The experience of lying in bed at night, sometimes for more than half an hour, and being unable to fall asleep can be particularly frustrating. So can long stretches of wakefulness in the night—or waking up well before your alarm clock is due to ring in the morning.
These symptoms are especially common among women, who, by some estimates, are 40% more likely than men to experience insomnia during their lifetime. Insomnia can negatively affect health and well-being, a person’s ability to perform daily tasks, their relationships, mental health and quality of life. For these reasons, women should be aware of the risk factors for insomnia and the steps they can take to improve sleep health.
What Causes Insomnia in Women?
There are many causes and risk factors for insomnia among women. Some are biological, such as hormonal changes, while others are related to mental health, chronic conditions and external stressors like work and family responsibilities. In some cases, insomnia can persist for long periods without a clear cause.
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The Menstrual Cycle
Women are more likely to experience sleep problems at certain phases of their cycle. Between ovulation and menstruation—roughly the last two weeks in a standard 28-day cycle—women may wake more frequently during the night and struggle to fall back asleep. This may be caused by hormone-related changes in sleep architecture, reducing time spent in deep, restorative sleep.
Symptoms of insomnia are even more common in those with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). These conditions can cause both physical discomfort and emotional disturbances, which can severely impact sleep. In cases of PMDD, studies show decreased sensitivity to melatonin (the sleep hormone) and reduced overall sleep duration during the luteal phase of the cycle.
Additionally, painful cramps, heavy bleeding, and irregular periods can disrupt sleep further.
Pregnancy
Pregnancy—especially in the third trimester—is another high-risk period for insomnia. Physical discomfort, acid reflux, frequent urination, and fetal movement can all lead to frequent nighttime awakenings and difficulty falling asleep. Some people also develop conditions like Restless Legs Syndrome (RLS) or Obstructive Sleep Apnea (OSA) during pregnancy, both of which contribute to disruption in sleep quality.
On top of the physical factors, many expectant mothers experience worry or anxiety about their baby’s health, childbirth, or upcoming lifestyle changes. These concerns can contribute to insomnia that may continue into the postpartum period, when sleep is already compromised due to infant care.
Menopause
Sleep problems are common in the years before and after menopause. One of the most disruptive symptoms is hot flashes or night sweats, which affect the majority of women during this transitional period. These can lead to physical discomfort, soaked bedding, and the need to wake up and change clothing—often paired with feelings of anxiety and frustration.
Additionally, after menopause, the body’s natural sleep-wake rhythms become less robust, leading to fragmented sleep. The risk of developing depression, anxiety, sleep apnea, and RLS also increases during and after menopause—all of which are closely linked to insomnia.
Stress and Mood Disorders
Research shows that women are more likely than men to experience stress-related sleep disturbances, which makes them more vulnerable to insomnia. They are also more frequently affected by mental health conditions such as anxiety and depression, which tend to have a bi-directional relationship with sleep problems. This means that poor sleep can worsen these conditions— and these conditions can in turn make it harder to get sound and restful sleep.
Women are particularly at risk of depression during the premenstrual phase, pregnancy, postpartum, and menopause—all stages of life where hormonal changes can heavily influence mood and sleep. These mood shifts can prolong or intensify insomnia if not addressed.
The Bottom Line
Insomnia is not just a nuisance—it’s a serious health concern that can affect women at every stage of life, often due to hormonal, emotional, and social pressures. Understanding the root causes, from menstrual and reproductive changes to stress and mood disorders, is essential for recognizing insomnia and seeking the right support.
For women, improving sleep may require not only good sleep hygiene, but also addressing underlying hormonal or mental health conditions, practicing stress management, and seeking help when needed. A proactive approach can lead to better sleep and better overall health.
If you or a loved one may be experiencing Insomnia, it may be wise to schedule a sleep consultation with ISD Health Solutions. Through non-invasive diagnostic testing, expert guidance and tailored treatment solutions, you can take meaningful steps toward improving not just your sleep, but your overall health, mood and quality of life.