Sleep plays a huge role in cardiovascular, metabolic, and brain health, yet research focused specifically on women’s sleep is relatively recent.
For decades, women’s health research focused largely on the reproductive system, while studies of nearly everything else, including sleep, were mostly done on men. The NIH didn’t require the clinical studies it funds to include women until 1993.
Sleep scientists now recognize that women’s sleep is affected by biological differences in sleep architecture, hormonal shifts across the lifespan, and social and cultural factors.
Understanding Women’s Sleep Through Life Stages
From the first period (menarche) through pregnancy, postpartum, perimenopause, and postmenopause, hormonal transitions affect women’s sleep. These changes can influence how easily you fall asleep, how your body regulates temperature overnight, and even how open your airway stays while you rest. Sleep medicine has been slow to account for these differences. A 2024 study in the Journal of Clinical Sleep Medicine found that the criteria for diagnosing sleep-disordered breathing were historically based on male physiology, which is one reason obstructive sleep apnea often goes unrecognized in women.
1. How May Your Menstrual Cycle Affect Sleep?
Women experience monthly variations in hormones that may influence sleep. Estrogen, which rises through the first half of your cycle and peaks just before ovulation, may protect against sleep-disordered breathing. While in the luteal phase, progesterone rises, which has beenlinked to more nighttime waking and poorer sleep.
For most women with regular cycles, these shifts, when they are present, are subtle. Overall sleep stays fairly consistent from week to week. Women with severe premenstrual syndrome (PMS) or painful cramps are more likely to report sleeping poorly in the days leading up to and during their period. Some gynecological conditions, including endometriosis and polyendocrine metabolic ovarian syndrome (PMOS, previously called PCOS), can also disrupt hormone patterns and sleep.
Member Tip: Use Cycle Insights to compare your Sleep Score across two or three cycles and add Tags for symptoms like cramps or bloating. Over time, you may notice where your more restless nights tend to fall.
2. How Can Pregnancy and Postpartum Affect Sleep?
If you’ve been pregnant, you may remember how hard it was to get comfortable at night, between a growing belly and the middle-of-the-night trips to the bathroom. The changes in sleep go beyond this physical discomfort. In a meta-analysis of more than 15,000 pregnant women, 38% reported insomnia symptoms, rising to nearly 40% in the third trimester.
Changes in sleep during pregnancy can affect the health of the pregnancy, too. In the NIH-funded nuMoM2b study of more than 10,000 first-time pregnant women, those whose sleep shifted later, with the midpoint of their night falling after 5 a.m., had higher odds of developing gestational diabetes. One study also found an association between breathing disturbances at night and medical conditions in pregnancy, such as gestational DM and gestational HTN.
“Many women just assume that their poor sleep and feeling tired is because they are pregnant,” says Dr. Chris Curry. “However, these symptoms may also be related to undiagnosed obstructive sleep apnea.”
In the first three months after birth, mothers reported sleeping about an hour less per night than they did before pregnancy. Even when their first child was 4 to 6 years old, mothers were still sleeping about 20 minutes less than before pregnancy.
Member Tip: If you’re pregnant,Oura’s Pregnancy Insights lets you follow your nighttime temperature, resting heart rate, HRV, and respiratory rate throughout pregnancy. You can also look at trends in sleep and print out your sleep data to share with your doctor or midwife to support conversations about good sleep habits.
3. How Do Perimenopause and Postmenopause Affect Sleep?
For many women, sleep becomes harder through themenopause transition. In the Study of Women’s Health Across the Nation (SWAN), which surveyed more than 12,000 midlife women, 45% of those in late perimenopause reported difficulty sleeping, among the highest rates of any group.
In a study of more than 3,000 midlife women, declining estrogen levels were linked to more trouble falling and staying asleep. Night sweats are another major contributor, but the transition is linked to poorer sleep even in women who don’t experience them.
In Oura’s2024 Perimenopause Report, which drew on data from more than 100,000 members, women lost up to two hours of sleep per week as they moved from premenopause to postmenopause, along with declines in deep and REM sleep.
“Sleep can change across the menopause transition, but not every symptom can be attributed just to the fact that someone is in perimenopause,” says Chris Curry, MD, PhD, Clinical Director of Women’s Health at Oura. “If a woman notices that sleep issues are impacting their daily life, talking to their doctor about sleep conditions and getting screened for things like obstructive sleep apnea is worth the time.”
Member Tip: Menopause Insights brings together your temperature, sleep, and HRV trends with the Menopause Impact Scale. Logging hot flashes and night sweats with Tags can help you see how they line up with your sleep, and gives you something concrete to share with your clinician.
