From incarceration to gaslighting, the medical system has long dismissed women’s sleep struggles—especially during menopause—putting their health and lives at risk.
I am a neuroscientist studying sleep, stress and mental health. I’m also a Gen X, perimenopausal, sandwich-generation woman. Currently, I’m 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’s flimsy, pierced by hot flashes, stress dreams, and sudden spikes in heart rate.
As author Glennon Doyle recently quipped on the We Can Do Hard Things tour, “Is this primal rage I’m feeling an appropriate response to tyranny—or just low estrogen?” The audience roared. It’s both.
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.
Federal research, which now faces catastrophic budget cuts, has long neglected women’s sleep and menopause. When addressed, it typically focuses on biological—estrogen fluctuations, weight gain, etc.—rather than social causes like accumulated trauma, gender-based violence, inadequate family leave, wage gaps and medical gaslighting. For Black women, who face higher rates of discrimination, poverty and interpersonal violence, the sleep disparities are particularly pronounced.
The data is unequivocal: Women’s sleep deteriorates in midlife more severely than men’s. 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.
As sociologist Jessica Calarco documented, midlife women are holding the social safety net together, picking up the pieces of a broken welfare system. Research 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.
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’s sleep—or lack thereof—has been weaponized against us.
A History of Criminalized Rest
For much of American history, menopause wasn’t just misunderstood; it was criminalized. In the 1800s and early 1900s, physicians routinely diagnosed middle-aged women with “climacteric insanity.” Symptoms included unrefreshing sleep, hot flashes, heartburn, and “inattention to ordinary domestic affairs.” The cure? Institutionalization. A husband’s word could land a woman in an asylum with no trial or formal diagnosis required.
The diaries women wrote from inside these institutions are harrowing. Mary Huestis Pengilly, a 59-year-old teacher and mother of six, lost her daughter and home. When she told her doctor she needed “good food and rest,” she was committed to St. John’s Lunatic Asylum. Her hidden diary describes acute neglect and abuse.
In 1927, 37-year-old Martha Nasch underwent a traumatic surgery. Her adulterous husband used the physician’s observation that she had “a case of the nerves” to have her committed to Minnesota’s St. Peter State Hospital. Her secret poetry journal describes the pain of miscarriage, grief and sleep deprivation. “Be thankful for your rest and sleep,” she warned. “For here I am, lost forever, Suff’ring alive in hell.”
These stories of incarcerated perimenopausal women are just two among tens of thousands—including my great-grandmother, Mary Elizabeth Hopewell—whose story was never recorded.
From Incarceration to Sedation
The medical establishment’s approach to women’s 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’s weariness was pathologized and medicated.
My literary heroines of that era—Virginia Woolf, Anne Sexton and Pulitzer Prize winner Sara Teasdale—didn’t survive menopause. All expressed desperate sleep needs but received inadequate care. All three died by suicide.
Today, we know that poor sleep isn’t just a symptom of mental illness but rather a trigger. Our research shows that even amid immense hardship, the ability to sleep well buffers against suicidal thoughts. What if these women received compassionate, evidence-based care? Even as medical understanding advanced, women continued to suffer and die from inadequate care.
The Modern Crisis
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’t adequately educated about sleep or menopause, and federal research doesn’t prioritize them. Although perimenopausal and menopausal women make up 13 percent of the U.S. population, in 2023, the NIH dedicated just 1 percent of its budget to menopause research.
Things have only gotten worse.
The 2025 Trump administration slashed billions in federal research funding, targeting projects mentioning “discrimination,” “oppression,” “vulnerable populations” or “women.” The NIH’s Safe to Sleep campaign—credited with saving over 150,000 infants—was terminated. On June 9, hundreds of federal scientists signed the Bethesda Declaration protesting these actions, which violate the NIH’s mission “to enhance health, lengthen life, and reduce illness and disability.”
Sleep depends on physical and psychological safety. But Trump’s “Big Beautiful Bill” guts the programs that ensure it: food banks, Medicare, Medicaid, SNAP, housing aid and children’s health insurance. These cuts disproportionately hurt women, especially caregivers. Who can sleep well when they can’t afford food, rent or medicine?
These policies deserve the full force of menopausal women’s primal rage. And that’s exactly what they’re getting.
Women Are Fighting Back
Women are organizing, protesting and advocating. The Citizen’s Guide to Menopause Advocacy provides concrete actions to change research and insurance policy. Project Sleep educates lawmakers, providers and the public on sleep health and equity.
Beyond policy work, we must also shift the culture. Black women have long led this charge.
Civil rights leader Fannie Lou Hamer, forced into early menopause after a non-consensual hysterectomy, centered health in her activism. “I’m sick and tired of being sick and tired,” she proclaimed.
Theologian Tricia Hersey, author of Rest Is Resistance, reminds us that rest is an antidote to capitalist white supremacy.
And Melani Sanders’ viral community, the “We Don’t Care Club,” gloriously reclaims the “inattention to ordinary domestic affairs” as a feminist menopausal badge of honor.
Sleep health is political, and it’s time we treated it that way. Demand your doctor take sleep complaints seriously. Support candidates prioritizing healthcare funding. Join organizations like Project Sleep lobbying for research. Share personal stories to break the shame.
To resist, we must reclaim rest itself. Our lives depend on it.
Special thanks to Stacy Keltner for her editorial guidance on this piece.
Great Job J. Roxanne Prichard & the Team @ Ms. Magazine Source link for sharing this story.
