Dr. Wright, M.D., is an Anatomic and Clinical Pathologist with a focus on hematopathology. She has a decade of experience in the study of disease.
A reported 1 in 4 women have at least one symptom of insomnia, whether it’s difficulty falling asleep, staying asleep, or both. In fact, women are 40% more likely to have insomnia at some point in life than men are, despite needing more sleep than men.
Different sleep strategies can be more or less helpful depending on what’s causing your insomnia. We cover some of the common causes of insomnia in women and highlight effective sleep tips for women.
Women carry a greater risk for insomnia for a number of reasons. Women are 1.7 times more likely to have anxiety or depression, both of which commonly coexist with insomnia. Women also carry a higher risk of certain sleep disorders, including restless legs syndrome (RLS) and nocturnal sleep-related eating disorder. Women’s hormone levels also fluctuate throughout the month and over the course of their lifetimes, during menstruation, pregnancy, and menopause.
For example, 2 in 3 women report sleep problems during menstruation. The most common symptom of premenstrual syndrome (PMS) is feeling tired, reported by 84% of women. Depression, anxiety, and backache are other commonly reported symptoms — all of which can contribute to insomnia.
Pregnancy is associated with poor sleep, due to changes in mood, pain, and incontinence, among other things. As a pregnancy progresses, these symptoms often intensify and become more frequent. Nearly 8 in 10 pregnant women have trouble sleeping, according to data collected from a Women and Sleep Survey.
The average pregnant woman wakes up three to five times per night during their third trimester. The risk of restless legs syndrome also increases from 8% in the first trimester to 22% in the third. Up to 25% of pregnant women report frequent snoring, which may be a symptom of sleep apnea, another condition that worsens sleep quality and leads to sleep disruptions.
Hormone levels change again during menopause, when a woman’s risk of sleep-disordered breathing increases by 21% to 41% compared with premenopausal women. Hot flashes affect 75% to 85% of women during menopause and can disrupt sleep. Women may also gain weight after menopause, which increases the risk for sleep apnea and poor sleep. Other symptoms of menopause may also negatively impact sleep, including increases in breast tenderness, migraines, depression, and anxiety.
There are many strategies you can try to improve your sleep. Some strategies are sleep hygiene best practices that can be helpful to anyone looking for a better night’s sleep, while other strategies are more specific to women who are menstruating, pregnant, or experiencing menopause.
Our bodies naturally cool down in the evening as we prepare for sleep. By keeping your bedroom temperature cool, you can help facilitate this process. Wear light, breathable clothing and choose sheets made from materials like bamboo or cotton.
Wearing layers of clothing to bed can be especially helpful for women in menopause, since it’s easy to remove layers in case of a hot flash. You can also keep a fan on the nightstand for a cool breeze.
Following a bedtime routine every night can help your brain learn to recognize when you are about to go to sleep, so you become tired accordingly. Plus, studies of new mothers show that a consistent bedtime routine is a helpful tool for improving a baby’s sleep, as well as the mood of the mother. Fill your bedtime routine with relaxing activities like meditation, stretching, reading, journaling, drawing, or listening to music.
Many people choose to include a warm bath or shower in their bedtime routine. Not only is the experience soothing and relaxing, but it may assist with your body’s natural cooling down process prior to sleep. Your body heat rises during the bath or shower, and then cools down as the water evaporates from your skin. One study found that those who bathed at night made fewer body movements during the first half of their sleep, suggesting an increase in sleep quality.
Lukewarm temperature showers may be the better option for menopausal women, however, in order to avoid triggering a hot flash.
If possible, avoid letting screens play a part in your bedtime routine. Electronic devices, including televisions, computers, tablets, and smartphones, emit an energizing blue light that causes the brain to think it’s still daytime. Exposure to this light at night, even for a few hours, can delay melatonin production, the hormone that makes you sleepy.
You may also want to limit how often you scroll through social media. There’s a link between increased social media use and difficulty sleeping, with women being more likely to report disturbed sleep than men.
Urinary incontinence is an experience common to pregnancy and menopause, and increases with age. Prevent your bladder from waking you up at night by limiting what you drink before bed, and using the restroom one last time before going to sleep.
Late-night eating can cause indigestion and discomfort that leads to poor sleep quality. Pregnancy also increases your risk for acid reflux, and spicy foods can trigger a hot flash that may interrupt sleep.
Schedule your last big meal for at least three hours before bed. If you get hungry after that, try a light snack of yogurt, nuts, milk, or fruit.
Caffeine, alcohol, and nicotine can all negatively impact sleep. Caffeine stays in your system longer than you may think, disrupting sleep as late as six hours after your last cup.
And while alcohol can help some people fall asleep, for others it only increases the amount of time it takes them to fall asleep. Alcohol also disrupts normal sleep architecture, and can increase your risk of sleep movement disorders or waking up during the night, leading to poorer sleep quality. Finally, smoking may also reduce sleep quality.
Regular exercise has been consistently shown to improve sleep. Aerobic exercise can also reduce your feelings of stress and anxiety for up to two hours afterwards. Even a short, 20-minute yoga class can have positive effects.
Any kind of exercise can be beneficial to your sleep and overall well-being. One study found that an eight-week program of aerobic exercise, performed three times a week for 20 minutes at a time, significantly reduced symptoms of PMS. Another study found that six weeks of resistance training improved the quality of sleep in women and reduced the amount of time they stayed in bed on the weekends. In other words, exercise can make it easier to get out of bed.
Exercise is a powerful stress management technique, but there are a number of other activities that can lower your stress and improve sleep. Relaxation exercises can improve sleep quality for pregnant women in the third trimester, enabling them to fall asleep faster and wake up fewer times during the night. With better sleep, they feel less tired the following day.
For older women, a mindfulness meditation practice can significantly improve sleep quality, while relieving symptoms of depression and insomnia. Even something as simple as slowing down your breathing can help you fall asleep more quickly and fall back to sleep if you wake up.
If thoughts of unfinished tasks are keeping you awake, consider writing down a to-do list. One study found that spending five minutes before bed writing a to-do list can help you fall asleep faster.
Sleeping on the side is typically the most comfortable sleep position for pregnant women. Experts recommend the left side in particular to promote healthy blood flow to the fetus. Placing a pillow between the legs and under the abdomen can also relieve pressure and back pain.
You can also use pillows to ease discomfort during menstruation, relieving tension and making it easier to fall asleep.
If your mattress is more than five to eight years old, it may be the culprit behind your aches and pains. One study found that when people replaced their old mattresses — the average of which was 9.5 years old — their sleep quality and back pain significantly improved.
If you wake up during the night, keep the lights off and lie there, breathing as you try to relax back into sleep. If you find you’re still awake after 20 minutes, get up and go into another room so your mind doesn’t associate your bed with frustration and restlessness. Keep the lights low and do something relaxing until you feel sleepy again.
Motion-activated night lights can prevent falls while walking to the bathroom. These can also be helpful for mothers who are breastfeeding or sleep training their baby, ensuring a safe walk to the baby’s room. If possible, choose a night light with a red bulb to minimize blue light exposure and disruption to your sleep.
Try some of these sleep tips and see if they improve your sleep. If your sleep problems persist, talk to your doctor. They can recommend additional strategies, based on your personal medical history, to help you get better sleep.