Women and Sleep
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Is there a difference between women and man sleeping?

Several aspects distinguish a women’s sleeping habits from that of a man.

Women sleep for lesser hours. The average number of hours of sleep in women aged 30-60 years is less than 7 hours a day. This is due to various factors.

  • Certain physiological stages such as the monthly periods, pregnancy, menopause, and the changing levels of hormones in the body affect the quality of sleep in women.
  • Women also have a special role in the family, for bringing up children and other outdoor activities. This directly affects their sleep.
  • Lack of sleep at night significantly affects women during the daytime.

Understanding the importance of the above-mentioned factors can help women get adequate sleep.

How does menstruation affect sleep?

Menstruation brings a shift in the female hormones level in the body, which affects sleep. However the effect of that on women may vary from one to another. It is categorized as follows:

  • Pre-menses period:During this time, women often feel tensed, disturbed, and nervous, this affects their sleep. Most women suffer from sleeplessness and disturbed sleep. On the contrary, some women may suffer from extra sleep and drowsiness.
  • Through the menses:There is a shortage in the progesterone hormone during this time and many women suffer from disturbed sleep. It is known that 63% of women suffer from sleep intermission within the first days of the menses.

There is no specific treatment for this problem, but for women who suffer from extremely disturbed sleep in this period, we recommend that they play sports regularly, sleep and wake up at a fixed time, and they should stay away from stimulants and sweet foods before sleeping.

How does pregnancy affect sleep?

Many changes occur during pregnancy that affects sleep. Pain in the limbs, muscle pain, nausea, acidity, and fetus movement, all of these factors affect sleep. Moreover, a study in USA observed that 78% of pregnant women suffer from a disturbed sleep. Broadly speaking, the effects of pregnancy on sleep can be categorized to three time periods:

  • The first trimester (0-3 months):This is when theprogesterone hormone level increases in the blood, and causes the following:
  1. Extra drowsiness compared to pre-pregnancy period.
  2. Extra need to urinate at night which affects sleep continuity at night, so extra drowsiness at day.
  • The second trimester (3-6 months):The progesterone hormone increases slowly and causes the following:
  1. Sleep becomes better compared to the first trimester, but is still not at par with pre-pregnancy period.
  2. The need to urinate decreases so sleep is relatively uninterrupted.
  • Third trimester (6-9 months):In this period, many women suffer from disturbed sleep.
  1. Some studies show that 97% of pregnant women suffer from sleep disturbances at the end of pregnancy.
  2. Within this period, the need to urinate at night increases due to the pressure of the fetus on the bladder, leading to disturbing sleep.
  3. In addition, many women suffer from nasal congestion (the reason for sleep apnea), especially at night, can affect sleep.

Throughout pregnancy, some sleep disorders that did not exist earlier may suddenly appear. 30% of pregnant women, who never snored, were snoring for the first time during pregnancy. If nasal congestion is severe it may lead to obstruction in the upper airway and sleep apnea which may cause sleep disorder, extra drowsiness during daytime, possible shortage of oxygen level while sleeping, and increased blood pressure. If a pregnant woman suffers from snoring it is highly recommended to visit a doctor.

Pregnant women are also susceptible to the restless legs syndrome which is a sleep disorder characterized by strange sensation and discomfort in legs at any time of the day. It usually increases just prior to sleep and is accompanied by a serious desire to move the legs or to walk. As a result, the patient encounters difficulty in sleeping and consequently gets insomniac. This syndrome affects 15% of pregnant women.

What are the recommendations for the pregnant women?

  • The pregnant women are recommended to sleep on their left side during the last three months of the pregnancy, as this allows the flow of the blood to the fetus and kidneys, also it is recommended that she should avoid sleeping on her back for a very long time.
  • Drink a lot of fluids during the daytime and reduce it by night.
  • Exercise regularly.
  • Put pillows to support the head while sleeping
  • Avoid citrus fruits and spicy food as acidity may cause a problem at sleep.
  • Have frequent snacks throughout the day to fill the stomach and avoid acidity or nausea.

A mother complains usually of disruptive sleep, after delivery, because of her infants frequent waking up in the night, which affects her activities during day. This can even result in depression. Thus, young mothers are recommended to take a nap when the baby sleeps. The family’s cooperation is critical in these cases.

What is the effect of menopause on sleep?

The female hormones (estrogen and progesterone) gradually decrease in women approaching the menopause age, which cause some changes within the body. Some women experience hot flashes in which whole body starts sweating.

These were reported by 36% of women at that age. This affects the quality of their sleep. These sensations usually continue for five years. At this age women may get the same duration of sleep but the quality of sleep is poor. Thus women going through menopause are recommended to visit a gynecologist to discuss the available treatments.

Are there any other sleep disorders that women suffer?

Sleep in Women

Insomnia: It is regarded as the most common of sleep disorders. The causes for the same may be divided into psychological, physical and behavioral (see: Insomnia). Women are more susceptible to insomnia than men and it increases with age, the reasons for the same is unclear. Treatment for insomnia depends on the cause (see: Healthy Sleeping Tips).

  • Sleep apnea:It is more common amongst men than women and is usually accompanied with a loud snoring. Women usually suffer from it after 50 years of age or after menopause.
  • Pain while sleeping:Women suffer from this more than men and it affects their sleep, cause insomnia and disturb sleep. Women are more susceptible to headaches caused by tension or migraine, and chronic fatigue syndrome along with fibrous muscle pain(Fibromyalgia). Treating this pain can ensure smooth and quality sleep.

 

Ahmed BaHammam, FACP, FCCP
Professor of Medicine
Director, University Sleep Disorders Center
College ofMedicine, King Saud University

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