During the 2025 World Sleep Congress, Bei Bei, PhD, a research lead and clinical psychologist at Monash University Health Sleep Clinic, Australia, delivered a keynote presentation highlighting the unique challenges for women with insomnia and the need for CBT-I tailored specifically to women. This article highlights some of her latest findings regarding women and sleep.
Differences Between Women and Men
Sleep problems are common, but they affect women more often than men. About one in four women have insomnia, compared to one in five men. Around 17% of women say they have trouble sleeping, while 12% of men report the same. Women also have more trouble staying asleep—21% compared to 15% of men. These differences become bigger as people get older. Hormones, body changes, and life events all play a part in why women may struggle more with sleep.
Insomnia
Insomnia means having trouble falling asleep, staying asleep, or waking up too early, even when there’s time to rest. For women, sleep problems often change during different stages of life. Periods, pregnancy, new motherhood, and menopause can all affect sleep. Hormone changes, body discomfort, and stress can make it harder to rest. Over time, poor sleep can lead to negative thoughts and habits that keep insomnia going.
How Life Stages Affect Sleep
Menstrual Cycle
During the menstrual cycle, hormone changes can make sleep harder. Many women sleep worse right before and at the beginning of their period because of cramps, mood changes, or feeling too warm.
Pregnancy
Pregnancy can be a tough time for sleep. In late pregnancy, many women wake up often because of discomfort or needing to use the bathroom. After giving birth, new mothers often face total or partial sleep loss from caring for their baby. This can lead to long-term sleep problems if unhealthy sleep habits or worries about sleep develop.
Postpartum
After childbirth, sleep is often broken up by nighttime feedings and baby care. Hormone changes and lack of support can make things worse. Even if this isn’t always true insomnia, it still causes tiredness and stress.
Menopause
During menopause, hot flashes and night sweats can wake women up often. These changes can lead to poor sleep, low energy, and mood swings.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Cognitive Behavioral Therapy for Insomnia, or CBT-I, is a proven way to treat long-term sleep problems. It helps people change unhelpful thoughts and habits about sleep. Studies show that CBT-I works well for both women and men. When CBT-I is designed especially for women, it works particularly well to address their specific concerns. In menopausal transition, CBT-I helped women feel less bothered by hot flashes; in pregnancy, it reduces insomnia and helps women sleep better, and in the postpartum period it improves sleep quality, reduces daytime fatigue, and improved mood.
Why Tailored Treatments Matter
Because women’s sleep problems are often connected to life changes and hormones, treatments that focus on these issues can work better. Teaching women about how their bodies affect sleep, helping new mothers manage sleep loss, and supporting women through menopause can make CBT-I more effective.
Conclusion
Women face unique sleep challenges throughout life. Hormones, pregnancy, and menopause all play a role in how well they rest. CBT-I is a strong, science-based treatment that can help women and men sleep better. When it’s adjusted to fit women’s needs, it can improve sleep, mood, and overall health. Understanding how life stages affect sleep is key to helping women get the rest they need.