Best treatments for insomnia in women

Published March 2023 | 6 min read
Expert contributors Dr Lillian Nejad, clinical psychologist; Deb Herdman, registered nurse and sleep practitioner
Words by Nicola Conville

Women are more likely to experience insomnia than men, due to hormones and higher rates of anxiety and depression. Struggling to sleep? Here are some expert tips.

While sleeping problems affect us all, women are more likely than men to experience poor sleep quality. Insomnia is up to 1.4 times more common in women, and the daytime symptoms associated with poor sleep – like depressed mood, poor concentration and reduced reaction times – are experienced more frequently by women.

While a woman’s hormones are mostly to blame for these sleep issues, both men and women will experience bouts of insomnia at some point. There are lots of treatments and interventions that can help.

What is insomnia?

According to the Sleep Health Foundation, insomnia is when you regularly find it hard to fall asleep or stay asleep. You may find it hard to fall asleep initially, or you might experience night waking, or both.

"Sleepless nights are common when we’re experiencing stress, jet lag or even if we’re really excited about something," says clinical psychologist Dr Lillian Nejad. "But if you are part of the 10 to 15% of the adult population that has persistent sleeping difficulties, it’s more likely to cause problems in one or more areas of your life."

In clinical terms, difficulty falling asleep is called sleep onset insomnia. Difficulty staying asleep, or sleep-maintenance insomnia, can mean you wake several times a night or wake up much earlier than usual and are not able to get back to sleep, Dr Nejad says.

Common causes of insomnia for women

"The main biological factor for women [who experience sleep problems] is the hormonal fluctuation and changes that we experience in our lives, like menstruation, pregnancy, the postpartum period, perimenopause and menopause," says Dr Nejad.

When hormone levels spike or drop the way they do during these life stages, it can cause changes in your sleep quality. Lower levels of progesterone also make some women irritable and less able to relax. Progesterone levels begin declining in your late 20s and are almost non-existent by menopause.

Social and cultural factors like caring for young children and relatives, physical and mental health issues also play a part.

"Most people experience insomnia as a secondary issue to another problem or disorder, and women are more likely to experience depression and anxiety disorders, both of which are associated with sleeping problems," says Dr Nejad.

"Women are more likely to worry at bedtime, one of the main causes of insomnia. Women also experience physical conditions like restless legs syndrome, migraines, rheumatoid arthritis, polycystic ovary syndrome, fibromyalgia and bladder issues that all interfere with sleep. Also age-related changes to sleep regulation affect women’s sleep more than men."

Other factors that can affect sleep include shift work and lifestyle habits that disrupt sleep like drinking alcohol or caffeine.

Insomnia during pregnancy

The physical changes and hormonal fluctuations that occur during pregnancy can cause fatigue, while ongoing hormonal fluctuations can disrupt the sleep-wake cycle.

“Women also report increased insomnia during the third trimester in pregnancy when there is likely to be more physical discomfort,” Dr Nejad says.

“Socio-cultural issues that may place women at higher risk for insomnia include being the main caregivers, not only of infants and young children but elderly parents as well. It can take three-to-six months to regulate sleep after childbirth and many women report sleeping difficulties continuing for two years.”

Main types of insomnia

There are two main types of insomnia.

Short-term insomnia, also known as acute insomnia, which is a brief episode or episodes where you have difficulty sleeping. According to the Sleep Foundation, it lasts less than three months and symptoms may fade on their own or it may develop into chronic insomnia.

Chronic insomnia is when your sleeping difficulties occur at least three times a week for three months or longer and have a significant impact on one or more areas of your life, like your work, social life or relationships, says Dr Nejad.

How does insomnia affect your body?

A chronic lack of sleep can impact your daily functioning, emotional wellbeing and physical health, causing you to feel mentally and physically tired during the day. It can also have long-term consequences for your physical health.

“There is substantial evidence that shows insomnia can lead to hypertension and cardiovascular disease, cancer, diabetes, obesity,” says Deb Herdman, a registered nurse and sleep practitioner.

“Sleep is one of the three pillars of health along with exercise and nutrition. It can be difficult to maintain health when tiredness impacts your desire and motivation to eat well and exercise.”

How does insomnia affect your mental health?

Nobody feels their best after one disrupted night’s sleep, so ongoing sleep problems can have a serious impact on your mental and emotional wellbeing.

"You may have issues thinking clearly, it decreases your reaction time, affects your ability to concentrate, plan and make decisions and can affect work performance and productivity," says Dr Nejad.

"It can also make you grouchy, increase anxiety and even increase your risk of depression."

This is why it’s really important to seek help and get on top of any ongoing sleep problems.

Insomnia treatment and interventions

How do you know if a lack of sleep is becoming an issue that you need help with? "Some signs you need help include spending a lot of time in bed not sleeping, feeling fatigued and irritable during the day, worrying about how much sleep you’re going to get and feeling like you can’t cope with day-to-day life," says Dr Nejad.

If you’re dealing with insomnia, there’s a wide range of treatments and interventions you can try as well as some home-based habits and remedies. Talk to your GP to devise a plan that’s tailored to your needs.

Medical treatments for insomnia

• A very effective treatment for insomnia is cognitive behavioural therapy for insomnia, or CBT-I, which helps you identify and modify unhelpful thoughts and beliefs that are impacting on your sleep and your ability to function well during the day, says Dr Nejad.
• Sleep restriction therapy is a component of CBT-I treatment for insomnia that aims to correct circadian rhythm dysfunction by retraining your body to be sleepy at the appropriate time. In other words, it’s pushing the reset button on your body clock by limiting the time you spend in bed.
• Light therapy may also be included to get your sleeping pattern back on track.
• Medication for insomnia may be prescribed. "It’s important to consult your doctor to make an informed choice about whether medical interventions like hormone therapy, antidepressant medication, melatonin or other sleep aids would be useful, particularly in the short term," says Dr Nejad.

Lifestyle treatments for insomnia

Improving your sleep hygiene by making some modifications to your lifestyle can also help and can work hand in hand with psychological or pharmacological treatments.

Dr Nejad has these suggestions, which help your body and mind prepare for the best sleep conditions:

• going to bed and waking up at the same time every day
• reducing or cutting out caffeine
• minimising your alcohol intake and avoiding it at night
• exercising regularly
• exposing yourself to natural sunlight in the morning
• creating a healthy bedtime routine by dimming the lights in the evening, limiting screen time and listening to soothing music or a guided meditation.

"Some studies also suggest that yoga and Pilates may improve your sleep and reduce symptoms of insomnia," she adds.

What can a doctor do if I have insomnia?

See your GP if you’re having trouble sleeping or are waking up not feeling refreshed. Track your symptoms and share them with your health professional.

If necessary, your doctor can refer you to a sleep specialist or psychologist. You can also access telehealth services through our partner

"It can be hard for women to put their needs first when often they are the carers of others. In order to give your best, you need to feel your best," says Deb.

"Start by giving yourself a sleep check-up. Begin with a sleep diary and record your sleep for seven days. Do you fall within the diagnosis of insomnia? If so, seek professional advice."

Help for a better night’s sleep

We want to help you build better sleep habits and improve your overall wellbeing, so we’ve partnered with Sleepfit Solutions. Eligible members^* can get a free 12-month subscription to the Sleepfit app, designed to improve sleep and overall wellbeing, identify sleep issues and give you access to personalised tools.

You can also access a range of evidence-based online treatment programs through This Way Up^** to help you take control of your mental wellbeing. Clinically proven to help, the programs help you understand and improve mental challenges like stress, insomnia, worry, anxiety and depression.