The quality of a woman’s sleep is an important component of the quality of her life. For years, very little research was available concerning the sleep problems unique to women, and healthcare providers did not always take sleep complaints by women seriously. Recent studies, however, have paid more attention to the particular patterns, changing needs, and special problems associated with sleep throughout a woman’s life. Notable among the findings is that women are twice as likely as men to have difficulties falling asleep or staying asleep.
In general, a woman’s sleep is most sound and least prone to disturbances during young adulthood. The sleep disturbances most common to young women include those associated with the menstrual cycle, pregnancy and motherhood. Also, many young women in today’s fast – paced world cut back too often on their sleep and ignore signs of fatigue, daytime sleepiness and other effects of insufficient sleep. As a woman ages, physical and hormonal change effect her sleep quality. Older women get less deep sleep and are more likely to wake up at night. Physical factors – such as arthritis, disorders of breathing, or hot flashes – may also disturb sleep.
A woman’s feelings and concern are also important components of sleep quality. Acute stress, depression, fear and other emotional components can affect sleep patterns.
Getting enough sleep is enormously important to a woman’s life, as it positively impacts her concentration, job performance, social interaction, and general well – being.
The Menstrual cycle
Distinct changes in sleep patterns accompany the changing phases of the menstrual cycle. An increased number of awakenings and more sleep disturbances occur during the premenstrual period in some women. Dreams are more frequent and more vivid during this phase of the cycle. Some women report excessive daytime sleepiness, and longer sleeping hours during the premenstrual period.
Sleep changes are often associated with other premenstrual signs, such as abdominal cramping, irritability, food cravings, and emotional changes. These sleep problems generally disappear a few days after menstruation begins. For women who find these changes particularly disturbing, however, increased tension and irritability can result in lingering sleep problems and even to chronic insomnia.
Women who experience menstrual – related sleep disorders should pay careful attention to their sleep needs, maintain a regular sleep / wake schedule, eat a healthy diet, and try to reduce stress. If sleep problems interfere with daily functioning, medical advice should be sought.
Sleep during pregnancy
Early in pregnancy, most women report feeling fatigued during the day and sleeping longer hours at night. Increasing levels of the hormone progesterone during pregnancy probably causes this almost universal change in sleep requirement.
Later in pregnancy, particularly during the last trimester, women often note poor sleep quality. Certain changes in sleep patterns have been confirmed by studies; the amount of slow – wave sleep (deep stages of sleep) decreases, and the number of awakenings increases. Women may find it difficult to sleep in certain positions. Overall sleep efficiency begins to decrease by the second trimester, and continues to decrease in the third trimester.
There are many causes for sleep disruption in the late stages of pregnancy: leg cramps, backache, heartburn, movements of the fetus, general discomforts of pregnancy, and increased frequency of urination. After the baby is born, the physical stresses of pregnancy on sleep maybe replaced by the demands of the baby’s feeding schedule and frequent awakenings at night.
Throughout pregnancy, women need to make sure they are getting enough sleep, maintaining regular sleep / wake schedules and avoiding stress as much possible. Sleeping pills and alcohol should be avoided during pregnancy and other measures to improve sleep should be considered. Muscle relaxation techniques may be effective in promoting better sleep and reducing the discomforts of pregnancy. Maintaining a balanced diet and avoiding heavy meals and spicy foods within 2 or 3 hours of bedtime will help avoid provoking heartburn. After delivery, getting enough rest continues to be very important, as severely disturbed sleep can be tied to postpartum depression and child abuse.
Some natural changes in sleep accompany the ageing process in women. The amount of deep sleep decreases, sleep becomes lighter, and more awakenings, occur during the night. In the years surrounding menopause, sleep disturbances occur with increased frequency. A gradual change in sex hormone levels impacts sleep directly and indirectly by affecting other important hormones that are related to sleep. Hot flashes and night sweats – associated with decreased levels of estrogen – may cause repeated awakenings associated with the sensation of heat and sweating, increased heart rate and feelings of anxiety. Although hot flashes usually last only a few minutes, in severe cases a woman may wake up several times during the night. The sleep disturbances and resultant sleep deprivation generated by these hot flashes may result in daytime fatigue, irritability and depression.
Some general measures may help alleviate the sleep disturbances associated with hot flashes: Control the bedroom temperature, use light and comfortable (preferable cotton) bed linen. Eliminate caffeine, sugar and alcohol from the diet. Increase vitamin E intake in the diet, or take a vitamin E supplement. Estrogen replacement therapy can be helpful in relieving severe hot flashes and resultant significant sleep loss. A doctor can offer advice on this mode of treatment.
Some sleep disorders occur frequently in the postmenopausal years. For example, sleep disordered breathing – uncommon in young women- is much more common in postmenopausal women. This may be related to falling progesterone levels, since younger women who experience surgical menopause are also at increased risk of developing sleep- disordered breathing. Higher body weight and lower levels of physical activity are also risk factors for this syndrome. Signs of sleep – disordered breathing include loud snoring during sleep and excessive daytime sleepiness.
Other factors that influence the quality of sleep in postmenopausal women are psychological environment, physical health and emotional state. The connection between worry and insomnia may be obvious, but at times subtle signs and concerns can be less visible in their influence on tension and insomnia.
To promote better sleep during the postmenopausal years, women should follow these guidelines:
- Maintain a comfortable, safe environment in the bedroom; reduce disturbing noise and extreme temperature.
- Go to bed and get up at the same time every day.
- Avoid staying in bed late in the morning to make up for sleep loss
- Get up early in the morning and maintain structure daily activity.
- Stay away from fatty, spicy foods that are likely to cause indigestion or heartburn.
- Seek medical advice if following these measures does not alleviate excessive daytime sleepiness.
Emotional issues continue to impact sleep in women of all age groups. Two conditions worthy of mention are depression and nocturnal eating syndrome.
Insomnia is one of the most common symptoms of depression at any age. Women who are depressed tend to fall asleep fairly quickly but often awaken in the middle of the night, unable to go back to sleep. The insomnia may be interpreted as the cause of the depression – “If I could just get more sleep I would not feel depressed” – but getting professional help and treatment for the depression can often solve the insomnia problem.
Nocturnal Eating syndrome
Some women wake up in the middle of the night and feel that they are unable to go back to sleep until they eat. Unless there is a medical cause (such as an ulcer), this type of problem is typically associated with dieting during the day.
When to see a healthcare provider
Occasional disturbances in sleep can happen to anyone, and generally do not require medical intervention. Serious sleep problems, however, can affect a woman’s daily functioning, her relationships, and her sense of well-being. When a sleep problem results in disruption in one of these areas, it may be wise to consult with a healthcare provider.
Women are particularly sensitive to sleep difficulties because they are affected by hormonal changes, family stresses and role conflicts, any of which can affect sleep quality.
Guidelines for Good sleep
Following some general guidelines can be helpful in alleviating all types of sleep problems:
- Get up about the same time every day
- Go to bed only when sleepy
- Establish relaxing presleep rituals, such as a warm bath, light bedtime snack, or 10 minutes of reading.
- Exercise regularly. Consult a healthcare provider before beginning an exercise program. Confine vigorous exercise to early hours, at least six hours before bedtime, and do mild exercise – such as simple stretching or walking – at least four hours prior to bedtime.
- Keep a regular schedule. Regular times for meals and other activities help keep the inner clock running smoothly.
- Avoid ingestion of caffeine within six hours of bedtime. Don’t drink alcohol, especially when sleepy. Even a small dose of alcohol can have a potent effect when combined with being tired.
- Avoid smoking close to bedtime.
- Avoid self-medication with sleeping pills.