The Sleep Crisis Women Ignore—And Why Your Hormones Might Be the Real Culprit

Chronic insomnia isn't just a bad night here and there—it's months or years of exhaustion quietly woven into daily life, and women experience it far more often than men. A new sleep health group offered through PCOM Psychological Services provides evidence-based support for women experiencing chronic insomnia, combining clinical expertise, peer connection, and Cognitive Behavioral Therapy for Insomnia (CBT-I), a frontline treatment that addresses the underlying behaviors and thought patterns keeping people awake.

Why Do Women Struggle With Sleep More Than Men?

Women are significantly more likely than men to experience sleep disturbances, yet they're also more likely to minimize their symptoms or place their own health needs last. Hormonal changes across the menstrual cycle, pregnancy, postpartum, perimenopause, and menopause can dramatically affect sleep quality. Roughly 10% of women experience chronic sleep difficulties overall, with even higher prevalence during pregnancy and the postpartum period. Despite this widespread problem, sleep disruption—especially in the context of motherhood—is often normalized or dismissed as simply part of being a woman.

"There's a cultural narrative that exhaustion is just part of being a woman, particularly a mother," said Dr. Alexa Bonacquisti, an associate professor and reproductive health psychologist at PCOM's Department of Clinical Psychology. "But chronic sleep deprivation has real consequences for mental health, physical health, and quality of life."

How Does CBT-I Actually Work?

Unlike sleep medications, which offer only short-term fixes, Cognitive Behavioral Therapy for Insomnia addresses the root causes of poor sleep and produces long-term improvement. The therapy focuses on two core components that work together to rebuild a healthy relationship with sleep:

• Cognitive Strategies: Challenge unhelpful beliefs, worries, and fears about sleep that can perpetuate insomnia and keep your mind racing at night.
• Behavioral Strategies: Include sleep scheduling, stimulus control (using the bed only for sleep), and time-in-bed restriction to help reset your body's sleep-wake cycle.
• Mindfulness and Relaxation: Participants practice breathing techniques, present-moment awareness, and sensory grounding to support change between sessions.

"Many people don't realize that insomnia is treatable," explained Dr. Jacqueline D. Kloss, a professor and longtime sleep health specialist who leads the program. "They might assume poor sleep is something they just have to live with, or they may rely on short-term fixes that don't resolve the problem."

The PPS Sleep Group for Women is a structured, eight to ten-week program designed for women ages 18 and older. After an initial individual evaluation to assess whether CBT-I is the right fit, participants move into small-group sessions that blend psychoeducation, skills training, and guided practice. Between sessions, participants track their sleep using diaries and build healthier sleep habits. The group format also provides something many participants have never experienced before: connection with others facing similar sleep challenges.

What Happens When Sleep Improves?

Sleep is a core regulator of mental, emotional, and physical health, alongside nutrition and physical activity. Sleep disturbance is often associated with depression, anxiety, daytime fatigue, and impaired functioning, yet it frequently goes unaddressed in routine health care. When sleep improves through CBT-I, people often notice changes that extend far beyond the bedroom.

"Treating sleep is treating overall health," Dr. Kloss said. "CBT-I works for most—and it works without the risks that may come with long-term medication use. When sleep improves, people often feel more rested and notice changes in mood, concentration, resilience, and their ability to cope with daily stressors."

The program is grounded in the science of sleep while uniquely addressing issues relevant to women's lives that may interfere with sleep, such as hormonal fluctuations, psychosocial stressors, and reproductive experiences. For many people with insomnia, nighttime becomes a breeding ground for worry, rumination, and frustration—patterns the program directly targets through both cognitive and behavioral work.

Those interested in participating in the PPS Sleep Group for Women can schedule a free screening call by contacting PCOM Psychological Services at 215-871-6487 or visiting pcomhealth.org/psychological-services.