What women need to know about sleep problems

September 23, 2020 Providence Women's Health Team

This article was updated on September 28, 2020 to reflect recent research.


Women are more prone to sleep problems, but COVID-19 may be worsening their insomnia.

  • A recent report shows an increase in use of anti-insomnia medications, especially in women ages 45-64.
  • A survey conducted in Greece also showed that women were more likely to have sleep issues during the pandemic.
  • Sleep affects so many areas of our health — everything from mood to the immune system — so it’s crucial to get seven to nine hours every night.


No one would blame you for losing sleep over the coronavirus (COVID-19). Uncertainty around the virus combined with new stresses of quarantine, remote school, working from home and sustained change is bound to keep anyone up at night.

But for women, COVID-19 may be having an even greater impact on sleep. While women are more likely to have sleep problems than men, a recent report shows that prescriptions for insomnia are on the rise since the pandemic started, particularly in women ages 45-64.

If you’re one of the many women who find yourself up at night, there are plenty of tactics you can use to get a good night’s sleep. Let’s dive in to some of the most common sleep issues women face and how you can overcome them with healthy routines and lifestyle changes.

COVID-19 and its effects on women’s sleep

Although overall use of insomnia medication has declined in recent years, anti-insomnia prescriptions increased 15% in the U.S. between mid-February to mid-March of this year, according to a report from Express Scripts. The report also shows that women are more likely to take anti-insomnia medication, especially women ages 45-64 and women older than 65.

Looking globally, Greek women were more likely to experience sleep issues according to a survey done earlier this year. The survey asked more than 2,400 people about sleep difficulties and insomnia related to COVID-19.

In an article published a few months back with the Society for Women’s Health Research, Hraryr Attarian, MD, a professor of neurology at the Northwestern Feinburg School of Medicine, said he’s seen an increase in patients who are having sleep problems. Stress and anxiety caused by COVID-19 has been a major factor in those patients’ sleep issues.

The bottom line: The stress and anxiety around COVID-19 is affecting everyone’s sleep these days. But because women are already more likely to develop sleep problems, the pandemic is worsening their insomnia.

What causes sleep problems for women?

It may often feel like there aren’t enough hours in the day, which is why many women stay up late to get it all done, losing out on sleep in the process. However, that may be masking an actual sleep issue, says Andrea Matsumura, M.D., a sleep medicine specialist at Providence Sleep Disorders Centers and The Oregon Clinic-Pulmonary Critical Care & Sleep Medicine East in Portland, Oregon.

“Oftentimes there is a delay in women seeking help from a sleep medicine specialist because they are told by friends, family or a health care provider that they can’t get the sleep they need because it’s secondary to those lifestyle factors,” Dr. Matsumura says. “But in fact there may be something else underlying their inability to fall asleep.”

Sleep apnea

When women have trouble sleeping, Dr. Matsumura focuses on whether they have trouble falling sleep, staying asleep or whether they feel they’re getting quality sleep. She will then dig deeper to see if they are experiencing symptoms of insomnia, sleep apnea (problems breathing during sleep) or excessive movement such as restless leg syndrome.

For instance, postmenopausal women have the same risk of obstructive sleep apnea as men, but they sometimes don’t have the same symptoms — men tend to snore loudly, but not all women do. Dr. Matsumura says a few studies have noted that while women are observant of their male partner’s sleep behaviors, men are not as in tune. Without those noticeable symptoms or feedback from a partner, women often don’t know why they feel tired during the day.

“They naturally accept the fact that they are chronically sleep deprived,” Dr. Matsumura says. “When a woman comes in and talks about sleep, she may not say she snores loudly, but she may say she feels fatigued, has fragmented sleep or is starting to feel depressed.”

She adds that women who are still menstruating and premenopausal usually are prone to sleep apnea if they are morbidly obese.

Neurological factors

Other women may lack sleep because of a movement issue such as restless leg syndrome. This intense urge to move the limbs can keep women up through the night and prevent them from getting to sleep. Some women may also have narcolepsy that manifested earlier in life and can lead to excessive daytime sleepiness or fragmented nighttime sleep.

Hormone changes

Another big factor for women is hormones. When women are menstruating, there will be a couple of days late in the cycle when some women may experience a little trouble sleeping. Other women going through perimenopause and post-menopause can experience hormonal changes that can cause night sweats or fragmented sleep. Dr. Matsumura recommends those women talk with their gynecologists about potential treatments.

Abuse and trauma

Dr. Matsumura also points out that the recent #MeToo movement has brought to light that women may be at disproportionate risk for forms of abuse that are unrecognized as affecting sleep. Perhaps there was childhood trauma or an interaction with a boss or partner that made them feel uncomfortable or put them at risk verbally, physically or emotionally and that impaired their ability to fall asleep. That is a real issue that should be investigated, says Dr. Matsumura.

What to do if you’re experiencing sleep problems

Dr. Matsumura urges women who are experiencing sleep issues to talk to their health care provider, giving specifics about the trouble they have getting to sleep.

“Are they having a lot of trouble getting to sleep, spending a lot of time in bed unable to sleep, waking up too many times in the middle of the night,” Dr. Matsumura says. “They should focus on what time they go to bed, what time they actually fall asleep and what time they wake up.”

Create a bedtime routine

There are other things women can try to do on their own to improve their quality of sleep. That includes preparing themselves for sleep.

“Many people stay busy up until the minute they go to bed, but we should all be trying to wind down for the evening, ideally an hour before we go to bed and go to sleep,” Dr. Matsumura says. “That means not using any electronics or working. The key is to set the stage for good sleep. Also, it’s important for people to not take their worries to bed. They need to allow themselves permission to relax and get to sleep.”

It also helps to not drink too much caffeine at least six hours before bed, and also be mindful about not drinking too much alcohol, as both can affect sleep. Dr. Matsumura says she can’t overstate the importance of unplugging from electronics at night.

“We live in a sleep-deprived society at this point in time,” she says.

Keep a sleep diary

Women can also try to keep a sleep diary to track their nighttime patterns if they are having sleep issues. Dr. Matsumura says many devices that track sleep are good at indicating if something may be wrong but aren’t precise or accurate enough to give a complete picture of sleep habits. In fact, Dr. Matusmura notes that the devices may cause anxiety in some people who are over-reliant on them.

Because sleep affects so many areas of our health — everything from mood to the immune system — it’s crucial to get the necessary seven to nine hours of rest. “I always say to patients that sleep is food for the brain — don’t starve it.”

How deep is your sleep?

Although getting seven to nine hours of sleep is critical, it’s also important to make sure those hours include quality, deep sleep. When thinking about your sleep routine, do you:

  • Take a long time to fall asleep?
  • Stay asleep? Or do you wake up several times throughout the night?
  • Have bad dreams regularly?
  • Have trouble staying awake during the day?

This assessment from CredibleMind can help you learn more about the quality of your sleep and whether you need to change up your sleep habits or see a sleep specialist.


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Find a doctor

If you’re looking for a doctor who can help you improve your sleep health, you can find a Providence doctor or specialist using our provider directory or search for one in your area.






#COVID19 may be increasing sleep problems in women, who are already more prone to insomnia. Learn what you can do to improve your #sleep routine. #womenshealth

Related Resources

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The A to Zzzzs of not getting enough sleep

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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

About the Author

The Providence Women's Health team is committed to providing useful and actionable insights, tips and advice to ensure women of all types can live their healthiest lives.

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