Why Sleep Is Different For Women: Hormones, Life Stages, and Restless Nights

By Annapolis Asthma, Pulmonary & Sleep Specialists

. https://www.annapolispulmonary.com

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Why Sleep Is Different For Women: Hormones, Life Stages, and Restless Nights

Sleep plays a critical role in physical and mental health, but women often experience more difficulty achieving restful, uninterrupted sleep than men. This isn’t just a matter of lifestyle or stress — biological differences, particularly hormonal fluctuations across a woman’s lifespan, significantly affect how women sleep.

Throughout the menstrual cycle, changing levels of estrogen and progesterone can influence sleep quality. Many women report insomnia, restless sleep, or vivid dreams in the days leading up to menstruation. These symptoms may be more pronounced in those with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), which can disrupt both mood and rest.

During pregnancy, sleep often becomes more fragmented. In the first trimester, increased progesterone levels can lead to excessive daytime sleepiness. As pregnancy progresses, physical discomfort, frequent urination, leg cramps, and vivid dreams can make sustained sleep difficult. Some women also develop sleep apnea or restless legs syndrome (RLS) during pregnancy, even if they never had these issues before.

Menopause and perimenopause bring another wave of changes. Declining estrogen levels can contribute to hot flashes and night sweats, which frequently interrupt sleep. Many women in midlife also experience increased insomnia and lighter, more fragmented sleep. Sleep apnea risk also rises after menopause, sometimes without the classic snoring that typically signals the condition in men.

Outside of hormonal shifts, women are more likely to be diagnosed with insomnia and report higher rates of anxiety and depression — both of which are closely tied to disrupted sleep. Additionally, the burden of caregiving, multitasking, and emotional labor often falls more heavily on women, leaving less time and mental space for restorative rest.

Improving sleep often starts with recognizing its complexity. Good sleep hygiene — including consistent bedtimes, limiting screen time before bed, and creating a cool, quiet sleep environment — can help. However, persistent symptoms may signal an underlying sleep disorder like insomnia, restless legs syndrome, or sleep apnea.

Because symptoms of these conditions can differ in women, they are sometimes overlooked or misattributed to stress or aging. Seeking evaluation for ongoing sleep problems is important, especially when fatigue begins to interfere with daily life.

Understanding how hormonal and life-stage factors impact sleep allows women to better navigate these changes and take proactive steps toward healthier, more restorative rest.