Why Can't Women Sleep? Part I: Building Better Sleep Basics

If you are a woman who has trouble getting to sleep or staying asleep, you're in wondrous - and populous - company.

According to the National Sleep Foundation's 2007 Sleep in America poll, "67% of women say they frequently experience a sleep problem. Additionally, 43% say that daytime sleepiness interferes with their daily activities."

Add up those figures and you'll end up with a larger-than-life percentage -- one that truly illustrates the emotional and physical pain of not-sleeping.

What is sleep? Why can't women sleep? How can we sleep better?

Sleep: What is it?

Sleep was a non-thing, I thought. The opposite of being awake. But sleep is an activity. How else could so many otherwise-accomplished chicks "not be able to do it well?"

For the purposes of this post, I'm going to define sleep as, "a state of physical and emotional rest over time". I'm going to define rest as, "a worry-free state."

Worry-free...ah! Now, that's a state I'd love to live in. How about you?

But taking a quick look back to early human days, a womanly state of calm does not seem to be our natural historical domain.

Successful cavewomen outwitted deadly predators using rapid response techniques to deal with ever-unpredictable enemies (the classic "fight or flight"). Their remaining time was spent cooking, tending, gestating, birthing, raising, reaping...lather/rinse/repeat and dying. If that sounds exhausting, it was. Life was a daily exercise in adrenaline overload.

Our neolithic grand-mères' life was relatively short. On the other hand, they probably didn't find themselves watching re-runs of cave paintings at 4 am, thanks to an adrenaline on-off switch that had frazzled into a constant anxiety-drip.

And let's not forget modern life's "normal" female chemical tangos.

"There are specific times women tend to have trouble sleeping," says Shelby Freedman Harris, PsyD, Director, Behavioral Sleep Medicine Program in the Sleep-Wake Disorders Center at Montefiore Medical Center.

From our twenties into our fifties (which is to say, way-generally speaking, from first pregnancy age through menopause), women's bodies are being remodeled by hormones on a regularly irregular basis. Some hormone shifts are chillaxing. Others can be sleep robbers.

Low progesterone, a common condition among peri-menopausal and menopausal women can "make your brain feel like your finger's in a light socket," says Sheilagh Weymouth, D.C., P.C.

Add a "You-can-do-it-all!" culture into the mix, and you've got a psychological and biochemical recipe for Up At Night.

Luckily, there are ways to work with the situation we've inherited.

Get your head out of your bed.

Picture this scenario: You went to bed at 11 pm. Woke up at 2. Stayed up til 4. Slept til 5. And now? You have a huge presentation at work at 9.

"Oh my God!!!" you might think. "I'm gonna screw it up big-time!!!!"

It seems responsible to stress about the effects of your sleep-deficient night. And yes, a body that's frazzled by lack o' sleep is more prone to fueling a freak-out. No blame there.

But, Dr. Harris advises, the first step to better sleep is to rethink our worries. The things we're freaking out about feel real. But are they really happening?

We worry about botching the big presentation, for instance. Was that "accurate or not?" Did we forget the kids at school (or the dog at doggy daycare)? If the answer is no, there's really nothing to worry about, really....other than our worrisome attachment to worrying.

At the risk of sounding like a bedtime Buddhist, separating the illusion from the essence of not sleeping does sound like a sensible antidote to some forms of day-after-cruddy night suffering. Tonight is another night. Powered (or powered down) by the knowledge that I can focus on a good night's sleep (as opposed to a bad day's weariness), I could have a head-start on the zzzz's I need.

If one must fret, Dr. Harris advises us to schedule a 20-30 minute worry session into our day. After a few minutes, many patients find they've run out of reasons to worry.

Feed Your Brain

Dr. Weymouth, a chiropractor and ex-insomniac, practices "Functional Medicine" whose aim is to answer the why's, what's and how's of health. When a woman appears in her office complaining of poor sleep - and most do - she asks what they're eating.

"If you're not sleeping well at night, you're probably not eating as well as you think you are," she says.

