Women and Sleep

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Women and Sleep
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What You Will Learn

• The benefits and importance of sleep
• States and stages of the sleep cycle
• How a womans physiology affects sleep
• Common disorders in women that affect sleep
• Womens role in society and sleep
• Where to find additional materials and
  information
• Healthy sleep tips along the way!

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The Benefits and Importance of Sleep
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Why is Sleep Important?

• Key to our health, performance, safety and
  quality of life
• As essential a component as good nutrition and
  exercise to optimal health
• As necessary as the water we drink, the air we
  breathe and the food we eat to function and live
  at our best

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Womens Sleep

• Women
• have unique physiology that can disrupt sleep
• are more likely than men to report poor sleep
• are more likely to experience daytime sleepiness
• are three times more likely to suffer insomnia
• experience more depression and anxiety that
  disrupts sleep

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The Benefits of Adequate, Restorative Sleep

• Quality Sleep Promotes
• alertness and daytime productivity
• mental wellness
• hormones that restore, rejuvenate and repair body
  organs and systems
• weight maintenance and can aid weight loss
• overall good health and wellness

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States and Stages of the Sleep Cycle
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Sleep is Regulated by Two Body Systems

• Sleep/Wake Homeostasis
• The process that balances sleep and wakefulness
• Circadian Biological Clock
• The clock-dependent process that regulates
  alertness

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Circadian Biological Clock

• The internal mechanism that regulates when we
  feel sleepy and when we feel alert
• Resides in the brain and is affected by light and
  dark

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The Sleep Cycle

• Alternating states and stages of sleep that occur
  over an 8-hour time period
• NREM Non-Rapid Eye Movement, Stages 1-4 75 of
  the night
• REM Rapid Eye Movement Dreams occur 25 of the
  night

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During the Sleep Cycle

• Core body temperature
• Growth hormone
• Cortisol
• Melatonin
• Sleep stage

Body temperature lowers Hormone levels rise
and fall
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How a Womens Physiology Affects Sleep
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A Womans Physiology Can Affect Her Sleep

• Menstrual cycle
• Pregnancy
• Post-partum
• Menopause

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Menstrual Cycle and Sleep
Hormonal changes unique to women can cause more
than half the sleep problems women experience.

• Most effects occur around menstruation
• Severe PMS and cramps disrupt sleep

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Sleep Promoting Tips Around Menstruation

• Exercise regularly, but not close to bedtime
• Avoid caffeine, it can contribute to bloating
• Avoid alcohol, which can lead to fragmented sleep
  
• Avoid large meals and too much fluid close to
  bedtime
• Pain relievers can lesson sleep disrupting cramps
• If possible, try taking a short nap

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Pregnancy and Sleep

• In a NSF women sleep poll, 79 of women said
  their sleep was more disturbed during pregnancy
  than at any other time.

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Changes in Sleep During Pregnancy
Second Trimester Improved sleep and energy
possible snoring, heartburn, and frightening
dreams
First Trimester Difficulty sleeping through the
night daytime sleepiness increased urination,
and nausea
Third Trimester Difficulty sleeping, increased
urination, snoring, back pain, restless legs
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Pregnancy Related Sleep Problems

• Snoring or Sleep Disordered Breathing (SDA)
• 30 of women experience during pregnancy
• This can lead to high blood pressure, headaches,
  and daytime fatigue
• Restless Leg Syndrome (RLS)
• Increased risk during pregnancy due to lower
  levels of ferritin iron and folate
• RLS may disrupt sleep and lead to daytime
  sleepiness

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Sleep Tips for Pregnancy

• Drink lots of water, but not too close to bedtime
• Raise the upper body and elevate your head on a
  pillow to reduce heartburn
• Exercise regularly to improve circulation and
  reduce leg cramps, stretch, walk or massage legs
• Use pregnancy pillows for support
• Nap, if possible and as necessary
• Sleep on left side to allow easy blood flow to
  fetus

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Postpartum and Sleep

• Moods can change and range from feeling
  temporarily blue to developing clinical
• depression
• Motherhood may bring lighter
• sleep
• Irregular schedules
• Additional Responsibilities

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Postpartum Sleep Tips

• Nap when your baby sleeps
• Share baby care to the extent possible
• Consult your health careprovider if you
  arefeeling depressed

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Menopause and Sleep

• 75-85 of menopausal women have hot flashes that
  disrupt sleep
• Menopausal women have 8 times the risk for sleep
  disordered breathing (snoring) or sleep apnea
• Women are more likely to suffer from depression
  from hormone fluctuations during menopause

Use of HRT is inconclusive
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Menopause Sleep Tips

• Eat healthy
• Dress appropriately for sleep
• Try to reduce stress and worry
• Exercise regularly

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Common Disorders in Women that Affect Sleep
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Common Disorders in Women that Affect Sleep

• Insomnia
• Depression and Anxiety Disorders
• Restless Leg Syndrome
• Obstructive Sleep Apnea
• Fibromyalgia, Pain and Headaches

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Insomnia

• Did you know?
• Insomnia affects nearly twice as many women than
  men

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What is Insomnia?

