434, 435, 436 …

Does it sometimes seem like there are just not enough sheep to conquer restless nights?

The National Sleep Foundation states about 40 million women and men have some sort of sleep disorder — with insomnia being the most common. Women are 1.4 times more likely to report insomnia than men, and that, in general, sleep problems plague women more than men. The reason for the gender disparity: hormones, at least in part, are to blame. Women experience constant hormonal changes that coincide with their menstrual cycle, but the greatest shifts are pregnancy and menopause. And so, it is no surprise that these two groups of women in particular battle insomnia at increasing rates.

Pregnancy seems to be linked with certain sleep problems. Hormonal changes can lead to changes in sleepiness, either feeling more or less sleepy. And let us not forget that hormones can also make a woman feel nauseous during her pregnancy any time of day (morning sickness is a such misnomer). Another culprit, restless leg syndrome which plagues many women in the third trimester of pregnancy. In addition to the barrage of hormonal changes, a pregnant woman’s body is also going through drastic physical changes that may cause discomfort and lead to insomnia (empathy goes out to the obligate stomach sleeper).

And menopause, the other life-changing, hormonal event women experience. Research shows that 35 to 40 percent of menopausal women have sleep problems. Be it changes in sleep needs, sleep rhythms, or the awful hot flashes, menopause is known for its accompanying insomnia.

With less sleep, follows negative consequences. Sleep disorders increase the risk for a number of health problems, the list is long and includes stroke, cardiovascular disease, mortality, hypertension, depression, and obesity. Sleep loss may also cause accidents, decreased libido, forgetfulness, early aging, among other things. There is no magic number of hours of sleep required to avoid health problems (although there are no report cases of negative effects of sleeping too much). With the prevalence of insomnia, more and more people are turning to their healthcare providers for solutions. The rate of sleeping pill prescriptions have increase four-fold over the last few years, with zolpidem (Ambien ©) being the most common. And like all medications, these too have risks and side effects – some of them alarming, like memory loss and hallucinations.

But before you ask your healthcare provider for the lackluster “wonder-drug” for sleep, first try some evidence-based sleep techniques from the National Sleep Foundation:

  1. Stick to the same bedtime and wake up time, even on the weekends.

    This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.

  2. Practice a relaxing bedtime ritual.

    A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.

  3. Avoid naps , especially in the afternoon.

    Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.

  4. Exercise daily.

    Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.

  5. Evaluate your room.

    Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool  – between 60 and 67 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner’s sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.

  6. Sleep on a comfortable mattress and pillows.

    Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.

  7. Use bright light to help manage your circadian rhythms .

    Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.

  8. Avoid alcohol, cigarettes, and heavy meals in the evening.

    Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. It is good to finish eating at least 2-3 hours before bedtime.

  9. Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading.

    For some people, using an electronic device such as a laptop or smartphone can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.

  10. If you can’t sleep, go into another room and do something relaxing until you feel tired.

    It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.

And if after an ernest effort of sleep-conditioning techniques, you are still unable to find rest, consider behavioral therapy or hypnosis (no kidding!).

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