Women who wake during the night may not feel hungry. But they may well be starved for nourishment their brain needs to make it calmly through the night.

"If we don't have enough fuel, the body asks the adrenal glands to make cortisol," Dr. Weymouth explains. Which, as I understand it, is like making fight-or-flight in a bottle that just happens to be your trying-to-sleep body.

To up your odds of sleeping well, Dr. Weymouth suggests eating breakfast within an hour of waking, have lunch within four hours of breakfast (and if you can't, have a snack, and then your meal).

If three to four hours pass between dinner and bedtime, eat a snack before bed made up of fat, protein and carbohydrate - part of an apple with a small amount of nut butter, cheese and crackers, a fork-or-two of dinner leftovers.

Orgasms can be a great natural sleep aid for women who find them relaxing. ("If you want to run around cleaning your closet afterward, then you have your sex in the morning," Weymouth says.)

Lemon balm, lavender and linden teas can have a calming effect on the nervous system, as can 2-3 minute rounds of slow deep breathing.

Insomnia, of course, is very real. So, where is the line between sleeping badly and sleep disorders?

Dr. Harris offers the 30/30 rule to assess your situation.

"Does it take me more than 30 minutes to fall asleep, or am I up for more than 30 minutes during the night - and has this been going on for more than 30 days?"

if you've answered yes to all three questions, it's time to see a caring sleep behavior pro -- if you haven't already.

In my next Women and Sleep post: Five incredibly low-tech tips for better sleep - and the real women who've tried them.

Follow Sharon Glassman on Twitter: www.twitter.com/sharonglassman

Comments

[BlackYowe]

I am sleeping much better since I leaned to switch off my brain and stop trying to start the next day before it begins. I also find I sleep better when I get excercise and eat right. Women take far better care of their cars than their own bodies sadly.

[laurelb]

Wacky hormones can really keep a gal up at night. I was tossing and turning and flashing. My doctor gave me some progesterone cream for estrogen dominance and the first night I slept better than I have in years. Now that I'm a few months into it I sleep soundly through the night. Here's a good article about Hormones and Insomnia from the Virginia Hopkins Health Watch: www.virginiahopkinstestkits.com/hormonesinsomnia.html

[BlackYowe]

Oh boy you have that right. I am so glad I am now over the hot flashes.

[ditchdigger]

i am 55 yearold male.my lover is 37.she is the most wonderful person(other than my 3 children who adore her).she has trouble sleeping sometimes.she is a blue collar worker so not always the case.when she does have trouble.she gives me the great pleasure of giving her a great orgasam.she snugs up next to me,and sleeps like a baby.that gives me great pleasure.to have her snug up to me.

[nippyfan]

Mary Jane is a wonderfully natural sleep aid.

[brooklyncitizen]

All too real...I've just decided to rely on supplements to knock me out-melatonin etc.

[Janet Kinosian - Huffpost Blogger]

I help counsel women who with sleep issues and while there are multitudes of individual reasons women don't sleep , I say like a few of the above; check for sleep apnea and also hormone testing with thyroid/adrenal tests as well. And even when the blood tests come back positive, there may still be issues and there are protocols to help. Sleep is not an option, and good sleep is available. Just don't lose hope. That's key. www.wellrestedwoman.com

[Treehuggindirtworshiper]

Don't use an alarm clock and never have. I don't care how tired I am I only sleep 5 hrs or less a night. Try to sleep in but 7AM is my limit. I have been known to take a 3 hour nap on the weekend though.

[BlackYowe]

That is not very good for you I am afraid.

[violettefemme]

Will the "caring sleep behavior pro" be covered by the health insurance I do *not* have?

I find articles like this frustrating, when they defer to experts which the uninsured can't afford, and the insured have a slim chance of getting a referral.

A sleep behavior pro? What do they charge? I'm being realistic here...who's health insurance even covers it, IF they are "lucky" enough to have any coverage at all?

[brooklyncitizen]

Ditto...or the special hormonal tests ...as if.

[ditchdigger]

great read.must of had some real sleep problems.way to be innovative.must be quite a lady.

