Why Women Struggle With Sleep—And How To Improve It

While women are said to sleep a bit longer than men, their sleep quality is far worse. Human’s need for sleep is much greater when we are young and the amount needed is the same for boys and girls until puberty. Then, girls report less sleep than boys and more sleep disturbance. Some studies suggest the change in sleep patterns is more gradual for boys and begins later. This fits with girls maturing earlier than boys.

Infants need 12-15 hours of sleep. Hours needed steadily drop to 10-13 for 3 to 5-year-olds, 8-10 for teens, and adults usually needing 7-9 hours.

How Hormones Disrupt Sleep

Once hormones hit women, all hell breaks loose for women’s sleep. When a woman’s period starts and she begins bleeding, her levels of progesterone and estrogen are low, and it may become harder to fall asleep.

Levels of both hormones rise as your body readies to release an egg (follicular phase). Some women are sleepier during this phase.

These hormone levels peak once the egg is released and your body prepares for a pregnancy. Sleep may be easier during this luteal phase.

At the end of the cycle, your hormones drop more quickly. The drop can prompt symptoms of PMS, which are very uncomfortable and can disrupt sleep.

Finally, as women go through menopause and have lower levels of hormones, they can have more irritability and difficulty sleeping from hot flashes and night sweats. In a National Health Interview Survey, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours. More postmenopausal women also complained of not feeling well rested. After menopause, sleep apnea and restless leg syndrome become more common.

Men And Women Have Different Sleep Patterns

We all go through different stages of sleep, called cycles. These include non-Rapid Eye Movement sleep, which is deeper, and a REM stage, with more intense dreaming. Carol Ash, DO, a board-certified sleep specialist at R.W.J. Barnabas Health, describes differences in this pattern, called sleep architecture, between men and women. She notes, “Women will fall asleep faster and spend more time in the deep stages of sleep.” This is very restorative sleep. Men spend more time in REM sleep, and “dream sleep helps us consolidate memory and learning.”

There are other differences. Women tend to have an earlier release of melatonin. They also tend to be more sensitive to noise at night, so their sleep is more easily disrupted. Because of the issues of the menstrual cycle, cramps, pregnancy, and then menopause, “There are all kinds of challenges that women face that will cause their sleep to be actually less quality,” Ash added.

Sleep Disorders Affect Men And Women Differently

Men tend to be most troubled by snoring and sleep apnea, which can lead to cardiovascular problems. Sleep-deprived women tend to have more symptoms of anxiety and depression, excessive daytime sleepiness, and more trouble sleeping at night, per a report in the American Academy of Sleep Medicine. They also have more difficulty concentrating and remembering things

Health Problems From Lack Of Sleep

There are many problems with not getting enough sleep. It can cause moodiness and impair creativity and decision-making. We’ve all likely experienced distractedness and difficulty concentrating when needing more sleep.

Sleepiness can also lead to more accidents, including falls, broken bones, and car accidents.

Sleep affects hunger-regulating hormones. Leptin signals satiety—that you’ve had enough to eat. Ghrelin, an appetite stimulant, rises when you are sleep-deprived, and leptin decreases. These hormone changes are thought to contribute to nighttime snacking and obesity. Sleep deprivation is also associated with insulin resistance, which can lead to diabetes mellitus and obesity. This leads to a vicious cycle as with added weight and age; you are more likely to develop sleep apnea and arthritis, with pain then further making it harder to sleep.

Dr. Ash says, “Women pay a heavier price for lack of sleep than men do. So we’re two times more likely to have high blood pressure. Women less than 50 will have issues with a higher rate of stress” and mood disorders. She adds, “Not getting enough sleep leads to all the common chronic diseases we’re trying to prevent and treat, such as strokes, heart attacks, high blood pressure and and all the the cardiac events and mortality.”

Sleep Health Equity

The National Sleep Foundation raises important concerns around sleep health equity and racism. People of color are disproportionately affected by poor sleep. This is also true for poorer people and those who are LGBTQ. Reasons include frank discrimination, unemployment and poverty, and access to care. The latter means they are less likely to be diagnosed with a sleep disorder like sleep apnea and receive effective treatment. Shift work and increased occupational hazards also pose an undue burden. And “neighborhoods with a higher percentage of underserved and underrepresented individuals” often are noisier, have higher levels of pollution and other things that contribute to poor sleep.

Improving Your Sleep

Dr. Ash offers several tips to help you get a better night’s sleep. “The one thing that is so critical is to wake up the same time every day and expose yourself to light,” Ash says. “And because that helps set the whole, it’s how you start your day.” Sleeping in on the weekend is “no different than what we’re going to experience with daylight savings time,” she adds, noting that it increases inflammation and can contribute to heart attacks. Daylight Savings Time is the opposite of what we need: more light exposure during the morning and less at night.

Other common tips are making your bedroom a peaceful sleep sanctuary and not multi-tasking by working or watching TV in bed. Avoid blue light and electronics before bedtime, too. Common sense tips are to avoid caffeine and chocolate because both can be stimulants and also worsen hot flashes. Having a relaxing evening routine will likely help. While studies using actigraphs (measuring movements) don’t show the efficacy of yoga or aerobic exercise for reducing sleep disturbances in menopausal women, self-reported sleep quality and insomnia severity were improved.

AASM also suggests you consider cooling sheets and lightweight blankets; your bedroom should be around 65-68 degrees Fahrenheit.

Calming and meditation apps are quite popular as well. “Calm” and “Headspace” are two of the biggest players. Calm has approximately 4.5 million users and made $300 million in 2023; Headspace has 2.8 million users and made $195 million in 2023. Some apps focus a bit more on meditation, like Insight Timer and Balance, but are helpful for sleep. If you have difficulty sleeping, I suggest trying several of them until you find one that works best for you.With these tips, you should be well-equipped to set new health habits, starting this Sleep Awareness Week.