By Linda A. Bakos, RPSGT, Supervisor, Gaylord Sleep Services

Why does it seem that women complain about sleep problems more than men? That is because sleep problems affect more women than men. The quality and quantity of a woman’s sleep change as she ages. Not only do women need a good diet and exercise for optimal health, but they also need sleep. Without good sleep women start the day with a poor functioning ground floor.

A poor night’s sleep can lead to daytime fatigue, increased accidents, poor work quality, and possibly increase in illnesses. According to a survey conducted by the National Sleep Foundation (NSF) in 1998, women tend to sleep only an average of six hours and 41 minutes a day during the work week.

Sleep quality is affected by changes that occur in a woman’s body. In a woman of menstruating age, the changes are affected by the stage in her cycle. Women have reported having poor quality sleep during the beginning days of menstruation but have reported feeling more sleepy and fatigued after ovulation. During the premenstrual period women may report having more sleep disturbances. These would include: more vivid dreams, excessive daytime sleepiness, fatigue and longer sleep hours according to the American Association of Sleep Medicine (AASM).

The NSF and the AASM recommend a few tips for women:

• Exercise regularly, but stop at least three hours before bedtime.
• Avoid foods and drinks high in sugar, caffeine, salty foods, and alcohol.
  
• Consult your doctor if needed.
  
• Maintain a regular sleep/wake schedule.
  
• Eat a healthy diet.
• Reduce stress.
  

Pregnancy

Pregnant women may experience other sleep issues. During the first trimester, there are reports of daytime fatigue and sleeping longer hours during the night. This is possibly due to the changes in the progesterone hormone levels. During the middle part of pregnancy, sleep tends to be better but sleep related problems return during the last trimester of the pregnancy. These sleep-related problems tend to be due to physical changes. These include: leg cramps, backaches, heartburn, fetus movements, and increased need to urinate.

Women may find themselves snoring during the final stages of pregnancy even if they have never snored before. The NSF reports that about 30% of pregnant women snore because of the increase in swelling of their nasal passages. Women who experience loud snoring and severe daytime sleepiness should consult their doctor. Up to 15% of pregnant women report having restless legs during the last trimester. This starts as a crawling or moving sensation in the leg or foot and is relieved with movement but returns once the leg is still again.

Sleeping tips for pregnant women are:

• Get enough sleep
• Maintain a regular sleep/wake schedule
• Exercise regularly to improve your circulation and decrease the leg cramps.
• Eat small meals and try to stay away from spicy, acidic or fried foods.
• Drink a lot of fluids
• During the third trimester sleep on your left side and try to stay off your back. This will allow the best blood flow to the fetus and to your uterus and kidneys.
• Taking short naps may help.

Once the baby is born it is still important to get enough of rest. Try to nap when the baby naps.

Menopause

Menopause brings other sleep disturbances with which to contend. These include hot flashes and night sweats. For comfort, try to control bedroom temperature, and eliminate caffeine, sugar and alcohol. Also increase your intake of vitamin E. Estrogen replacement therapy under the direction of a physician may also be helpful.

Postmenopause

In postmenopausal years women may be plagued with sleep-disordered breathing. They may also be affected by their psychosocial environment, physical health and emotional state, according to the AASM. In the Textbook of Women’s Health by Lila A. Wallis, M.D., M.A.C.P., the complaints by women of poor quality sleep increase with age and that approximately half of the population over 65 suffer from chronic sleep disturbance. The body’s temperature rhythm changes with age, thus causing body temperature to rise at a different time which leads to a disturbance in sleep. Thyroid dysfunction can also cause sleep disturbances.

Women may also experience other sleep-related problems such as insomnia, narcolepsy, nocturnal sleep-related eating disorder, and nighttime pain. The pain conditions that consist of migraines, tension headaches, chronic fatigue syndrome and fibromyalgia are more common among women according to the NSF. Occasional sleep disturbances happen to anyone, but when the disturbance is severe enough to affect a woman’s daily functioning, relationships or sense of well being they may want to consult a physician.

The AASM offers key sleep hygiene points that women can follow to help decrease their sleep disturbances:

• Get up the same time every day.
• Go to bed only when you are sleepy.
• Establish relaxing pre-sleep rituals.
• Exercise regularly.
• Keep a regular schedule
• Avoid caffeine within six hours of bedtime.
• Avoid smoking close to bedtime.
• Try to nap the same time every day.
• Avoid sleeping pills or use them conservatively.

Remember to see a physician before beginning any exercise program.

For more information on sleep and sleep disorders, check out the National Sleep Foundation's Web Site at www.sleepfoundation.org