‘SHE MD’ Breaks Down Why Women Struggle More With Sleep—and What to Do About It

If you’ve been doom-scrolling TikTok or Instagram before bed and waking up more confused than rested, this SHE MD episode is for you. 

Host Dr. Taïs Aliabadi sits down with Dr. Shelby Harris—behavioral sleep medicine specialist and author of The Women’s Guide to Overcoming Insomnia—to get practical about what actually helps sleep and how to get more of it. The long-standing “golden rule” of aiming for eight hours isn’t wrong, but it’s also not one-size-fits-all. As she explains, “The number eight that most people reference is really just because it’s in the middle of seven to nine,” which means your “perfect” number might be different—and that’s okay.

‘SHE MD’ Shares the Best Tips for Better Sleep

She reminds listeners that with insomnia, “Effort, effort is the enemy of sleep.” If you’re lying there white-knuckling your way to dreamland, you’re not broken—you’re just human, and there’s a better approach. 

Why sleep matters more than you think

Sleep isn’t just downtime—it’s deeply connected to physical and mental health. Harris notes how she first became interested in the field after working on a study with people in early alcohol recovery. “They found that when people slept better early on in their rehab, they actually didn’t go back to alcohol. Their relapse rates were lower,” she explains. That insight lit up a bigger question for her: Why wasn’t sleep being treated as a central part of recovery and overall wellness?

Since then, Harris has made it her mission to show how quality rest affects nearly every aspect of life. She asks, “Why are we not talking about sleep and recovery?” For her, the answer is clear—when sleep improves, so does health, resilience, and the ability to handle everyday challenges.

What is the right amount of sleep?

Most people have heard that eight hours is the “gold standard,” but Harris says that number is more of a guideline than a strict rule. What really matters is figuring out how much sleep leaves you feeling refreshed and functional throughout the day—not chasing a number on the clock.

To get closer to your personal baseline, Harris suggests experimenting. One option is adjusting bedtime gradually until it feels natural. Another is using a weeklong vacation to reset. “Just go to bed naturally when you feel sleepy and wake up without an alarm and do that for seven days,” she advises. Then average out how much sleep you got each night—that number likely reflects both your sleep need and your natural circadian rhythm.

Sleep hygiene isn’t enough enough for insomnia

While advice like limiting screens and cutting back on alcohol is useful, Harris is quick to point out that good habits don’t always solve bigger problems. “Most people who have insomnia, they’re like, I do all the things right. I don’t watch screens before bed. I don’t drink much alcohol, I do those things. That’s really not a treatment in and of itself for insomnia,” she said. Those habits, she explained, are just the basics—similar to brushing your teeth. “Sleep hygiene is like brushing and flossing…It helps prevent cavities, but once you have one, you need more treatment,” says Harris. 

For many, that next step is cognitive behavioral therapy for insomnia (called CBT-I), a structured approach that helps retrain both the body and mind. “We limit time in bed for a lot of people. If someone’s only sleeping six hours a night, but they’re in bed for eight hours, I might actually limit the time they’re in bed,” Harris explains. “I might work on what they’re doing in the middle of the night if they wake up. Maybe it’s getting out of bed if they’re anxious or trying to force sleep to happen.” 

Harris notes that CBT-I gives people practical tools to consolidate rest, reduce nighttime stress, and finally break the cycle of sleepless nights.

What women need to know about sleep

When it comes to midlife, women often face unique hurdles that stack up all at once. Harris describes it as a “perfect storm” of biological, psychological, and social pressures. “You’re having sharp drops in estrogen and progesterone, and these are all things that can definitely impact your sleep,” she explains. 

At the same time, women are often balancing careers, raising children, and caring for aging parents, creating  the classic “sandwich generation” scenario. Add in higher rates of anxiety and depression, and the stage is set for more disrupted nights. 

These challenges don’t mean better rest is out of reach. Harris pointed to proven approaches like CBT-I, mindfulness, and in some cases, hormonal therapy as ways to reclaim restorative sleep. 

Simple shifts that make a difference

While the science of sleep can sound complex, Harris emphasizes that small changes often have the biggest impact. Limiting caffeine to earlier in the day, cutting alcohol within three hours of bedtime, and keeping the bedroom cool and dark are easy starting points. Even timing matters—like moving a hot bath to two hours before bed so the body can cool down and trigger melatonin production naturally.

To hear Harris’s full breakdown of strategies—from what to do when you wake at 3 a.m. to how to handle sleep trackers—listen to the complete conversation on the SHE MD podcast, available wherever you get your podcasts.

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