[Sharon Glassman - Huffpost Blogger]

I am so on your side about this! Not having health-care -- or sufficient heath-care makes sleep issues that much worse. (Trust me. I know.) There are conditions that require help from a sleep lab. And there are diagnostics we can do. Carol Ash, who's in my next post, tells folks with sleep problems to ask themselves (bear w/me here): 1) Are you going to bed and rising at the same time *every* night? 2) Are you getting eight hours of sleep (ten for kids)? 3) Do you snore/have a larger neck size -- 16 1/2" for women? 4) Do you feel the urge to move yr legs while sleeping/awake w/bedclothes a mess? and 5) Why do you think you're not sleeping? (I know that sounds D'oh! But it works.) If you answer No to 1-4, you may be able to sleep better using the rules in the next post. And if you need a specialist, it might be worth it to call and ask if they can work w/you in an affordable way. (I'm not saying they can or will, but given how much sleeplessness sucks, it can't hurt to ask...)

[SLGIRL]

Female sleep problems=epidemic.... I am mid-40's and suffered w/sleep problems for year. most conventional doctors told me I was fine according to all blood tests. Basically, in conventional medicine, unless they have a protocol and a blood test for something AND your not dying-- you're just fine. Out of desperation (I started to have mild hallucinations because of lack of sleep-- and that was on sleeping pills) I sought out more progressive specialists. There's a woman in St. Louis, Kathy Maupin, MD who specialized in bio-identical hormone replacement. She found through blood tests that I had no testosterone (critical for deep sleep), low progesterone, and another specialist did a saliva test for adrenal function, which was low, plus I had borderline low thyroid--- all of which were never discovered by the world-renowned sleep doctor or other conventional, by-the-book physicians. Hormone replacement has helped UNBELIEVEABLY. I also saw an alternative internist who looks at environmental factors (Simon Yu). I was skeptical, but now I'm convinced. Was diagnosed with high mercury sounds wacky, but my conventional physician said it's valid test). Doing chelation, and my sleep has continued to improve, my thyoid has corrected itself without medication. Other really helpful books: Fatigued to Fantastic, and books by Mark Hymann, and Joseph Mercola.

[Dr Manhattan]

Check for sleep apnea. No sleep will make you have low level of hormones due to interruption circadian rhythm on your pituitary. Taking hormones without checking out sleep apnea could be treating the symptoms but not the underlying cause.

[davidwayneosedach]

Ambien is a multi-billion dollar business. They have a sleeping pill for everyone.

[allonfla]

That orgasm suggestion really does work. It also takes my mind off hunger and gets rid of headaches.

[SLGIRL]

HI there...my doctor told me fibromyalgia is caused by sleep disturbance, not the other way around...lack of hormones leads to lack of sleep which leads to fibromyalgia, which hurts and makes problems worse....Great book is Fatigued to Fantastic.....Teitelbaum is expert on CFS and Fibromyalgia....

[Siobhan11]

I just started taking the supplement 5HTP to sleep. Found out about it on on Fibro website - treatingandbeating.com. Sleeping better that I ever did. I will check out Fatigued to Fantastic.

[sheilaofmiami]

Many things cause sleep issues. I have Fibromyalgia and it REALLY messes with sleep and all the hormones. I struggle with sleep. I do drugs to stay up sometimes, in hopes of being tired enough to sleep more at night and I take pain killers at night no matter what, pain is not something that helps with sleep.

This was sleep 101 for the very and otherwise healthy.

In this economy, I don't see how anyone can sleep, except in exhaustion.

[fumes]

alarm clocks are meant to destroy a good night's sleep..

and start your day off wrong. who can sleep knowing that awaits?

[Fernando Cavallo]

I do, like a block!

[Fromageball]

haha, i can't! i guess i sort of have an internal alarm clock because i usually will wake up right before it goes off...or, if I have to get up really early, I will wake up every couple of hours because I do *not* want to wake up to the alarm.

[Aranxa]

Three words - Hormone Replacement Therapy. Works sleep issue miracles.