Periods, Pregnancy, Menopause--and Sleep
Sleep disorders affect men and women differently. Although men apparently suffer more from sleep apnea, women are more likely to report spending their nights tossing and turning.
Researchers aren't sure why women seem to have more trouble sleeping than men, but they have noticed that women have the most difficulty when hormone levels fluctuate. In other words, women are most likely to have problems sleeping soundly during pregnancy, early motherhood, menopause, and at certain times during the menstrual cycle.
Whether changing hormone levels is directly linked to sleep is yet to be determined, and several studies are underway.
Your period and sleep
Researchers know that the hormone progesterone causes sleepiness. They also know that a woman's progesterone level rises during midmonth ovulation and then drops dramatically at the onset of a menstrual period. That drop also is the time when many women report having sleep problems.
To improve sleep during your period:
Take a warm bath a couple of hours before bedtime. The warmth should help you relax.
Schedule more time for sleep. Either go to bed earlier or take a nap in the afternoon.
Avoid caffeine late in the day. Drink your last cup of coffee by 4 p.m.
For a relaxing evening drink, try a glass of milk.
Don't do anything energizing close to bedtime. Exercising, paying the bills, or anything that causes you to be alert may keep you awake.
Avoid sleeping pills. Changing your behavior works better and is less dangerous in the long run.
Pregnancy and sleep
As any woman who has ever been pregnant can attest, the body goes through profound changes during pregnancy. It's probably not too surprising that the quality of sleep suffers, too.
In the first trimester when the body is adjusting to abnormally high hormone levels, women often feel sleepier than usual, but they also wake more frequently. Nearly all women experience disturbed sleep by the third trimester, which is often related to the physical discomfort of carrying a baby. Sleep disorders can emerge with pregnancy, such as restless legs syndrome, snoring, and insomnia.
Most women have difficulty with sleep during the postpartum period, but begin sleeping better after the first year. However, it's unclear whether they have the same sleep quality as they did before pregnancy.
To improve sleep during and after pregnancy:
Be prepared to get more sleep. Take naps and go to bed earlier. Your body needs more sleep during this time. If you work and can't nap, put your feet up and rest.
Sleep on your left side. Many women find sleeping on their left side--and often putting a pillow under their legs--relieves physical discomfort. It's also best for the baby. Don't sleep on your back as it could compress the uterus and make it hard for the baby to get oxygen.
Take naps when the baby takes naps. You are going to need the sleep to cope with the around-the-clock feedings that the new baby will demand.
Menopause and sleep
Once women reach menopause, most report difficulties sleeping.
Much of the reason for this may be physiological--women often experience hot flashes, a sensation of heat spreading from the chest to the neck and face. But while a hot flash might rouse a sleeper, life changes and the worries that come with older age may also be a source of wakefulness.
To improve sleep during menopause:
Practice slow, deep, meditative breathing. Rhythmic abdominal breathing can decrease hot flashes and help promote sleep.
Keep the bedroom temperature cooler than the rest of the house to lessen the effect of late-night hot flashes. A dual-control electric blanket helps, too.
Avoid alcohol before going to bed. Many people mistakenly believe that alcohol will cause better sleep. In fact, it disrupts the body's ability to reach deep sleep and causes you to wake up only a few hours after falling asleep.
- Bowers, Nancy, RN, BSN, MPH
- Freeborn, Donna, PhD, CNM, FNP