Common Sleep Disorders in Women
Some sleep disorders, especially insomnia and restless legs syndrome (RLS), are significantly more common in women than in men. Others, like obstructive sleep apnea (OSA), are likely to go undiagnosed in women.
- Obstructive sleep apnea (OSA): One study estimated that 93% of women with moderate to severe sleep apnea had never been diagnosed. Women are more likely to report fatigue, insomnia, or morning headaches than loud snoring, and those symptoms are easy to attribute to stress or menopause. Having OSA in pregnancy also puts someone at risk for pregnancy complications like high blood pressure in pregnancy, such as preeclampsia. Risk also rises after menopause: in a Wisconsin Sleep Cohort Study, postmenopausal women had 2.6 times the odds of sleep-disordered breathing as premenopausal women.
- Insomnia: Women are about 1.4 times as likely as men to report insomnia, with risk rising during pregnancy and the menopause transition.
- Restless legs syndrome (RLS): RLS, an uncomfortable urge to move your legs that’s worse at night, is about twice as common in women. Pregnant women face two to three times the risk, especially in the third trimester, and low iron is a common contributor.
How Can Oura Help You Track Breathing Patterns During Sleep?
Oura’sNighttime Breathing feature, as part of Health Radar, can help you notice changes in your breathing over time. After seven nights, it shows how steady your breathing has been across a 30-day window, from Steady to Highly varied, and lets you know when a varied pattern on several nights may be worth discussing with a healthcare provider.
Logging symptoms like fatigue or morning headaches with Tags lets you see them alongside your breathing pattern, and in the U.S., members with elevated patterns may choose to be connected with Resmed for a sleep assessment and the option to see an independent provider.
Nighttime Breathing doesn’t diagnose any condition; if you’re concerned, speak with a clinician.
What Can Help Women Sleep Better Across Life Stages?
“An important step to getting good sleep is taking the time to learn your own sleep patterns and data,” says Dr. Chris Curry. Many parts of a woman’s health journey, she notes, can change or affect sleep.
Whatever stage you’re in, these steps can support or improve your sleep:
- Keep a consistent sleep schedule. Going to bed and waking up at similar times, including on weekends, helps support your circadian rhythm when your hormones shift. Oura’s Bedtime Guidance feature suggests a bedtime window based on your Chronotype.
- Keep your bedroom cool. As bedtime approaches, your core body temperature naturally drops slightly. Setting your thermostat at 65–67°F can help support that and improve sleep quality.
- Get care if you have insomnia. When working with your clinical team, cognitive behavioral therapy for insomnia (CBT-I) has some of the strongest evidence for treatment. A meta-analysis of 11 randomized trials found that it significantly improved sleep quality and reduced insomnia severity in menopausal women, whether delivered in person, by phone, or online.
- Make sure you stay up to date on your preventive care. Common conditions, like thyroid disease or iron deficiency, can impact your ability to sleep well. Things like high blood sugar can lead to frequent urination and disrupted sleep. Staying on top of primary care visits can help catch issues early.
- Look at your trends over several months. Use Oura’s Tags and Trends features to see how symptoms like cramps, hot flashes, or morning headaches affect your sleep over time. Eligible members in 43 U.S. states can also share those trends with a licensed physician through Connect to Care, Oura’s Counsel Health integration, available in Oura Labs.
Frequently Asked Questions About Women’s Health & Sleep
Do sleep trackers work for women who want to improve their sleep?
Sleep trackers like Oura can help women improve their sleep by showing patterns and biometric data on how sleep shifts across the menstrual cycle, during pregnancy, or through perimenopause. Understanding these patterns can help women get the care they need or make lifestyle changes that improve their sleep. Consumer sleep technology is not a substitute for a clinical evaluation.
How does Oura support women’s health tracking beyond general fitness?
All health is women’s health, and sleep health is a key part of taking care of yourself. Oura tracks body signals that shift with women’s hormones, including nighttime temperature, resting heart rate, heart rate variability (HRV), and respiratory rate. Depending on your life stage, you can use Cycle Insights to follow your menstrual cycle, Pregnancy Insights to see your trends from week 4 through week 40 alongside reference ranges for each stage, or Menopause Insights to bring together your temperature, sleep, and HRV trends with the Menopause Impact Scale.
How can I get a more accurate understanding of my sleep quality?
The Oura App gives you a daily Sleep Score based on contributors like total sleep, efficiency, restfulness, REM and deep sleep, latency and timing, alongside overnight trends in heart rate, HRV and body temperature. Looking at your Trends over several weeks shows how those numbers change over time. Wearing your ring consistently and logging factors like caffeine, alcohol, cramps, or hot flashes with Tags gives you a fuller picture of what may be affecting your sleep.
