The Secret Causes of Insomnia: What Every Woman Should Know About Sleep Problems

A hectic lifestyle isn't the only thing keeping women up at night. Here are some key causes of sleep problems in women.

Reviewed by Louise Chang, MD on November 19, 2008
From the WebMD Archives

Whether you're living the sizzling life of a "Desperate Housewife" or you're a stay-at-home mom with four kids and a dog, there's a good chance you may be tired -- and with good reason.

When it comes to catching some zzz's, it seems women just aren't making the grade. From careers, to kids, to social and family events, life comes first, sleep comes last.

"Where you are in your lifestyle has an affect on how much sleep you get," says Mark Rosekind, PhD, a board member of the National Sleep Foundation (NSF).

Throw biology into the mix -- like a woman's menstrual cycle -- and insomnia becomes even more common. Sleep problems can make it even harder to get the recommended 7.5 to 8 hours of shut-eye necessary to perform your best.

But you don't need to lose sleep over the fact that you're losing sleep! To understand insomnia, learn what's keeping you up at night. According to experts from the National Sleep Foundation, here are the most common reasons why you may be burning the candle at both ends.

Insomnia and Your Lifestyle

According to a "Sleep in America" poll released by the NSF in March 2007, if you're a single working woman you probably spend the least amount of time in bed -- sometimes fewer than six hours a night. And if you're like many women in the survey, you probably also wake up feeling tired at least a few days of every week.

One of the primary reasons you aren't sleeping? It could be something as simple as spending a bit too much time socializing with friends instead of hitting the sheets earlier in the evening. When this is the case, the solution involves a little self-discipline -- force yourself to hit the hay earlier a few nights a week, and you're likely to feel better overall, says Rosekind.

Stay-at-moms aren't much better off, however. The NSF survey found that three-quarters of the women in this category experience symptoms of insomnia. What's keeping moms up at night? It could be the kids -- worse, the dog -- bunking in with you. Or maybe it's a lack of quiet leisure activities to help you unwind at the end of the day. If your evening is spent primarily on chores or kids' activities, that could lead to sleep problems.


Last but not least is the Wonder Woman -- and you know who you are. Married, with school-aged children and working full time, if you fall into this group it's almost a sure bet you aren't getting enough sleep, says Rosekind, who is also president and founder of Alertness Solutions. These women, he says, are usually getting fewer than six hours a night.

In addition to being overloaded with work and family obligations, you may not have enough time to exercise or relax -- or have sex -- which can help a girl when the sun goes down. Often, the solution here is as simple as making just a little more time for yourself at the end of every day.

Sleep Problems and Your Hormones

If you're like many women, it may not be your lifestyle that's sabotaging your sleep but your own body -- primarily, your hormones. It all begins, say experts, with your monthly menstrual cycle.

"More than 70% of women complain of sleep problems during menstruation, when hormone levels are at their lowest," says Amy Wolfson, PhD, author of TheWoman's Book of Sleep: A Complete Resource Guide.


Indeed, experts say that not only does your period affect sleep quality, any menstrual symptoms you may experience can also keep you up at night. In fact, research reveals that menstruating women often report bloating significant enough to disturb their sleep at least two or three days during each menstrual cycle, according to the NSF.

If this rings true for you, talk to your gynecologist. There are treatments that can help some of your menstrual-related symptoms, which in turn may help solve these sleep problems.

Be aware, however, that as you enter perimenopause and eventually menopause, hormonal changes are back in the picture, disrupting your bedtime yet again.

Generally, post-menopausal women are less satisfied with their sleep, with more than half reporting insomnia symptoms," says Wolfson, who is a spokesperson for the Better Sleep Council.

The oft-cited causes of sleep problems include hot flashes, mood disorders and sleep-disordered breathing like snoring, all common and sometimes severe even in post-menopausal women.

Again, talk to your doctor about symptom relief that can do double duty by also helping you sleep better.

Could You Have a Sleep Disorder?

You do all the right things -- relax before going to sleep, and get to bed on time -- but somehow you still can't get a decent night's rest. When this is the case, a sleep disorder could be at the root of your sleep problems.

