“…Rarely (have) any time to myself without skipping out on sleep. Guilt over not getting everything done. Anger over lack of motivation. Jealousy that others don’t struggle over simple chores the way I do.”

“Baby won’t sleep well, I’m exhausted, (there’s) not enough money, not a lot of help from family.”

“I spend so long commuting I spend extremely little time with my baby. Significant lack of sleep for whole family.”

We’ve now heard from over 3,500 parents, mostly Moms (97%) who have been doing more of everything since March of 2020. And they’ve shared a lot about sleep. And how fatigue is a significant barrier to self-care and preventative health routines. Of course, this isn’t surprising.

We’ve rolled from crisis to crisis. And when changing conditions effect family life, Moms tend to take on the added work and worry. With a mere 24 hours on the menu, the increased demands, often mean less sleep.

We’re busier, but it’s more complicated than that. Many of us roll from the sleep disruptions of fertility treatments or pregnancy, to unexpected sleep hurdles. Everything from potty training to perimenopause. So, how can we get more restorative sleep to emerge with the energy we need each day?

Understand What Works Against Our Sleep

In the current wave of our study, that began in January, 64% of Moms want to make “more sleep” part of their self-care routine. And countless studies show that good sleep is essential for memory, mood, and immune function. But how?

Dr. Shelby Harris, Licensed Psychologist and Behavioral Sleep Doctor said, “When I think about sleep for women, there are three different circles, like a Venn diagram, that overlap and have insomnia or sleep loss in the center. There are psychological, social, and biological factors.”

Including Hormonal Changes

Shelby said, “So, starting with the biological, often once we hit puberty and add hormonal changes to the mix, the rate of insomnia becomes higher for girls and women. So, we notice that some women have insomnia 3 to 5 days before they get their periods. It’s not everyone, some will have the exact the opposite experience, and become excessively sleepy. It can be very cyclical. I always suggest tracking your cycle to see if it coincides with sleep diary problems.” Brilliant. There’s an entire hormonal arc that can impact sleep and it may start when you’re trying to conceive. And it’s not just our cycles, there’s pregnancy.

“Many women are on different medications trying to get pregnant. So, medications to help with infertility can lead to insomnia or excessive sleepiness. And then you get pregnant.” She explained what many of us experience. “It’s not necessarily that you’re uncomfortable because of the size of the baby, it’s all of the hormonal changes. The second trimester tends to even out a bit more and by third trimester, you’re big, uncomfortable, urinate a lot and may even have heartburn.”

Or Other Underlying Medical Conditions

Shelby said, “We see higher rates of sleep apnea in a lot of women at that point. Which doesn’t get evaluated a lot of the time. We also see a lot of restless leg syndrome, it’s when you cannot keep your legs still. And the only way they feel better, is by moving them. I had that myself during my pregnancies.”

She explained it can be due to an iron deficiency. “I told my OB to test my iron levels and that I might need an iron supplement. When I did, it helped. But a lot can get in the way of you falling asleep, including vivid dreams that happen with stress.”

Like Being Postpartum or in Perimenopause

The trials of pregnant sleep can feel trivial compared to a newborn’s uneven schedule. Shelby said, “After the baby, your hormones are all over the place. You’re either trying to breastfeed or manage a baby that’s up all hours. Sometimes, even if we have help, we can’t turn our brains off because of the hormonal aspect.”

As more women have children later in life, big hormonal shifts can start before their kids are out of diapers. She added, “In perimenopause we face hormonal changes again. And it can start as early as your late thirties. Often, we have trouble with hot flashes, night sweats or insomnia, from a racing brain.”

Interruptions From Our Partners and Work Calendars

Shelby takes a holistic view to assess sleep challenges with patients. “We also take social factors into account. Like, maybe you have a child who has ADHD, autism, or another medical issue. Or maybe you have a spouse or bed partner who has a very different type of sleep pattern or snores and keeps you up. Or maybe they work nights and you’re at home or working during the day.”

She also mentioned that hybrid work schedules, for some, make it harder to develop a consistent waking time. Because the routine varies on commute days. And no parent is immune to worry, and stress certainly doesn’t stop as our children grow.

And Let’s Not Forget, Good Old-Fashioned Stress

There’s a huge mental health crisis. And rising rates of depression and anxiety plaguing teens and young adults impact the stress parents feel. Not to mention the economic issues forcing many adult kids to remain in the nest.

Shelby explained, “We also see social issues with women working, taking care of the household and often, it’s not just their kids. They’re taking care of aging parents and other family members. And for the psychological part, we see higher rates of anxiety and depression in women. So, put that on top of the social and hormonal stuff and it’s a firestorm for insomnia issues.”

Not Having Opportunity to Sleep

Many have changed jobs in the past few years and as the economy wobbles, organizations continue to pivot, and demand more. Shelby explained many people work long hours and aren’t making time for sleep. “If you can sleep but just can’t find the time to do it, because you burn the candle at both ends, that’s a little bit different. But if you feel like something’s off, don’t let anyone brush your sleep issues aside. You are the expert on you.”

She added, “So, if you have external work demands or a child who’s up at night preventing you from sleep, that’s not necessarily a sleep disorder. We would target trying to get external help, working on your child’s sleep, the snoring partner or whatever those things might be.”

Differs From Being Unable to Fall or Stay Asleep

Distinguish not having the time, from when you have the opportunity to sleep, but can’t. Shelby said, “If your kid comes in and wakes you up but you can’t go back to sleep, for hours even after they go back to sleep, that’s probably insomnia. So, you would talk to your doctor about it and say, ‘I think I’m suffering from insomnia. I have trouble falling asleep, staying asleep or I awaken earlier than I want to. Despite trying to sleep.’ If sleep is just not happening multiple days a week that’s when you would talk with them about targeting treatment.”

Get the Right Kind of Help

The good news? There are many ways to get support for the sleep help you need. Shelby works with her patients to diagnose what’s going on and develop an action plan. She explained, “I specialize in cognitive behavioral therapy for insomnia. A lot of Moms don’t want to use medication, especially when they have kids that might have to come in and get them up. If you feel it might have a hormonal component, it’s definitely a conversation to have with a gynecologist, who specializes in perimenopausal care.”

Many thanks to the talented Dr. Shelby Harris!

Check out her amazing book, “The Woman’s Guide to Overcoming Insomnia” and follow her great adventure on her website, Instagram, TikTok and LinkedIn.

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About Shelby:

Shelby Harris PsyD, DBSM is a clinical psychologist and sleep specialist in private practice in NY. She is board certified in Behavioral Sleep Medicine and treats a wide variety of sleep, anxiety and depression issues using evidence-based non-medication treatments. Her self-help book The Women’s Guide to Overcoming Insomnia was published in 2019 by W.W. Norton Books. Dr. Harris holds an academic appointment as Clinical Associate Professor at the Albert Einstein College of Medicine in Neurology and Psychiatry.

Before going into private practice she was the longstanding director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center in NYC. In addition to her clinical work, Dr. Harris is the Director of Sleep Health for Sleepopolis.com.

Dr. Harris has been an invited columnist for the New York Times, and is frequently in the media including the New Yorker, Washington Post, CBS Mornings, Today Show, Good Morning America and The Drew Barrymore Show. Dr. Harris can be found on Instagram at @SleepDocShelby where she provides evidence-based information about sleep wellness and sleep disorders.