By Jyotsna Sahni, MD
Like most women, I love my bed and I love my sleep. Unfortunately, many of us have trouble falling asleep and staying asleep. Simply stated, most of us don't get enough sleep. Did you know that women have more complaints about their sleep and are more likely to use sleeping pills than men? Women also tend to need more sleep, spend more time in bed and sleep for longer periods than men.
Fatigue, impaired memory and concentration, mood problems like depression and anxiety, daytime sleepiness, tension, headaches and stomach discomfort can occur due to poor sleep quality. But it gets worse: High blood pressure, obesity, increased pain, increased accidents, job absenteeism, and higher health costs are also associated with poor or insufficient sleep.
A lot of women underestimate the role that our hormones play in the quality of our sleep; the truth is -- our sleep issues should be evaluated in the context of our reproductive cycles. Where a woman is in her menstrual cycle makes a big difference to her ability to fall and stay asleep. Premenstrual syndrome (PMS) can cause either insomnia or hypersomnia, where women want to sleep too much both before and after getting their periods. Some women suffer from bloating and cramps during their periods that disturb sleep.
In pregnant women, sleep patterns vary across the trimesters as hormones change. Pregnant women may sleep poorly because of nausea, backache, frequent bathroom trips, heartburn, leg cramps, and shortness of breath, especially during the third trimester. At least one study showed that women who slept less than 6 hours a night during the ninth month of pregnancy had longer labors and a higher rate of caesarian deliveries.
Pregnant women are at increased risk for two sleep disorders. The first is sleep-disordered breathing where they may snore excessively because of congested nasal passages due to increased levels of progesterone. Weight gain can also cause pregnant women to stop breathing for long stretches during the night. This can lead to pre-eclampsia (extremely high blood pressure) and complications with the baby.
The second sleep disorder common in pregnancy is restless leg syndrome. This is a creepy, crawly sensation in the feet, legs, and sometimes hips that is relieved by movement. It is 2 or 3 times more common in pregnant women than the general population. Receiving adequate amounts of iron and folate, having warm baths and getting massages may help. Fortunately, this disorder usually resolves after the baby is born.
Perimenopause is the time when women begin the transition towards menopause; estrogen and progesterone levels start to become irregular and eventually decline. Hot flashes and night sweats disturb sleep and women may awaken several times during the night. The incidence of sleep-disordered breathing or sleep apnea triples in menopause, but hormone replacement therapy can reduce respiratory disturbance.
Clearly, good sleep is critical to good health and a happy life. Not only is your mood better and your mind sharper, but you take better care of yourself. You make healthier food choices and are less likely to turn to stimulants like sugar and caffeine. You have more energy to participate in a regular exercise program and are less likely to catch a cold. Even though sleep problems are common, the good news is that they are treatable. Sometimes it requires an expert to get to the bottom of a sleep disorder, but often the solution is simple.
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Dr. Jyotsna Sahni is the leading lecturer at Canyon Ranch in Tucson for integrative and ayurvedic medicine, women’s health, weight loss, genomics and preventive cardiology. She is a published author and recently co-authored an article on menopause-related sleep disorders