Sleep apnea. "There are 88 known sleep disorders," says James Maas, MD. "From apnea to restless leg syndrome, these are one of the major reasons why people lose sleep."

Among the most frustrating of these problems is sleep apnea.

"Sleep apnea is a pause in breathing during sleeping," says Rosekind. "The interruption to sleep occurs because the body has to wake itself up again in order to get the oxygen it needs." The longer the pauses in breathing and the more often they occur, the less sleep a woman gets.

"In some cases, apnea can occur five or 10 times a night," says Rosekind. "In other cases, it could be hundreds. Studies suggest that apnea is more prevalent in men than in woman, but the NSF survey leads us to believe that apnea could be much higher in women than we realize."


What's key here, however, is that most of the time you won't be aware of the momentary wake-ups -- so you end up feeling tired, and you don't know why.

Snoring. Another nighttime issue: snoring, yours or theirs.

"We know snoring is symptomatic to apnea," says Rosekind. "A woman wakes up to breathe and she is gasping for air, and it comes out as a snore." If your snoring wakes you, that's a clue there's a problem, but in many cases you won't have a clue what's going on unless a partner tells you.

Snoring can also cause sleep problems even if you're not the one doing it. "Snoring can be a problem when it's the spouse who has the issue," says Rosekind. "The audible noise plays a role in keeping her up at night."

In either case, talk to your doctor -- there are a number of new stop-snoring remedies that can help.

Restless legs syndrome (RLS). Among the sleep disorders garnering more attention these days is a frequently undiagnosed neurological disorder known as restless legs syndrome (RLS).With RLS, you may experienceunpleasant sensations in the legs and an uncontrollable urge to move them to relieve the feelings, according to the NSF. Lying down and trying to relax makes the feelings worse, making it hard to fall and stay asleep.


"And the more frequent the episodes, the more likely a woman is to experience insomnia, daytime sleepiness, consume caffeine, and use sleep aids," says Rosekind.

If your sleep problems persist despite your best efforts -- if you are consistently tired during the day, you are snoring, your partner says you are moving a lot at night -- it's time to talk to your doctor, and maybe think about seeing a sleep specialist as well.

"Go see a sleep disorder center accredited by the American Sleep Medicine Association for an evaluation," says Mass. "Your sleep is well worth it."

The Sleep Solution

Fortunately, getting a good night's rest usually requires simply paying better attention to a few key factors. First and foremost: Make sleep a priority.

"You need to value your sleep," says Maas. "The biggest mistake women make is to put sleep last. By making sleep a priority, you can be a more effective mom, wife and career-woman."

What can also help: Making a few changes to your nighttime routines. Mass offers these suggestions:

  • Stress -- physical and mental -- is a major cause of insomnia. If something is bothering you, try to deal with it during the day, so it doesn't keep you up at night worrying.
  • Avoid alcohol after 6 p.m. at night and caffeine after 2 p.m. Both can keep you awake nights.
  • Keep your bedroom cool rather than warm, dim rather than bright, and dry rather than humid for optimum sleeping conditions.
  • Make certain your bed is adequately sized for you and your partner, and that it offers proper support so you feel comfortable and relaxed while sleeping.
  • Take some time choosing a pillow that really feels good. A pillow that's too soft or too hard can cause sleep problems.
  • Don't bring your work or your laptop into bed at night. Instead, look to do something that helps your mind unwind -- like reading or listening to relaxing music.
WebMD Feature


SOURCES: James Maas, MD, author, Power Sleep; professor of psychology, Cornell University, Ithaca, NY. Mark Rosekind, PhD, president and founder, Alertness Solutions; board member, National Sleep Foundation, Cupertino, CA. Amy Wolfson, PhD, professor of psychology, College of Holy Cross; spokesperson, Better Sleep Council; author, The Woman's Book of Sleep: A Complete ResourceGuide, Worcester, MA. National Sleep Foundation: "Understanding Your Monthly Cycle" and "How Much Sleep Do We Really Need?"

© 2007 WebMD, Inc. All rights reserved.