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8 May 2003
Sleep Loss In Women A Problem Of Epidemic Proportions 
Skip the flowers and chocolates this Mother's Day. What do moms really need? Sleep! Women face specific challenges, including work and family pressures, hormonal changes, a propensity for certain illnesses and, in the case of new moms, enhanced sensitivity to sound, which can all disrupt sleep and contribute to sleep loss. For women experiencing chronic sleep problems, health and quality-of-life risks can be significant, including possible increased risk of heart disease and obesity, decreased ability to handle job and household responsibilities, and relationship problems. According to a National Sleep Foundation survey, almost three out of four women between the ages of 30 and 60 do not get eight or more hours of sleep per night during the workweek. In fact, the average woman gets a little more than six and a half hours of sleep per night during the workweek. Working mothers are particularly prone to sleep disturbances. Almost three out of four American mothers working outside the home (74%) agree that "feeling tired all the time is a problem in their lives." "Many women, particularly working moms, exist in a constant state of sleepiness," said Suzanne Griffin, MD, clinical assistant professor of psychiatry at Georgetown University Hospital in Washington, DC, and mother of two children. "Unfortunately, for many women, it's more than just the physical demands on time that make it difficult to get a full night's rest. Sleep loss in women is often the result of hormonal shifts or particular health conditions, such as arthritis and depression, that are more likely to affect women than men." There are several gender-specific conditions that contribute to widespread sleep loss among women. Specifically, sleep is affected by biological factors such as hormonal fluctuations. For example, a woman's sleep is disturbed 2.5 days on average during the menstrual cycle. More women complain of sleep problems during menstruation (71%), when hormone levels are at their lowest, than during the premenstrual week (43%). A woman's sleep is further disrupted after menopause. According to the 2003 "Sleep in America" Poll sponsored by the National Sleep Foundation, older women are more likely than older men to report that the quality of their sleep has declined over the past ten years. This deterioration may be caused by hormonal changes associated with perimenopause and menopause, as well as medical problems associated with aging. Studies show that women are also more prone to certain diseases often associated with sleep disturbances. For example, more women (58%) than men (48%) suffer from nighttime pain - including pain due to arthritis and headaches - which may make it more difficult to get a good night's sleep. Also, depression and anxiety disorders are twice as common in women than in men. According to the American Medical Women's Association, women may be more vulnerable to stress-induced illnesses than men. For moms, changes in maternal "wiring" can also have a detrimental impact on sleep amount and quality. Most women with children develop a high sensitivity to the sounds of their children, which causes them to wake easily. Unfortunately, it is possible that many women never lose this sensitivity and continue to wake easily even after their children have grown, since women who have had children sleep less efficiently than those who have not had children. The amount of sleep a woman gets may directly affect her health. Studies published in the Journal of the American Medical Association and the Lancet suggest that sleep loss may increase hunger and affect the body's metabolism, which may make it more difficult to maintain or lose weight. Sleep loss may also interfere with the body's ability to metabolize carbohydrates and cause high blood levels of glucose, a basic sugar. Excess glucose promotes the overproduction of insulin, and can also lead to insulin resistance, a critical feature of adult-onset diabetes. In addition, research shows that short-term sleep deprivation may increase blood pressure. In fact, a recent study published in the Archives of Internal Medicine demonstrated that chronic sleep loss is associated with an increased risk of heart disease. Women between the ages of 45 and 65 who slept an average of five hours or less per night were 39% more likely to have heart problems than women who slept eight hours per night. Sleep loss can also hinder a woman's ability to perform daily responsibilities and may also impact her relationships. According to the National Sleep Foundation's Women and Sleep Poll, a majority of women (51%) say that their sleep problems hinder their ability to perform daily activities at least a few days per month. Of those women, 46% report interference with carrying out household duties, 27% report interference with job performance, and nearly two thirds say that lack of sleep causes problems with their relationship with either their spouse or their children. "Adequate sleep is critical for women of all ages and is especially important in helping moms perform daily activities and preserve peaceful relationships with their spouse and children," said Dr. Griffin. "Mother's Day is a great opportunity to take a break and get a good night's sleep. It is important, however, for those who experience sleep disturbances for more than a few weeks to see their doctor and discuss the problem." Dr. Griffin recommends that women should examine their sleep habits and adjust them accordingly, to help maintain a healthy lifestyle. The following tips can help women get their much-needed rest: - Avoid alcohol as well as foods or beverages high in caffeine (eg, coffee, colas, tea, chocolate), sugar (including honey), and salt.
- Exercise regularly, but finish your workout at least three hours before bedtime. Exercise may relieve some PMS symptoms and promotes a good night's sleep.
- If you are having trouble falling asleep, try warming up your feet. Inadequate vasodilation (opening of blood vessels to increase blood flow) may cause sleep problems. This remedy might be especially helpful to older women with poor circulation in their extremities.
- If you can't fall asleep in bed after a reasonable period, get up, go into a darkened or dimly lit room, and participate in a quiet activity such as reading, knitting, or listening to soothing music. Do not use this time to catch up on laundry or paperwork.
If you experience sleep disturbances for more than a few weeks, see your doctor. In addition to behavioral and lifestyle modifications, there are prescription sleep medications that may help individuals fall asleep quickly and increase their total sleep time with minimal next-day effects.
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