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WOMEN’S SLEEP HEALTH

women sleep healthWOMEN’S SLEEP HEALTH


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For additional links: Women’s sleep health links (2018 curation)

Have a question about women’s sleep health? Send it to the curator and it may be answered in an upcoming SHC production!

WOMEN’S SLEEP HEALTH

INTRODUCTION

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Women’s bodies are different than men’s. It should come as no surprise that their sleep processes are different as well.

The two primary differences in sleep between men and women relate to hormones and the prospects of pregnancy. The cyclical hormonal changes in a woman’s body throughout her mature life—primarily related to estrogen and progesterone levels—have a major impact on sleep.

In addition, there are environmental and lifestyle factors that can account for the fact that women may not be getting the same quality and quantity of sleep as men.

A 1998 National Sleep Foundation (NSF) Women and Sleep Poll found that the average woman (age 30-60) sleeps less than 7 hours a night during the work week. This may be due to pulling double duty as a working parent (working full time, then coming home and working full time in the household raising children, caregiving for elderly parents, or both).

More recently, a 2005 NSF Sleep in America poll showed that women struggle more with falling and staying asleep and experience more daytime sleepiness than men.

Many women also work unusual shifts (as medical professional, for instance), which can throw the entire sleep-wake cycle into chaos if maintained over time.

When women don’t get enough sleep, or the sleep they do get is poor in quality, this can result in daytime sleepiness. This places them at higher risk for car accidents, issues with job or school performance, concentration problems, and a likely increase in health issues including breast cancer and obesity.

WOMEN’S SLEEP HEALTH

COMMON SLEEP PROBLEMS AMONG WOMEN

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Listed below are the most common complaints regarding sleep; these are often unique (but not mutually exclusive) to being female.

Insomnia

The inability to sleep seems to plague women at every lifespan event. Insomnia is defined as the failure to fall asleep promptly, the inability to stay asleep, or both, all within the presence of adequate opportunities to sleep. For women, the major shifts in hormones during menstruation, pregnancy, and menopause are due to major drops in progesterone, which is a sleep-promoting hormone.

Sleep breathing disorders

Obstructive Sleep Apnea (OSA) occurs when the upper airway is crowded by an overlarge tongue or adenoids, or is otherwise obstructed due to narrow airways or swelling caused by allergies, illness, or other health conditions.

Women are less likely to suffer from OSA until they are past age 50, but sleep apnea is found among women of all ages, regardless. It is not a male- or age-specific disease, but one of mechanics.

Women who are pregnant are also more likely to experience sleep apnea. Why? For the simple reason that they carry up to forty percent more body fluid during this time. These fluids, while a pregnant woman stands upright, collect in the lower body, leading to the common experience of ankle edema. However, when a pregnant woman reclines to sleep, these fluids redistribute, swelling the tissues of the upper airway and increasing the likelihood of obstruction.

Another related condition that strikes many younger women (including those with lower body mass) is upper airway resistance syndrome (UARS). This concerns problems with the airway passages and may or may not be considered in a sleep breathing disorder diagnosis. Learn more here.

Hypersomnia

Excessive daytime sleepiness can be the result of a number of factors not related to gender. For women who are ovulating, however, the feeling of extreme sleepiness in the day can also be due to increases in progesterone at this time of the month.

Movement disorders of sleep

These are common in women as well. Restless Leg Syndrome (and its nocturnal cousin, Periodic Leg Movement Disorder) can interrupt the onset of sleep or its overall quality and quantity. Either condition is thought to be due, in part, to imbalances in blood iron. If left untreated, either RLS or PLMD can result in major increases in daytime sleepiness, mood swings, anxiety, and depression.

Pain

Perhaps the most significant enemy of sleep is pain. It has been shown to affect more women than men, so it’s no surprise that issues with migraines, arthritis, heartburn, and other painful conditions are more likely to keep women from falling or staying asleep.

WOMEN’S SLEEP HEALTH

PREVIOUS POSTS ON WOMEN & SLEEP HEALTH

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PREVIOUSLY IN SHC: These posts address women’s sleep health

For additional links: Women’s sleep health links (2018 curation)
Women’s sleep health news stories, research studies, personal essays, blog posts, and other sources for the year 2018.

This resource is for anyone interested in women’s sleep health: the general public, physicians, researchers, allied health professionals, students, or journalists—anyone who is looking for reliable information on sleep health.

WOMEN’S SLEEP HEALTH

SLEEP ACROSS THE LIFESPAN

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Menstruation

Typically, women report that sleep patterns change most noticeably just prior to menstruation. These patterns might change due to shifting hormones. They could also be symptomatic of larger imbalances related to PMS (Premenstrual Syndrome) or PMDD (Premenstrual Dysphoric Dysfunction). Both are measurable, legitimate health conditions related to menstruation.

Cramping, bloating, cravings, and mood swings can impact both sleep and waking behaviors.

Insomnia and less REM sleep due to sleep framentation are common complaints.

In addition, fluctuations in core body temperature caused by menstruation can alter sleep architecture. This can lead to the possibility of unwanted early awakenings or less REM sleep or deep sleep.

Pregnancy

The first and third trimesters of pregnancy offer the most opportunities for challenges to quality sleep due to:

All of the sleep problems listed previously are likely to impact sleep for pregnant women in every trimester.

Menopause

Insomnia is perhaps the biggest sleep complaint among women going through this major change in the lifespan. It can be a side effect of menopause or it can be caused by symptoms of menopause, such as:

  • hot flashes
  • bloating
  • cramping
  • cravings
  • mood swings

Shifting hormone levels lead to:

  • difficulty falling asleep
  • frequent awakenings
  • difficulty maintaining sleep
  • unwanted early awakenings, and
  • the sense of having not slept well

All of these problems result in waking up unrefreshed.

Post-menopause

Sleep problems don’t end for women with the end of menopause. After menopause, hormone levels may stop fluctuating. However, the nervous and endocrine systems may no longer make enough serotonin, progesterone, estrogen, and other hormones related to sleep regulation.

In addition, fewer hormones can result in less muscular tension in the upper airway. Match this with increases in body fat resulting from menopause, and the risk for developing obstructive sleep apnea goes way up.

Add the likelihood of chronic pain from arthritis, the development of GERD, and other common problems of aging, and it’s easy to see how women can continue to struggle with sleep issues even after menopause.

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