Causes of insomnia in women can include hormonal changes, stress, and restless leg syndrome. Some women may be at increased risk due to pregnancy and menopause.

Women, regardless of their sex at birth, may experience insomnia because of the effects of hormonal changes throughout the month and over time. Hormone fluctuations throughout the menstrual cycle, during pregnancy, and during perimenopause can lead to problems falling and staying asleep.

In the United States, 1 in 4 women live with symptoms of insomnia.

Some health conditions that lead to insomnia are also more common among women. These include anxiety, depression, and restless leg syndrome.

Read on to learn the leading causes of insomnia in women, risk factors for sleep problems, and prevention tips.

There are a variety of issues that can contribute to insomnia and prevent you from getting a good night’s rest.


Stress causes hormones like cortisol to flow through your body, activating your fight-or-flight mode. These hormones raise blood pressure and increase your heart rate. You may be able to fall asleep during stressful periods, but the quality of your sleep will probably be poor.

Premenstrual syndrome (PMS)

Hormone fluctuations during your menstrual cycle can cause premenstrual syndrome (PMS). PMS can affect how your body responds to melatonin, the hormone that promotes sleep.


Hot flashes and night sweats may begin as your body transitions into menopause and can disrupt your sleep. About 40–60% of people experience insomnia during perimenopause or menopause. Waking up earlier than you normally do may also begin to occur, leaving you feeling less rested. These conditions may occur alongside depression or anxiety, making sleep even more difficult.


Some medications, like pseudoephedrine, make it harder for you to fall asleep. Drinking alcohol or using some drugs can also cause problems falling asleep or reduce sleep quality. Drinking caffeine or using other stimulants too close to bedtime might also prevent you from falling or staying asleep.

Certain medical conditions — some more common among women — may cause insomnia. If you’re in pain or have restricted mobility, this could also interfere with your ability to fall or stay asleep. Pregnancy and menopause are also common causes of insomnia among women.

Other medical factors that influence sleep and are more common in women include the following:


A 2023 study of Korean adults found that participants with insomnia were 9.8 times more likely to have anxiety than others. Researchers believe this is because anxiety and insomnia both involve a state of hyperarousal. If you’re dealing with these conditions, the neurotransmitters in your brain that help regulate sleep may not be functioning properly.


The same Korean study found that participants with insomnia were 19.7 times more likely to have depression than people without. Importantly, depression and insomnia are linked in a cycle where one worsens the other.

Restless leg syndrome

Some people describe restless leg syndrome as a crawling or creeping feeling and the urge to move their legs. It’s usually worse at night and can make sleep difficult. Several causes include low iron levels, diabetes, medications, pregnancy, and kidney failure.

Often, women experience insomnia because of the complex hormonal balance involved in menstruation, pregnancy, and menopause. Some health conditions that are more common among women also trigger insomnia, like anxiety and depression. Chronic pain, which is common in women, can also cause insomnia.

Sleep depends on several factors that allow you to relax and turn off your mind.

Other non-medical factors that might contribute to insomnia include:

  • noise
  • temperature
  • light
  • snoring
  • exposure to toxins or chemicals
  • irregular sleep schedule

Preventing insomnia begins with good sleep habits, sometimes called sleep hygiene. A few recommendations from the Centers for Disease Control (CDC) include:

  • a consistent bedtime, even on the weekends
  • a quiet, dark, cool bedroom
  • removing electronic devices from the bedroom
  • avoiding large meals, caffeine, and alcohol before bed
  • exercising during the day but not too close to bedtime

Insomnia is common for women and may be chronic or come and go. Pregnancy, menstruation, and menopause all increase the risk of insomnia. This is due to hormonal fluctuations and other factors like discomfort, stress, and increased risk of mental health conditions.

Good sleep hygiene creates the right atmosphere for sleep and may help you relax before bed and sleep better through the night.