Sleep, in Women’s Terms

Recently in SLIC (Spotlight: Longevity in Context), we’ve deeply explored women’s health across the lifespan, from hormones and menopause to nutrition, exercise, and preserving muscle [LINK]. Today we’re rounding out this module with the final pillar: sleep.

In this chapter, we’ll translate the best evidence into practical language: what’s different about women’s sleep, what reliably helps, what still needs better research, and simple steps you can try this week. The goal is to protect sleep now and compound benefits for energy, cognition, and long-term health.

Let’s start from a quick reality check:

Now, why does this matter beyond just feeling rested? Sleep is a core pillar of longevity. It supports brain health, metabolism, immune function, and emotional resilience. Importantly, women’s sleep is not the same as men’s. Biology, hormones, and life stages, from the menstrual cycle to pregnancy to perimenopause and menopause, shape how women sleep, what disrupts it, and how to improve it. Below is a clear, practical guide designed for action. Let’s start with the burning question:

Short answer: women often get slightly more sleep than men, and they may need a bit more, on average around 10-20 minutes, though the difference is small and varies person to person. Several large population analyses show women report around 11-23 minutes more sleep than men; whether that reflects need or just time in bed is debated. Either way, for most adults, the lowest risk for cardiovascular disease, mood problems, and cognitive decline sits around 7-8 hours with stable timing and fewer awakenings. For women, the priority is not chasing an extra full hour by default but protecting continuity and treating common disruptors. In other words, the win comes from better, steadier sleep, and whether your personal sweet spot ends a little above or below someone else’s matters less than building nights that are regular and uninterrupted.

Across studies and ages, women are more likely than men to report insomnia symptoms and poor sleep quality. The gap widens with hormonal transitions and midlife. Restless legs syndrome, a major cause of difficulty falling or staying asleep, is also more common in women. Post-menopause, the risk of obstructive sleep apnea (OSA) rises markedly, likely due to changes in hormones, like estrogen and progesterone, that influence airway tone and fat distribution. These differences are clinically meaningful and too often underdiagnosed because women may present with non-classic symptoms (fatigue, insomnia, morning headache).

Women’s body clocks often run a little earlier than men’s; on average, women tend to feel sleepy and wake up a bit earlier than men. Many also run a touch “faster”, basically if you took away all time cues (no clocks, no daylight), women’s sleep-wake cycle would drift a little earlier each day, therefore their internal day can feel slightly shorter. Add in a slightly higher core body temperature, and the changes that come with the menstrual cycle and menopause, and you get a few common patterns: feeling sleepy earlier in the evening, being more sensitive to bright light at night, and waking up more frequently from feeling too warm.

RLS feels like an uncomfortable, hard-to-describe urge to move your legs, often in the evening or at night when you’re trying to relax. People use words like creepy-crawly, pulling, buzzing, or soda bubbles under the skin. The feeling usually eases when you move (walk, stretch, shake your legs) but comes back when you lie down again. Because of this, RLS can make it hard to fall asleep and can wake you up repeatedly through the night.

RLS is 1.5 to 2 times more common in women and often shows up or worsens during pregnancy or around midlife. A frequent, fixable driver is low iron stores, specifically low ferritin, which is your body’s iron “storage tank.” You can have low ferritin even if your hemoglobin (the iron-rich protein in your red blood cells that carries oxygen) is normal, so a basic anemia test can miss it. Treating low iron, usually with iron supplements under medical guidance, can significantly reduce RLS for many people.

Women tend to experience more insomnia at every stage of life, and the problem often intensifies during perimenopause and menopause. Hot flashes and night sweats (“vasomotor symptoms”) repeatedly wake the brain, so even if total time in bed looks decent, sleep becomes light and broken. When these symptoms are a major driver, treating them, often with appropriately chosen menopausal hormone therapy (MHT/HRT) under a clinician’s guidance, can meaningfully improve sleep quality. It’s also worth checking for other common, fixable disruptors like the restless legs syndrome (RLS) and ask your clinician for a ferritin check. Finally, when insomnia has become a pattern, cognitive behavioral therapy for insomnia (CBT-I) is the gold standard. It retrains the sleep system without relying on nightly pills and has better long-term results than sedatives, which can help in the short run but don’t fix the underlying problem.

The “women need more sleep” idea likely reflects a small average difference and large person-to-person variability; there’s no one-size-fits-all number. Personalized circadian care, like tailoring light timing, temperature strategies, and bed/wake schedules by menstrual phase, contraceptive use, pregnancy, and menopausal stage, looks promising but needs rigorous trials. Pregnancy and postpartum sleep interventions that are both effective and truly workable in real life remain under-studied.

At The LSF, we spotlight these gaps because closing them can meaningfully extend women’s healthspan. We’re vetting projects that build better diagnostics for women’s health, test tailored protocols, and evaluate menopause-specific solutions. If you’re a clinician, researcher, or donor, your support can accelerate the studies women deserve.

Women's sleep is shaped by hormones, temperature regulation, circadian timing, and changing life demands. The average woman may sleep slightly longer than the average man, typically about 10-20 minutes, but this is a small duration difference. The health benefit target remains similar for both sexes, roughly 7-8 hours of regular and uninterrupted sleep. Start with light, regularity, and a cool room; time caffeine, alcohol, and meals; add cycle-savvy adjustments; screen for RLS and apnea; and use CBT-I and (when appropriate) HRT to address the drivers. It’s a woman-centered sleep plan you can put into practice this week, and one we’re working to strengthen through better science.