From incarceration to gaslighting, the medical system has long dismissed women\u2019s sleep struggles\u2014especially during menopause\u2014putting their health and lives at risk. Research shows that women are more likely to interrupt their own sleep to care for others. (Westend61 \/ Getty Images) <\/p>\n
I am a neuroscientist studying sleep, stress and mental health. I\u2019m also a Gen X, perimenopausal, sandwich-generation woman. Currently, I\u2019m second-shifting, helping my kids pack for camp, and assisting my uncle with the bureaucracy of Medicare. Needless to say, my once robust sleep has crumbled. It\u2019s flimsy, pierced by hot flashes, stress dreams, and sudden spikes in heart rate.<\/p>\n
As author Glennon Doyle recently quipped on the We Can Do Hard Things tour<\/a>, \u201cIs this primal rage I\u2019m feeling an appropriate response to tyranny\u2014or just low estrogen?\u201d The audience roared. It\u2019s both.\u00a0<\/p>\n Despite being among the top reasons women seek medical care, sleep disruptions during menopause have been understudied and undertreated. For women, sleep problems peak during the menopausal years, which span from their 40s to early 60s. Even more alarming, suicide rates also rise during these years. Yet, this crisis remains largely ignored.<\/p>\n Federal research, which now faces catastrophic budget cuts<\/a>, has long neglected women\u2019s sleep and menopause<\/a>. When addressed, it typically focuses on biological\u2014estrogen fluctuations, weight gain, etc.\u2014rather than social causes like accumulated trauma, gender-based violence<\/a>, inadequate family leave, wage gaps and medical gaslighting. For\u00a0Black women<\/a>, who face higher rates of discrimination, poverty and interpersonal violence, the sleep disparities are particularly pronounced.<\/p>\n The data is unequivocal: Women\u2019s sleep deteriorates in midlife more severely than men\u2019s<\/a>. Eight in 10 women experience hot flashes and night sweats lasting up to a decade. Hormonal changes trigger snoring, sleep apnea, restless legs and insomnia. But the causes extend beyond female hormones.<\/p>\n As sociologist Jessica Calarco<\/a> documented, midlife women are holding the social safety net together<\/a>, picking up the pieces of a broken welfare system. Research<\/a> from the National Library of Medicine (NLM) confirms that women are more likely to interrupt their own sleep to care for others. The costs are steep because when sleep erodes, so does mental health.\u00a0<\/p>\n Sleep is not a luxury. It is a nightly ritual restoring the brain through cellular growth and repair. To understand how we got here, we must examine the long history of how women\u2019s sleep\u2014or lack thereof\u2014has been weaponized against us.<\/p>\n A History of Criminalized Rest <\/p>\n For much of American history, menopause wasn\u2019t just misunderstood; it was criminalized. In the 1800s and early 1900s, physicians routinely diagnosed middle-aged women with \u201cclimacteric insanity<\/a>.\u201d Symptoms included unrefreshing sleep, hot flashes, heartburn, and \u201cinattention to ordinary domestic affairs.\u201d The cure? Institutionalization. A husband\u2019s word could land a woman in an asylum with no trial or formal diagnosis required.<\/p>\n The diaries women wrote from inside these institutions are harrowing. Mary Huestis Pengilly<\/a>, a 59-year-old teacher and mother of six, lost her daughter and home. When she told her doctor she needed \u201cgood food and rest,\u201d she was committed to St. John\u2019s Lunatic Asylum. Her hidden diary<\/a> describes acute neglect and abuse.<\/p>\n In 1927, 37-year-old Martha Nasch underwent a traumatic surgery. Her adulterous husband used the physician\u2019s observation that she had \u201ca case of the nerves\u201d to have her committed to Minnesota\u2019s St. Peter State Hospital. Her secret poetry journal<\/a> describes the pain of miscarriage, grief and sleep deprivation. \u201cBe thankful for your rest and sleep,\u201d she warned. \u201cFor here I am, lost forever, Suff\u2019ring alive in hell.