep Foundation’s 2007 Sleep in America poll. Behavioral sleep medicine, 8(3), 157-171.
- Burgard, S. A., & Ailshire, J. A. (2013). Gender and time for sleep among US adults. American sociological review, 78(1), 51-69.
