Women and Insomnia

I have a very sensitive nervous system – like 15 to 20 percent of humans.  Supposedly, this highly-atttuned nervous system evolved as a survival mechanism.

During the first trimester of my one and only pregnancy, I had tremendous difficulty sleeping.  Many nights, I did not sleep at all.  It was a version of hell, trying to practise law, fend off anxiety, exercise, eat right, and stay healthy for myself and my child.  It was psychologically distressing.  I remember a friend telling me at the time that I will sleep when I’m tired enough.  I couldn’t believe it!  I was beyond tired!  She obviously couldn’t comprehend what I was going through.  The day I entered into the second trimester of pregnancy, it seemed like a switch suddenly went off and I was able to sleep normally again.  What a relief!

Now, I am experiencing what I term, “extreme perimenopause”.  Sleep has become elusive again.  Some nights I do not sleep at all, some I sleep only a few hours. Seldom do I get seven or eight hours, let alone the average 6 hours and 41 minutes that women aged 30 – 60 get on average, according to the U.S. National Sleep Foundation which also reports that women are more likely than men to have difficulty falling, or staying, asleep. (1)  In my household, this is definitely true where I am outnumbered by peacefully slumbering males, 2 to 1.  And, both of these males have lifestyles which throw my circadian rhythm off balance, and which negatively impact my ability to, and quality of, sleep.  (Yes, I am in a version of hell again: sleep deprivation has been used as a method of psychological torture for centuries.)

A woman’s biology can certainly affect how well she sleeps. The menstrual cycle and pregnancy, perimenopause, and menopause all can affect the quality and quantity of a woman's sleep.  Because fluctuating hormones affect the nervous system, the more sensitive the nervous system, the more likely a woman is to experience moderate to extreme difficulty sleeping.  It is well-documented that changing levels of hormones like estrogen and progesterone have an impact on sleep.  Estrogen dominance is a key component which impacts a women's sleep negatively.

Research relating to sleep deprivation has uncovered that too little sleep results in daytime sleepiness, moodiness including irritability, and an increase in mood disorders such as anxiety and depression, an increase in the number of accidents, including those caused by poor coordination/poor balance/poor attention, problems concentrating/focusing, poor memory, poor job performance, compromised immunity causing illness, weight gain due to cravings and disordered eating, feelings of dissatisfaction and boredom, isolation due to difficulty having the energy to maintain friendships or attend social functions, blurred vision, an increase in muscle tension and headaches, and an increased risk of dying early from causes such as heart attack.

When insomnia persists over a long period of time, secondary anxiety can develop in which a person becomes anxious about not sleeping well, and about all the increased risk factors for his or her health due to not sleeping well. (Just 'google' sleep deprivation if you want to really worry about not sleeping well, and you'll get an idea of all the nasty things that may befall you due to insomnia.  Just to mention a few:  at increased risk of heart attack, alzheimer's, depression.)  It can become a 'vicious circle'.

Insomnia is the most common sleep problem in the United States (and I suspect elsewhere, too). Women are more likely than men to report insomnia. In fact, according to the 2002 NSF "Sleep in America" poll, more women than men experience symptoms of insomnia at least a few nights a week (63% vs. 54%). Fortunately, there are a number of approaches to improve sleep, including those you can do yourself such as exercising, establishing regular bed and wake times, making dietary changes (consuming less or no caffeine, avoiding stimulating foods and beverages, and avoiding alcohol), and improving your sleep environment and sleep hygiene (before-bed habits). One recent study found that overweight, post-menopausal women who exercise in the morning experience less difficulty falling asleep and better quality sleep than evening exercisers. (2)  Some individuals have found relief through yoga, meditation, or other relaxation techniques/exercises. Medications, supplements, and alternative remedies that induce sleep or relaxation, as well as those that treat underlying disorders may be helpful.  What works for one person, may not work for another.

D.

(1) and (2) National Sleep Foundation, “Women and Sleep", www.sleepfoundation.org