Sleep is a commonly overlooked aspect of women’s health, yet its absence is quietly taking a toll on millions of lives. Caregiving responsibilities, hormonal shifts, and the relentless mental load of modern life leave women uniquely vulnerable to poor sleep. For many women, poor sleep and feeling tired is seen as normal or expected. Cultural and clinical stigmas often discourage women from seeking help, with many being told their exhaustion is “just stress” or “part of aging.”
Because of this, women’s sleep struggles are often dismissed, misdiagnosed, or overshadowed. This silencing can delay potential treatment, deepen health risks, and normalize poor sleep. As a result, millions remain untreated for serious conditions like obstructive sleep apnea (OSA), at a time when hustle culture glorifies sacrificing sleep.
The sleep gender gap is not just a quality-of-life issue, it is a looming public health crisis. New research shows rising rates of sleep disorders in women are outpacing the rise in men by three-fold, but health systems, tools, and clinical screening for sleep apnea remains largely biased in favor of men. In fact, recent findings anticipate a 65 percent relative increase in OSA prevalence among women, reaching 30.4 million by 2050. As women both personally living with OSA, we know firsthand how urgently women’s sleep needs must be taken seriously. And like many women, our symptoms could have easily gone unrecognized, delaying diagnosis and access to treatment options.
To close this gap, the health care industry must stop treating women’s sleep as an afterthought and start building solutions that reflect our lived reality. While it is a change we do not anticipate taking place overnight, it is a pertinent challenge that requires a level of attention and education across providers, policymakers, health technology innovators, life science companies, and more to ensure meaningful progress is made.
Redefining diagnosis and addressing provider education gaps
Primary care is often the first stop for women struggling with sleep, yet medical training rarely covers how sex differences affect diagnosis and treatment. As Dr. Wells explains it, “OSA is not simply a sleep problem, it is a breathing disorder that silently strains the heart, brain, metabolism, and immune system. If the same number of breathing interruptions occurred while someone was awake, they would seek emergency care immediately. The fact that these events happen during sleep does not make them harmless; it makes them insidious.”
Left untreated, OSA can increase the risk of disease, including high blood pressure, heart disease, type 2 diabetes, and even dementia or stroke.
In our sleep health work across both clinical practice and medical affairs, we have long witnessed sleep disorders like OSA being diagnosed based on “classic” male symptoms, such as loud snoring and observed apneas. Yet, women often present differently, and current diagnostic standards can often render those struggles overlooked. We have seen this firsthand, not just in our work, but in our own diagnosis journeys where symptoms were not immediately connected to OSA.
For example, in Dr. Wells’ practice, many women come to her with long nighttime awakenings, low daytime energy, and memory or focus problems. Often these women self-diagnose with insomnia, unaware they could have OSA. True insomnia coexisting with OSA is also common, and both must be managed together.
Just as heart attacks often present differently in women than in men, we are now recognizing a sex-related disparity in how women’s sleep disorders are evaluated. Clinicians should maintain a low threshold for considering an underlying sleep condition as untreated disorders can quietly erode a woman’s health and well-being.
Provider education reforms must also help fill the diagnosis gap by equipping clinicians with the tools and confidence to recognize sleep disorders in women, initiate testing, and provide referrals. Continuing medical education (and expanding medical school curricula), coupled with digital resources, updated screening tools that reflect sex-specific presentations, and expanded use of validated questionnaires in primary care, can help scale this knowledge quickly.
When female patients feel their concerns will be validated rather than dismissed, they are far more likely to seek timely care.
Connecting the dots: sleep, mental health, and chronic conditions
Anxiety, depression, autoimmune disorders, migraines, and chronic pain, conditions that disproportionately affect women, are tightly linked with poor sleep. Yet the health care system often treats these issues in silos.
In some cases, providers are already addressing the consequences of chronically untreated or undertreated OSA, from uncontrolled blood pressure and weight gain to escalating cardiovascular risk, without considering the root cause. For example, among patients with persistent or treatment-resistant hypertension, OSA is not just a comorbidity but often an underlying driver. Treating OSA has been shown to improve blood pressure control and lower long-term cardiovascular risk, making it a critical lever for better outcomes in chronic disease management.
From a mental health perspective, when women tell their doctors they are not sleeping well, feel exhausted, or are constantly tired, many are first diagnosed with depression or advised to try sleep hygiene or stress management techniques, rather than being referred for a comprehensive sleep evaluation to check for OSA. Our experience shows that women with OSA are frequently treated for depression before receiving an accurate OSA diagnosis.
Integrated care models are urgently needed, where sleep health is addressed alongside mental health and chronic disease management. For patients, this could mean earlier intervention and better long-term outcomes.
Designing solutions for women, not around them
Wearables, apps, medical devices, and AI-driven sleep technologies are rising in prominence, but most are designed using male-centric datasets. Women deserve devices and treatments designed with their physiology and needs in mind, from sleep mask fittings for smaller facial structures to algorithms that recognize female symptom patterns. Consumers already show high engagement with wellness tools; building inclusive solutions will accelerate adoption and improve health outcomes at scale.
Women require comprehensive sleep care tailored to their individual needs and preferences. By prioritizing women’s unique needs, we can create solutions that truly transform health and well-being at every stage of life. The path forward requires the health care industry to implement the following strategies:
- Redefine diagnostic criteria
- Dismantle clinical stigma
- Integrate comprehensive care
- Empower providers with new resources
- Demand and deliver inclusive innovation
Women’s sleep is not a niche issue, it is a blind spot with major implications for chronic disease, workforce productivity, and overall public health. If we want women to thrive, we must start treating sleep health as central to women’s health and longevity.
Kimberly L. Sterling is a health care executive. Audrey Wells is a sleep medicine physician.
