“I already want to take a nap tomorrow.” -Anonymous

Mar 18
3 min read

World Sleep Day was this past Friday and while some of us, myself included, were celebrating, some find sleep frustrating and elusive. “…women at any age are one of the most vulnerable groups to suffer from the public health problem of sleep disorders.” (1) There are so many factors that can contribute to poor quality sleep for women, but not all are obvious. I wanted to highlight some of the factors affecting a woman’s ability to sleep to hopefully help you catch some zzzz’s.

I created the above image to provide a visual of how complicated disturbed sleep can be. As you can see, perimenopause/menopause, stress, chronic pain/pelvic pain, anxiety/depression and nocturia (getting up more than once to pee at night) are all bidirectional concerns. This means that each of these can contribute to sleep disturbances and sleep disturbances can contribute to each of these. Vicious Cycle!! Plus, you have the complications of anxiety/depression causing stress and vice versa. There has also been research to support the fact that anxiety/depression and chronic pain often occur together. Even just the idea of all of these factors could keep someone up at night! So, what can we do about it??

EXERCISE!

I know, I know. But honestly, exercise is the answer. Not only does it directly address sleep disturbances, but it will also improve the factors that lead to the sleep disturbances in the first place. Let me explain…

According to the sleep foundation, both moderate to intense exercise as well as exercises aimed at relaxation, such as yoga, can improve a woman’s quality of sleep and improve their ability to fall asleep in the first place.(2,3) They also report that the more often you exercise, the more benefits one will see. The only caveat is not exercising vigorously too close to bedtime.(4)

When we take the individual factors affecting sleep into consideration, we also see strong evidence for the support of exercise. A 2025 study on perimenopausal symptoms highlighted the benefit of frequent exercise sessions showing “notable improvements in symptoms such as hot flushes, paresthesia, irritability, fatigue, arthralgia, and myalgia.” (5)

Exercise also has positive effects on depression. A 2024 study from the British Medical Journal found that “…walking or jogging, yoga, and strength training (are) more effective than other exercises, particularly when intense.” (7) This study is crucial because it highlights specific types of exercise over just the general recommendation of ‘physical activity’.

There is also plenty of anecdotal evidence on how exercise is beneficial. As a physical therapist of over 20 years, I’ve seen first hand how exercise can reduce pain and improve a person’s quality of life. On the other hand, I’ve also seen patients with chronic pain have a flare of their symptoms with exercise. So, while exercise is still recommended as a way to combat pain, we must focus on the individual and her needs and adjust her exercise program accordingly. (6) This is where having guidance is key to avoid over-exercising, causing yourself increased pain and avoiding physical activity altogether.

When it comes to the problem of frequent nighttime urination, there are changes you can make to your daily routine to reduce these issues as you do not want these bathroom trips to become habitual. Making sure that you drink plenty of water during the day but stopping all fluids 2-3 hours before going to bed will help. Also, filling out a Bladder Diary can help to determine if you are consuming anything that may be causing your increase in urinary frequency. The ultimate goal is to go to the bathroom only once per night so your sleep is not significantly disturbed.

While that was a lot to take in, I hope you don’t find yourself overwhelmed! If you don’t know where to start, pop into Empower Women’s Health for a full assessment to determine what exercises will help you get out of pain, reduce those perimenopausal symptoms and get you sleeping soundly!

Yours in Pelvic Health,

Danielle