The Sleep Challenges Faced by Women

Martin Reed | May 5, 2017

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A number of gender specific challenges contribute to complaints of poor sleep in women. Here are the specific causes of sleep complaints as identified by a 2014 review published by the Australian Psychological Society.

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Women need more sleep but don’t always get it

Studies have found that women report needing more sleep than men but are more likely to report non-refreshing sleep and other sleep disturbances. This may be linked to the hormonal, physical, and emotional changes that occur throughout a woman’s life.

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Sleep during the menstrual cycle

The Australian review found that 70 percent of women reported that menstrual symptoms had a negative effect on their sleep for more than two days each month. This may be related to a change in levels of estradiol and progesterone — hormones known to influence the sleep-wake cycle.

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How premenstrual syndrome (PMS) harms sleep

Although women with severe PMS are more likely to report sleep-related problems, clinical studies have not revealed the reason why. The review suggested that the anxiety connected to severe PMS may be a contributing factor.

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Menstrual cramps harm sleep quality

The review found that women with painful menstrual cramps had worse sleep quality, lower sleep efficiency, and spent more time awake compared to women who did not suffer menstrual pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce menstrual pain and improve sleep.

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Pregnancy affects sleep, too

Sleep quality and quantity decrease as a pregnancy progresses — and remain lower for up to three months after childbirth. The review identified the increase in estrogen, progesterone, and prolactin levels as contributing factors, but they’re not exclusively to blame.

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Pregnancy discomfort also harms sleep

Perhaps unsurprisingly, the review identified pregnancy discomforts such as nausea, headache, backache, shortness of breath, and heartburn as additional factors that disrupt sleep in women (here are some tips for improving your sleep when pregnant).

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How you deliver your baby can affect your sleep

The review found labor can lead to sleep deprivation for up to a week after delivery. Cesarean sections were associated with shorter sleep durations and more frequent awakenings compared to vaginal deliveries. The authors of the review pointed out this is likely related to surgical recovery.

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Your newborn can make sleep more difficult

A woman’s sleep closely matches the sleep-wake cycle of her baby for the first three months. Feedings and nighttime care also disrupt sleep — and this can have a bigger effect on subjective sleep quality than overall sleep duration (here are some baby sleep training tips).

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How menopause affects sleep

The review found that up to 51 percent of women reported sleep problems during menopause transition. Sleep complaints tended to increase during menopause and persisted into postmenopause.

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Hot flashes and night sweats may not be to blame

Research into the effect of hot flashes and night sweats on sleep have yielded mixed results. As the authors of the review stated, although they probably play a role, hormonal and mood changes are also likely to influence sleep.

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The link between sleep and mental health

Mental health is strongly linked to sleep health. This review suggested that sleep complaints in women not only affect current mood but can also be a risk factor for future mood problems.

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Improving sleep at all life stages

The authors pointed out that cognitive behavioral therapy for insomnia (CBTI) is proving effective at improving sleep in new mothers with insomnia and depression. Since CBTI addresses the thoughts and beliefs that influence sleep, it could be beneficial across the lifespan.