Editor's Note: We at POPSUGAR recognise that people of many genders and identities, including but not limited to women, may or may not have female sex organs such as uteruses or vaginas. This particular story includes language from studies, organisations, and experts that generally refer to people with female sex organs as women.
If you're tossing and turning at night more than the male-identifying members of your household — especially during the COVID-19 pandemic [1] — you're not alone. Even under normal circumstances, women suffer from insomnia at higher rates [2] than the rest of the population.
With the stress and additional responsibilities brought on by COVID-19, women's sleep is only getting worse [3], according to the Society for Women's Health Research. From mid-February to mid-March alone, there was a 39 percent increase in anti-anxiety, anti-depression, and anti-insomnia prescriptions [4] being filled for women. As COVID-19 cases continue to rise this winter, no one is sleeping better at night — but that's particularly true for this portion of the population, for a number of reasons. Here, POPSUGAR examines the state of sleep and if there's a path toward better rest.
Why Are Women More Likely to Have Trouble Sleeping?
Some of the sleep deficit is likely biological. People with female sex organs may struggle to sleep at certain points in their menstrual cycle. The hormone progesterone, which typically peaks in the third quarter of the menstrual cycle, between ovulation and menstruation, can act as a relaxant; when progesterone levels fall, sleep might be disrupted, Fariha Abbasi-Feinberg [5], MD, director of sleep medicine at Millennium Physician Group in Fort Myers, FL, and a member of the American Academy of Sleep Medicine [6] Board of Directors, told POPSUGAR. Insomnia is also more common during pregnancy, as are other conditions — such a restless leg syndrome — that can make it harder to get quality sleep, Dr. Abbasi-Feinberg explained.
Hormonal differences can also affect a person's mental health, and therefore, their sleep. "According to the Anxiety and Depression Association of America, the higher levels of oestrogen and progesterone in women cause fight-or-flight responses to be triggered more easily [7] and remain active for much longer than men," Nicole Avena, PhD, an assistant professor of neuroscience at Mount Sinai School of Medicine and visiting professor of health psychology at Princeton University, told POPSUGAR. That translates to feelings of anxiety, stress, or panic, which may keep you awake longer at night while others in your household sleep soundly.
Dr. Avena added that it takes more time for women's brains to produce the mood-lifting hormone serotonin, so anxiety and depression symptoms may linger for longer, especially at bedtime.
How Is the Pandemic Making Sleep Issues Worse?
It goes without saying that stress levels have spiked during COVID-19. Many people are worried about the possibility of getting sick or needing to care for a sick family member. Some are also learning how to work from home, while at times, helping children with remote learning. Everyone feels strained, but for some, the turmoil and uncertainty have taken a significant toll. Anxiety and depression are three times more prevalent this year than in 2019 [9], according to the Centres For Disease Control and Prevention.
Studies have found that household duties, like managing the family's schedule, primarily fall on women [10], contributing to a heavier mental load, which then affects sleep quality. "When your brain is on overdrive, worrying about the circumstances of the world and what you have to do, it's difficult to let your body and brain relax," Dr. Abbasi-Feinberg said.
Part of this has to do with the stress hormone cortisol. On a daily basis, cortisol fluctuates with your circadian rhythms, the body's natural internal clock. Cortisol goes up in the morning when you wake up, and should go back down when it's time for bed in the evening, Dr. Abbasi-Feinberg explained. When stress levels are high, your circadian rhythms may be out of whack. And it's a vicious cycle, she added — when you don't sleep as well, you might have more trouble handling stress, which can cause you to be less empathetic [11] toward your partner, your children, or your coworkers.
Mothers seem to be struggling with sleep even more so than usual during the pandemic. Jess Hernandez, a writer and mother of three from Chehalis, WA, wasn't getting much sleep before COVID-19 hit, as her youngest two children have sleep disorders. She was getting by then by napping at the same time as her 1-year-old, but now with virtual learning, she's going all day long, leaving little time for her writing. "My husband works two jobs, so the bulk of household duties and childcare are on me," Hernandez told POPSUGAR. And with the lack of a structured daily routine, bedtime — especially in the early days of the pandemic — became a two-hour production.
Hernandez's oldest child has also been experiencing heightened anxiety throughout this time, exacerbating the already existing sleep difficulties her family was facing. Most nights, she finds herself leading a story-time marathon until she herself conks out. "Usually I fall asleep on the floor in my kids' room while trying to put them to bed, then stagger out around 11, brush my teeth, and collapse," Hernandez said. Even though she's passing out immediately once her head hits the pillow, she's not able to get a quality night of sleep.
Sleep quality is not equitable for marginalised communities either. Research shows that BIPOC individuals experience sleep disparities [12], including shorter durations of sleep. For shift workers — many of whom are people of colour — it can be even more difficult to get adequate sleep, because working longer shifts can disrupt their circadian rhythms, Dr. Abbasi-Feinberg explained. She pointed out that healthcare shift workers are also fighting a mental battle during the pandemic [13], which can also affect their sleep. For these people, especially those who then come home and take care of household tasks, getting a good night's rest becomes even more complicated.
What You Can Do to Improve the Quality of Your Sleep
As challenging as it is to maintain a regular sleep schedule, that's one of the keys to getting a solid night's rest. Dr. Abbasi-Feinberg said you should carve out time to get at least seven hours [15].
Creating a healthy sleep environment [16] is also important — that means shutting off screens that might be informing you of bad news before bed, she added. If you feel like watching TV from across the room, that's fine for your eyes, but try to focus on even more relaxing activities, like reading, listening to a meditation app or podcast, or taking a hot shower or bath. Of course, these habits are easier said than done if you're a parent whose children aren't falling asleep right away or sleeping through the night. But if you have a child over the age of 1 who's waking up periodically at night, speak to your paediatrician, who can help address the issue or refer you to a sleep specialist.
Your dietary and exercise choices are also major factors in your sleep. "Going outside frequently is important, as exposure to sunlight helps the body maintain a healthy circadian rhythm, which will improve sleep," Dr. Avena told POPSUGAR. Regular exercise can make your body feel tired, too — Dr. Avena recommends evening yoga [17] to get your body moving and lower stress levels before bed. You may want to try dietary supplements like melatonin to boost your body's level of the sleep-regulating hormone, she added. Likewise, GABA — a chemical in the brain that helps calm the nervous system — "can have a calming effect on the brain, allowing you to fall asleep easier," Dr. Avena said. Just be sure to consult your doctor before taking any supplements.
It can be tempting to turn to alcohol as a stress reliever and sleep aid, Dr. Abbasi-Feinberg said, but more than one glass of wine each night can actually contribute to sleep disruption, especially in the later part of the night, when high-quality deep sleep is necessary. And as much as you want to medicate your exhaustion with coffee the next day, don't lean on it, she added, as the caffeine stays in your system for a long time and can make it tough to sleep the next night. As tough as it is to get into a better sleep routine, especially with heightened stress, focusing on as many healthy habits as possible really can make a difference.