Women and sleep problems

We all lay down to sleep in much the same way – our heads atop a pillow, our legs tucked beneath the sheets. Why then is sleep so different for women than it is for men?

The battle of the sleeping sexes is divided along several lines. On average:

• Women report greater sleep needs than men.
• Women sleep more than men, going to bed and falling asleep earlier than men. And yet women's sleep is not as restorative as men's sleep.
• Women's sleep tends to be lighter and more easily disrupted, often, as women report, by anxieties and concerns.
• Women describe their sleep difficulties differently than men do. Whereas men usually describe themselves as "sleepy," women say they feel "tired," "unrested," and "fatigued," words that indicate levels of mental as well as physical exhaustion.

And a woman's sleep may also be disrupted by hormonal fluctuations that men simply do not experience, most notably during menstruation, pregnancy, and menopause.

How menstruation can affect sleep

The hormonal shifts of a woman's menstrual cycle cause symptoms that make sleeping difficult. Aches and pains due to bloating, tender breasts, headaches, and cramps make it hard to get comfortable enough to get to sleep - and to stay asleep.

The mood swings associated with premenstrual syndrome could be made worse by the lack of quality rest. These effects may be amplified for women whose periods are already difficult due to endometriosis or premenstrual dysphoric disorder (PMDD).

There are other sleep disruption problems a woman might deal with during her reproductive years. For instance, women with polycystic ovarian syndrome (PCOS) have a higher risk of obstructive sleep apnea, a sleep disorder in which a person stops breathing for seconds at a time throughout sleep. And while taking oral contraceptives, a woman's sleep may become less deep.

How pregnancy can affect sleep

Throughout the 9 months of pregnancy, a woman's body undergoes amazing, transformative changes, many of which impact her ability to get enough quality sleep.

During the first trimester, sleepiness is on the rise, along with the hormone progesterone. This can mean more napping during the day and difficulty dozing off at night. Normal symptoms of early pregnancy can also disrupt sleep and make a woman uncomfortable - think morning sickness, back pain, frequent urination, and increased nasal congestion.

As a woman enters her second trimester, sleep generally improves, but she may be awakened in the night by bouts of heartburn, leg cramps, and snoring. This is an all-too-brief rest period before the third trimester! Those same symptoms increase, but you add to the mix a rapidly growing baby kicking, rolling, and pushing against her bladder and the nerves of the back. Sleep can become quite uncomfortable, and many women rely on contoured body pillows to find that sweet spot for sleep.

Once the baby is born, a new mother has all sorts of new sleep problems to contend with, most notably sleep deprivation due to night-time feedings and erratic baby sleep schedules.

How menopause can affect sleep

The symptoms that accompany a woman through the gradual transition into menopause can make sleep less and less comfortable. Hot flashes can have women kicking off the covers and waking covered in sweat. Urinary problems may mean more midnight wake-up trips to the washroom. And vaginal dryness and irritation can cause discomfort. Additionally, depression and anxiety are relatively common during menopause, both of which can interfere with getting to sleep.

To find out how to cope with the symptoms of menopause, explore the articles in the Menopause Health Centre.

Amy Toffelmire