Sleep

Sleep Awareness Month: What You Need to Know About Insomnia in Women

While insomnia affects all people, women are 40 percent more likely to suffer from it than men.

by

Casey Clark

Medically reviewed by

Kristin Gill, MD

March 29, 2023

March is Sleep Awareness Month, so we’ve gone through the research and pulled out the most interesting facts and tidbits about insomnia.

Plus, Dr. Kristin Gill, Chief Medical Officer at Minded, shares her expertise on the condition and what you can do to feel and sleep better.

What is insomnia?

Are you someone who has difficulty falling or staying asleep?  Not only is insomnia frustrating for the individual, it also greatly impacts your ability to function throughout the day.


While insomnia affects all people, women are 40 percent more likely to suffer from it than men.1

“I want to emphasize this statistic in case you missed it - women are 40 percent more likely to suffer from insomnia than men; this is a staggering difference. Women are also more prone to develop certain sleep disorders, including restless legs syndrome, and are more likely to experience daytime drowsiness” said Dr. Gill.  She added “To  me, insomnia in women is a public health issue. If you are a woman who is having trouble sleeping or feels excessively tired during the day, it is important to work with a healthcare provider, like one of our experienced clinicians here at Minded, to figure out the root cause(s) of your insomnia, so we can help you to not only sleep, but to get that great restful sleep.“

What causes insomnia in women?

The cause of insomnia will vary based on the individual, however, biological conditions unique to women, such as the menstrual cycle, pregnancy, and menopause, can all affect how well a woman sleeps. Women experience changing levels of hormones, like estrogen and progesterone during these times, which in turn can negatively impact their circadian rhythms.

Dr. Gill explains, “Women who are menstruating (even if they're not feeling too bad), often have a harder time sleeping and get more restless during the premenstrual week compared to other times of the month. And if a woman has serious premenstrual syndrome (PMS), she is likely to report more disturbing dreams, feeling sleepy and tired, and having trouble focusing during that week.”

“Pregnancy can also mess with a woman's sleep, and as the pregnancy goes on, she might start to have more and more trouble getting a good night's sleep. Once the baby's born, things don't get much better, thanks to the abrupt drop in hormones in addition to the unpredictable sleep schedule of a newborn. That can lead to even worse sleep and more fatigue during the early postpartum period” per Dr. Gill.

Dr. Gill adds “If you're going through menopause, you're probably not surprised to hear that insomnia is one of the most common health complaints during the perimenopausal period.” During menopause 75 to 80% of women report hot flashes and night sweats, symptoms which frequently cause unwanted disturbances to sleep.

Women are also twice as likely to have depression and anxiety compared to men. Difficulty sleeping is one of the diagnostic criteria for depression, and anxiety is commonly associated with insomnia. According to Dr. Gill, “During the hormonal transitions in a woman’s life, like menstruation, pregnancy, and menopause, women are at increased risk for depression and anxiety. We now have specific names for these conditions related to hormonal changes in women, including Premenstrual Dysphoric Disorder PMADs), Perinatal Mood and Anxiety Disorders (PMADs) including postpartum depression, and perimenopausal depression and anxiety. It is very important to distinguish these specific conditions as there are specific and nuanced treatment options for these conditions.”

While the scenarios above could be what is keeping you awake at night, if you are experiencing insomnia you should always share this with a primary care provider, Ob/Gyn, and your Minded clinician. Our providers at Minded specialize in treating conditions like PMDD, Perinatal Mood and Anxiety Disorders, and Perimenopausal Mood and Anxiety DIsorders.

How does lack of sleep affect women?

The average adult needs between 7 and 9 hours of sleep per night.2 As with most health-related queries, this will vary on an individual basis, but in general this is the recommended amount.

For those who don’t sleep this long, especially women, they’ll feel it in both their bodies and minds throughout the day.

Poor sleep may cause daytime sleepiness, decreased memory and concentration, and impaired performance at work and on daily tasks. Additionally, those with poor sleep tend to have increased negative feelings (sadness, anger, etc.) and decreased positive moods compared to those with better sleep cycles. Not only will you not feel well rested, but also irritable and tired.

“Insomnia can have a significant impact on physical, emotional, and mental health. It can also be a symptom of other mental health disorders, such as anxiety or depression” said Stacey Davis, PMHNP and Director of Psychiatric Services at Minded.

How do you stop insomnia naturally?

If you’re looking to have less restless nights and disturbed sleep patterns, then you’ll want to think about what your current sleep hygiene practice looks like.

The Sleep Foundation suggests thinking about starting a regular sleep and wake schedule, reducing your caffeine and alcohol intake, and improving your sleep environment.

This could involve going to bed and waking up at the same time each day, trying to avoid caffeine (coffee, chocolate, etc.) after 2pm, or decreasing blue light exposure prior to bedtime — yes, that means no late night scrolling through TikTok or watching an episode of your favorite reality television show.

This may seem overwhelming at first, but you don’t have to do everything at once. Pick one that you feel is most realistic for you and go from there.

What medicine helps with severe insomnia?

If behavioral changes haven’t worked for you, then you may want to consider medication. Although there are some medications that may actually cause insomnia, there are actually some that can help improve symptoms of insomnia.

“In my clinical experience, insomnia is often a symptom of a mental health condition, and most commonly is related to anxiety or depression. With insomnia, we need to treat the underlying condition. So in the case of anxiety or depression, SSRIs (commonly known as antidepressants) are the first-line and evidence-based treatment for those conditions, and once you begin taking an SSRI for anxiety or depression, typically you will start to notice gradual improvements in your sleep,” Dr. Gill said. She adds “as clinicians we all should be asking women about sleep, and even more so if a woman is pregnant, postpartum, perimenopausal or she is reporting difficulty sleeping and feeling tired in the time before she gets her period.”

Treatment of insomnia varies on an individual basis, but your provider will be able to walk you through the different types of medications and how they can best meet your treatment goals.

As with anything, taking an antidepressant for one night isn’t going to magically cure your insomnia (as much as we wish it could.) But with time and consistency, you may notice an improvement in your symptoms, which can provide some relief.

If you are suffering from insomnia, and particularly are a female suffering from insomnia, you are not alone. While sleep problems can be due to a variety of causes or due to a combination of factors, you do not need to suffer in silence (or look at the clock all night long feeling stressed out). Good sleep hygiene combined with addressing the underlying cause of insomnia, which may involve treatment with medication, will help you to sleep better and feel more rested. If you or a friend are struggling with sleep issues, Minded is here to help.

Sources Referenced
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  1. Mallampalli MP, Carter CL. Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report. J Womens Health (Larchmt). 2014 Jul;23(7):553-62. doi: 10.1089/jwh.2014.4816. Epub 2014 Jun 23. PMID: 24956068; PMCID: PMC4089020.
  2. Consensus Conference Panel, Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., Tasali, E., Non-Participating Observers, Twery, M., Croft, J. B., Maher, E., … Heald, J. L. (2015). Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine, 11(6), 591–592.

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