\u201d<\/p>\n These stories of incarcerated perimenopausal women are just two among tens of thousands\u2014including my great-grandmother, Mary Elizabeth Hopewell\u2014whose story was never recorded.<\/p>\n From Incarceration to Sedation <\/p>\n The medical establishment\u2019s approach to women\u2019s sleep eventually evolved, but not necessarily for the better. The post-war era brought a shift from incarceration to sedation. Pharmaceutical companies marketed amphetamines for pep and weight loss, and highly addictive barbiturates for sleep. Women\u2019s weariness was pathologized and medicated.<\/p>\n My literary heroines of that era\u2014Virginia Woolf, Anne Sexton and Pulitzer Prize winner Sara Teasdale\u2014didn\u2019t survive menopause. All expressed desperate sleep needs but received inadequate care. All three died by suicide.\u00a0<\/p>\n Today, we know that poor sleep isn\u2019t just a symptom of mental illness but rather a trigger. Our research<\/a> shows that even amid immense hardship, the ability to sleep well buffers against suicidal thoughts<\/a>. What if these women received compassionate, evidence-based care? Even as medical understanding advanced, women continued to suffer and die from inadequate care.<\/p>\n The Modern Crisis <\/p>\n In my lifetime, the pendulum has swung from pathologizing women to gaslighting them. Severe cramps, pregnancy, childbirth complications and debilitating menopause symptoms are often dismissed. Care providers aren\u2019t adequately educated about sleep or menopause, and federal research doesn\u2019t prioritize them. Although perimenopausal and menopausal women make up 13 percent of the U.S. population<\/a>, in 2023, the NIH dedicated just 1 percent of its budget<\/a> to menopause research.<\/p>\n Things have only gotten worse.<\/p>\n The 2025 Trump administration slashed billions in federal research funding, targeting projects<\/a> mentioning \u201cdiscrimination,\u201d \u201coppression,\u201d \u201cvulnerable populations\u201d or \u201cwomen.\u201d The NIH\u2019s Safe to Sleep campaign\u2014credited with saving over 150,000 infants\u2014was terminated<\/a>. On June 9, hundreds of federal scientists signed the Bethesda Declaration<\/a> protesting these actions, which violate the NIH\u2019s mission \u201cto enhance health, lengthen life, and reduce illness and disability.\u201d<\/p>\n Sleep depends on physical and psychological safety. But Trump\u2019s \u201cBig Beautiful Bill<\/a>\u201d guts the programs that ensure it: food banks, Medicare, Medicaid, SNAP<\/a>, housing aid and children\u2019s health insurance. These cuts disproportionately hurt women, especially caregivers. Who can sleep well when they can\u2019t afford food, rent or medicine?<\/p>\n These policies deserve the full force of menopausal women\u2019s primal rage<\/a>. And that\u2019s exactly what they\u2019re getting.<\/p>\n Women Are Fighting Back <\/p>\n Women are organizing, protesting and advocating. The Citizen\u2019s Guide to Menopause Advocacy<\/a> provides concrete actions to change research and insurance policy. Project Sleep<\/a> educates lawmakers, providers and the public on sleep health and equity.<\/p>\n Beyond policy work, we must also shift the culture. Black women have long led this charge.<\/p>\n Civil rights leader Fannie Lou Hamer, forced into early menopause after a non-consensual hysterectomy<\/a>, centered health in her activism. \u201cI\u2019m sick and tired of being sick and tired,\u201d she proclaimed. <\/p>\n Theologian Tricia Hersey<\/a>, author of Rest Is Resistance, reminds us that rest is an antidote to capitalist white supremacy. <\/p>\n And Melani Sanders\u2019 viral community, the \u201cWe Don\u2019t Care Club<\/a>,\u201d gloriously reclaims the \u201cinattention to ordinary domestic affairs\u201d as a feminist menopausal badge of honor.<\/p>\n Sleep health is political, and it\u2019s time we treated it that way. Demand your doctor take sleep complaints seriously. Support candidates prioritizing healthcare funding. Join organizations like Project Sleep<\/a> lobbying for research. Share personal stories to break the shame.\u00a0<\/p>\n To resist, we must reclaim rest itself. Our lives depend on it.<\/p>\n