• Complaints of quality and quantity of sleep
• Difficulty falling asleep
• Difficulty maintaining sleep
• Waking too early
• Not waking refreshed

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Insomnia

• Insomnia is more frequent in women across all age
  groups
• Insomnia is more common in the unmarried,
  divorced or separated and elderly and those
  under stress
• Often occurs during the menstrual cycle,
  pregnancy, post-partum, menopause and post
  menopausal phases

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Depression and Anxiety Disorders

• Depression and anxiety disorders can lead to or
  worsen insomnia
• Likewise, insomnia can lead to or worsen
  depressive and anxiety disorders
• Women are twice as likely as men to suffer from
  depression

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Tips for Insomniacs

• Use the bedroom for sleep and sex only
• If you cant sleep, engage in a relaxing activity
• Do not watch the clock!
• Avoid late afternoon and evening naps
• Avoid caffeine, smoking and alcohol
• Consult your health care provider for treatment

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Restless Legs Syndrome (RLS)
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Restless Legs Syndrome
RLS is a neurological movement disorder with
unpleasant sensations or tingling in the legs
during rest or sleep that cause an urge to move.

• Symptoms include
• Urge to move limbs during sleep
• Difficulty sleeping
• Daytime sleepiness

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Restless Legs Syndrome

• 10 of women experience RLS
• Approximately 20 pregnant women experience RLS
• RLS can cause insomnia that may be misdiagnosed
  as depression
• RLS is very common in women and men over 55

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Sleep Tips for Restless Legs Syndrome

• Exercise regularly but not to close to bedtime
• Yoga and/or stretching before bed may help
• Have your iron and folate levels checked
• Consult your doctor or a sleep specialist for
  treatment

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Obstructive Sleep Apnea

• Sleep Apnea is an extremely common condition in
  both males and females as common as asthma.
  Meir Kryger, MD

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Obstructive Sleep Apnea

• Sleep Apnea is a serious disorder with breathing
  disruptions during sleep and frequent awakenings
• Symptoms
• Loud snoring
• Pauses in breathing
• Gasps for breath and arousals during sleep
• Daytime sleepiness

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Obstructive Sleep Apnea

• At least 2 percent of middle-aged women suffer
  from sleep apnea
• Ten percent of postmenopausal women have sleep
  apnea
• In women, sleep apnea is often misdiagnosed as
  depression
• Sleep apnea can lead to hypertension and stroke
• Consult your doctor if you think you may have
  sleep apnea

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Fibromyalgia, Pain and Headaches

• More women than men report that a medical
  condition, pain or a physical discomfort disturbs
  their sleep
• Migraine headaches are three times more common in
  women and disrupt sleep
• Fibromyalgia and headaches can intensify sleep
  difficulties and contribute to daytime sleepiness

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Sleep and Lifestyle

• Sleeping in a World That Never Sleeps

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Sleep and Lifestyle

• Parenting and sleep
• Sleep and the caregiver
• The working woman

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Parenting and Sleep
Three key steps for developing positive sleeping
habits

• Develop a regular sleep schedule that is the same
  every day
• Establish a consistent bedtime routine
• Put baby to bed drowsy but awake

Put baby to bed on their back
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Sleep Tips for Mom

• Make your own sleep a priority
• Set (and keep) a regular wake time
• Grab some short strategic naps
• Add some break time between the days activities
  and your evening wind-down
• Form a satisfying bedtime ritual with children
  and yourself
• Consult your doctor if you are feeling depressed

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Sleep and the Caregiver

• Women frequently lose sleep when caring for an
  ill family member

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Sleep and the Caregiver

• 84 of caregivers for Alzheimers patients are
  women and on average, caregivers are sixty-five
  years old
• Caregivers often have to coordinate medical care
  and personal care for patients
• Caregivers must make sure they receive adequate
  sleep. If sleep deprived, caregivers should seek
  help and research other available resources

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Sleep Strategies for the Working Woman

• Identify a specific bedtime and stick to it
• Avoid doing work in the bedroom
• Gradually adapt schedule to night shifts or on
  call shifts
• Say yes to sleep when tempted to stay up late
• Deal with worries before bed or put on hold
• Dont skimp on sleep most adults need 7-9 hours
• Exercise regularly, at least 4 hours before
  bedtime

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Sleep is Essential to a Womans Health and
Quality of Life

• A womans sleep is uniquely influenced by
  hormones, biological life stage, stress level,
  health, mood, parental status, work hours and
  other responsibilities

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For More Information

• visit the National Sleep Foundation Web site at
• www.sleepfoundation.org

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References

• Kryger, Meir H., A Womans Guide to Sleep
  Disorders, McGraw Hill (2004).
• Walsleben, Joyce and Rita Baron-Faust, A Womans
  Guide to Sleep, Three Rivers Press (2000).
• Wolfson, Amy,The Womans Book on Sleep, New
  Harbinger Publications, Inc. (2001).