Causes of Insomnia in Females

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Dr. Colleen Ehrnstrom, PhD
Feb 16, 20227 min read
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Causes of Insomnia in Females

Many women struggle with getting a good night’s sleep. While sometimes, the causes of sleep problems are the same regardless of gender. In other cases, insomnia in women has its own unique causes.

What Is Insomnia?

Insomnia is a sleep disorder. It can:1

  • Make it harder to fall asleep
  • Cause you to wake up too early or have trouble staying asleep throughout the night
  • Make you feel tired throughout the day

Are Women Affected More by Insomnia?

Although anyone can suffer from insomnia, the condition is more than 40% more common in women.2 Additionally, women who experience insomnia are more likely to experience multiple insomnia symptoms, while men are more likely to report only one insomnia symptom.3

Overall, more than one out of four women deal with insomnia.4

Why Are Women More Likely To Have Insomnia?

There are several factors that may make insomnia more common in women. Many of these causes are linked to hormones.

Periods and Insomnia

The menstrual cycle is one possible cause of insomnia in younger females. Women are most likely to report poor sleep during the week leading up to their period.4

Your menstrual cycle is controlled by various sex hormones, including estrogen and progesterone. Levels of these hormones drop at the end of your cycle, just before your period, leading to symptoms like cramping, mood swings, and sleep problems.5

It’s not entirely clear how sex hormones affect sleep. Research shows that for some women, decreasing levels of estrogen and progesterone cause the body to make less melatonin, a sleep hormone.6

Pregnancy and Sleeping Problems

More than three out of four women experience sleeping difficulties while expecting.7 Pregnancy insomnia is usually worse during the third trimester.

There are several possible pregnancy-related health changes that could disrupt sleep, such as:7

  • Needing to wake up to frequently use the bathroom
  • Feeling nauseous
  • Experiencing heartburn or acid reflux
  • Having back pain or leg cramps
  • Experiencing breathing problems, such as shortness of breath
  • Feeling the baby moving or kicking
  • Having increased anxiety

Perimenopause, Menopause, and Insomnia

During perimenopause, the body produces less estrogen and progesterone and periods become more irregular. Once your periods stop completely, you are said to be in menopause.8

During this time, you may experience many symptoms, including hot flashes and night sweats, that can make it hard to sleep. Up to 60% of women in perimenopause or menopause have trouble sleeping.5 If you’re between the ages of 45 and 55 and are experiencing new sleep problems, peri/menopause could be the underlying cause.

Other Potential Causes of Insomnia in Females

Other causes of sleeping problems  may develop in people of all genders, but may be more common in women or affect women differently.

For example:

  • Restless leg syndrome (RLS) — Women have twice the risk of developing RLS, a condition that causes a strong urge to move the legs. Each pregnancy raises the risk of RLS, and women who have given birth three times have three times the risk of RLS compared with women who have never had children.9
  • Sleep apnea and other breathing issues — Men are more likely to develop sleep apnea than are women. However, different genders tend to experience symptoms differently. Common symptoms of sleep apnea in men include snoring, snorting and gasping; women are more likely to experience tiredness and depression.9
  • Stress, anxiety, and depression — Women are twice as likely as men to deal with mental health problems like anxiety and depression.10,11 These conditions are in turn strongly linked to insomnia.
  • Fibromyalgia — This condition leads to chronic pain and often affects sleep. Most people with fibromyalgia are women.9

Social issues can also play a role in sleep. For example, women are more likely to be responsible for taking care of a child or older relative, and caregiver roles can lead to stress and mental health struggles that translate to poor sleep. Additionally, women who do shift work are more likely to experience insomnia and other health problems.9

How to Recognize if You Are Suffering from Insomnia as a Woman

The following questions can help you understand whether you might be suffering from insomnia1:

  • Do you find yourself struggling to fall asleep?
  • Do you frequently wake up at night?
  • Do you feel like you spend most of the night awake?
  • Are you tired during the day?
  • Do you find it difficult to focus during the day?
  • Do you feel tired, but find yourself unable to nap?

Keeping a sleep diary can help you track when your sleep is good and when it’s less than optimal. Note when you lay down, how long it takes to fall asleep, your wake-up time, and how rested you feel.

Ways to Treat Insomnia for Females

Practicing good sleep hygiene can help women get a better night’s sleep. This strategy is effective and safe for women who are pregnant or dealing with other health concerns. To improve your sleep hygiene, try:7

  • Avoiding drinking fluids in the evening
  • Napping earlier in the day, rather than later
  • Getting more physical activity
  • Avoiding spicy or high-fat foods to prevent heartburn
  • Sleeping on your side with a heating pad on your back to reduce back pain

Addressing underlying causes of insomnia may also help. For example, using medication to control period cramps may lead to a better night’s sleep. Additionally, women going through perimenopause may be able to use treatments like hormone replacement therapy (HRT). Some studies have shown that these treatments could help improve sleep for menopausal women.5

Another safe and effective strategy to treat insomnia is cognitive behavioral therapy for insomnia (CBT-I), a type of talk therapy that helps people change their thought patterns and beliefs that contribute to insomnia. Early research shows that CBT-I could be useful for treating insomnia caused by periods, pregnancy, or menopause.5

To learn more about Dawn’s evidence-based CBT-I program that can help improve your relationship with sleep, fill out our questionnaire today!


  • MedlinePlus. (2021, September 9). Insomnia.
  • Zhang, B., & Wing, Y. K. (2006). Sex differences in insomnia: a meta-analysis. Sleep, 29(1), 85–93.
  • Jaussent, I., Dauvilliers, Y., Ancelin, M. L., Dartigues, J. F., Tavernier, B., Touchon, J., Ritchie, K., & Besset, A. (2011). Insomnia symptoms in older adults: associated factors and gender differences. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry, 19(1), 88–97.
  • Office on Women’s Health. (2018, November 21). Insomnia.
  • Nowakowski, S., Meers, J., & Heimbach, E. (2013). Sleep and Women's Health. Sleep medicine research, 4(1), 1–22.
  • Jehan, S., Auguste, E., Hussain, M., Pandi-Perumal, S. R., Brzezinski, A., Gupta, R., Attarian, H., Jean-Louis, G., & McFarlane, S. I. (2016). Sleep and Premenstrual Syndrome. Journal of sleep medicine and disorders, 3(5), 1061.
  • Hashmi, A. M., Bhatia, S. K., Bhatia, S. K., & Khawaja, I. S. (2016). Insomnia during pregnancy: Diagnosis and Rational Interventions. Pakistan journal of medical sciences, 32(4), 1030–1037.
  • National Institute on Aging. (2021, September 30). What Is Menopause?
  • 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 (2002), 23(7), 553–562.
  • Office on Women’s Health. (2019, January 30). Anxiety disorders.
  • Office on Women’s Health. (2019, May 14). Depression.

Dr. Colleen Ehrnstrom's profile picture
Dr. Colleen Ehrnstrom, PhD

Dr. Colleen Ehrnstrom is a licensed clinical psychologist with a specialty practice in Acceptance and Commitment Therapy (ACT). Areas of expertise include insomnia and other sleep disorders, anxiety, and depression.

Dr. Ehrnstrom is not a medical provider and is not providing any recommendations regarding medications. Rather, she is sharing and reviewing the research as it relates to education when learning how best to treat insomnia.

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