If you’re last on your own list, you often end up paying the price at night

Taking care of others is important, but self-care is just as important—otherwise it can come back to haunt you at night

Last week, a study was published that stayed with me—because the pattern is so recognizable in the conversations I have. Ipsos, one of the largest market research firms in the world, surveyed 9,000 women in Europe about sleep and stress.

The outcome was not surprising. Seventeen percent of women consistently sleep less than six hours per night. Four in ten feel stressed often or daily. The main reason? Caring for family and others takes priority over their own health.

This aligns with earlier research from Centraal Bureau voor de Statistiek, which showed that, compared to men, more Dutch women experience sleep problems (31% versus 21%). These differences apply to both younger and older people, and to all adult age groups in between.

Why stress so effectively sabotages sleep

People with sleep problems often get through the day on willpower, coffee, and the feeling that there’s still so much to do before they’re allowed to focus on themselves. At night, their minds fill up with all of tomorrow’s worries—and sleep stays away for a long time.

When you’re under pressure—whether from work, caring for family, or financial concerns—your body is in a state of alertness. The stress hormone cortisol keeps you awake and vigilant. That’s useful in urgent situations, but the brain doesn’t distinguish between a caregiving task tomorrow morning and a lion around the corner. Under stress, the body remains in a heightened state of readiness, preventing proper recovery during sleep. You either don’t get enough sleep or the quality of your sleep declines.

What follows is a pattern that sleep scientist Arthur Spielman described as a perpetuating problem. In the vicious cycle of insomnia, well-intentioned but counterproductive sleep habits (going to bed too early), sleep-disrupting thoughts (“I probably won’t sleep tonight”), and physiological and emotional hyperarousal reinforce each other. The stress continues, sleep worsens, and daytime fatigue makes everything—work, patience, relationships—feel heavier. Which in turn increases stress and further disrupts sleep.

Poor sleep is not a sign of weakness

Sleeping poorly when you’re carrying a lot is not a sign of weakness. It can be an early signal of overload and a predictable consequence of how the human nervous system works. People who are used to caring for others are rarely truly “off.” Their attention is always somewhere. And when there finally is rest, the mind keeps scanning, worrying, and planning.

Common advice for stress-related sleep problems includes: relax more, go to bed on time, build an evening routine. These aren’t bad suggestions in themselves, but they assume that your sleep problem is due to a lack of the right habits. In reality, your sleep is often trapped in a pattern of unhelpful thoughts and physical tension. Even if the stress decreases, the sleep problem can persist—because your brain has learned to fear the night.

The approach that works best scientifically — and the one I use — is Cognitive Behavioral Therapy for Insomnia. It doesn’t focus on eliminating stress, but on breaking the thoughts and habits that block sleep. It is effective for 70 to 80 percent of people with chronic sleep problems.

No two sleepers are the same

If you recognize yourself in this—busy, caring, exhausted, and not well-rested—the first step is understanding what’s actually going on for you. That’s where I start in every program: a thorough sleep analysis. No two sleepers are the same, and neither are the solutions.

Would you like to understand what’s going on for you? Feel free to request a no-obligation introductory consultation.