Insufficient Sleep - Women in Hawaii

Hawaii

Insufficient sleep is a public health challenge. Sleep is critical for basic functions such as cognitive processing, mood regulation, blood sugar level and immune system response. Insufficient sleep is a risk factor for many chronic diseases, including cancer, diabetes, hypertension and obesity. Insufficient sleep is also associated with reduced productivity and quality of life and increased symptoms of depression and anxiety, as well as increased risk of motor vehicle accidents, workplace injuries or accidents and medical errors. Drowsy driving caused 633 deaths in the United States in 2023 — 1.5% of all motor vehicle fatalities that year. Research indicates that shift work can decrease sleep quality, increasing the risk of developing chronic sleep problems or sleep disorders. A 2016 report by the Rand Corporation estimates that insufficient sleep costs the U.S. $411 billion each year in missed workdays and reduced productivity. 

Women experience a higher prevalence of insomnia compared with men. Biological events, such as menstruation, pregnancy and perimenopause, can impact a woman's hormones and body, leading to disrupted sleep and changes in sleep quality. 

Women may experience trouble sleeping during pregnancy due to pressure on the diaphragm, increased urinary frequency, and physical changes associated with pregnancy. Women who get insufficient sleep during pregnancy are at increased risk of complications, including high blood pressure (preeclampsia), gestational diabetes, longer labor time and higher rates of cesarean section.

According to America’s Health Rankings analysis, the prevalence of insufficient sleep among women ages 18-44 is higher among:

• Women ages 35-44 compared with women ages 18-34. The prevalence of insufficient sleep increases with age.
• Black women compared with Asian women.
• Women with some post-high school education compared with college graduates.
• Women with an annual household income less than $75,000 compared with women who have incomes of $75,000 or more.
• Women who have difficulty with self-care compared with women without a disability.
• Women who have served in the U.S. armed forces compared with women who have not served.
• Lesbian, gay, bisexual and queer (LGBQ+) women compared with straight women.

The National Institutes of Health recommends that adults sleep seven to eight hours nightly. Habits that help build and maintain a healthy sleep cycle include following a consistent sleep schedule, restricting the use of electronic devices before bedtime and limiting the consumption of caffeine, alcohol and nicotine products, as they can interfere with sleep. Engaging in aerobic exercise has been found to improve sleep quality, provided it isn’t done too close to bedtime. 

While taking naps may boost alertness, individuals who have difficulty falling asleep at night should take their naps earlier in the day and limit them to 20 minutes or less at a time.

A 2022 report in the American Journal of Industrial Medicine focused on workplace fatigue outlines recommended strategies to mitigate work-related fatigue, including optimizing work schedules, providing targeted sleep hygiene education and implementing comprehensive fatigue risk management systems.

Healthy People 2030 has several sleep-related objectives, including increasing the proportion of adults who get sufficient sleep and reducing the rate of motor vehicle crashes due to drowsy driving.

Hale, Lauren, Wendy Troxel, and Daniel J. Buysse. “Sleep Health: An Opportunity for Public Health to Address Health Equity.” Annual Review of Public Health 41, no. 1 (April 2, 2020): 81–99. https://doi.org/10.1146/annurev-publhealth-040119-094412.

Haufe, Annika, and Brigitte Leeners. “Sleep Disturbances Across a Woman’s Lifespan: What Is the Role of Reproductive Hormones?” Journal of the Endocrine Society 7, no. 5 (March 6, 2023): bvad036. https://doi.org/10.1210/jendso/bvad036.

Medic, Goran, Micheline Wille, and Michiel E. H. Hemels. “Short- and Long-Term Health Consequences of Sleep Disruption.” Nature and Science of Sleep 2017, no. 9 (May 19, 2017): 151–61. https://doi.org/10.2147/NSS.S134864.

National Center for Statistics and Analysis. Overview of Motor Vehicle Traffic Crashes in 2023. Traffic Safety Facts Research Note, Report No. DOT HS 813 705. U.S. Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis, April 2025. https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813705.

Nwaogu, Janet Mayowa, Albert P. C. Chan, John A. Naslund, and Shahnawaz Anwer. “The Interplay Between Sleep and Safety Outcomes in the Workplace: A Scoping Review and Bibliographic Analysis of the Literature.” International Journal of Environmental Research and Public Health 22, no. 4 (March 31, 2025): 533. https://doi.org/10.3390/ijerph22040533.

Reinganum, Michael I., and Janelle Thomas. “Shift Work Hazards.” In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2024. https://www.ncbi.nlm.nih.gov/books/NBK589670/.

Sullivan, Kelly, and Collins Ordiah. “Association of Mildly Insufficient Sleep with Symptoms of Anxiety and Depression.” Neurology, Psychiatry and Brain Research 30 (December 2018): 1–4. https://doi.org/10.1016/j.npbr.2018.03.001.

Weaver, Matthew D., Christopher P. Landrigan, Jason P. Sullivan, Conor S. O’Brien, Salim Qadri, Natalie Viyaran, Wei Wang, Céline Vetter, Charles A. Czeisler, and Laura K. Barger. “The Association Between Resident Physician Work-Hour Regulations and Physician Safety and Health.” The American Journal of Medicine 133, no. 7 (July 2020): e343–54. https://doi.org/10.1016/j.amjmed.2019.12.053.

Zeng, Liang-Nan, Qian-Qian Zong, Yuan Yang, Ling Zhang, Yi-Fan Xiang, Chee H. Ng, Li-Gang Chen, and Yu-Tao Xiang. “Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies.” Frontiers in Psychiatry 11 (November 20, 2020): 577429. https://doi.org/10.3389/fpsyt.2020.577429.