A good night’s sleep - between seven and nine hours for most adults - is essential for our physical and mental wellbeing. It gives us energy, boosts our memory, allows us to process information and ensures that we’re productive in our work and home lives.
Healthy sleeping habits for women
Consultant Gynaecologist, Miss Ana Zakaryan, talks about how women can develop good sleeping habits.
Perimenopause and menopause itself will affect sleep. In the vast majority of women, they're having problems with the sleeping process and not having restful sleep throughout the night. So, it's one of the commonest presentations to the menopause clinic. What happens with the body because of the physiology? First of all, due to aging, the need for sleep shortens. So, if the healthy, younger person needs to sleep eight to nine hours a day, with age that reduces to five to six.
Also, the pattern changes when the hormones in the body start fluctuating. And due to menopause, that affects sleep centre in the brain, which regulates the sleep pattern.
It can be further affected by all other co-factors surrounding particular woman, depending on her own habits around sleep, depending on her partner, depending on the conditions and stress that going around at the same time because we know levels of oestrogen do affect the sleeping centre in the brain, production of melatonin, dopamine and serotonin.
We try to regulate it with HRT first. And in the vast majority of cases, we are able to achieve improvement in a sleeping pattern, but it should heavily be supported by all the alternative methods as well. But HRT is just covering up for that shortage of oestrogen that goes on in the body. The second hormone of HRT is purely there to back up for oestrogen.
And as I said, in the vast majority of cases, the hot flushes and night sweats improve. And because of that, the quality of sleep improves as well.
Sometimes HRT only is not enough to achieve good sleep. And if the sleeplessness is associated with other cognitive functions, women might require antidepressants to be able to get over that problem.
Unfortunately, due to the name of this group of medications, many women are put off even trying them. But the understanding should be that antidepressants are the group of medications that correlate the levels of dopamine, serotonin produced in the brain as well. So, these are the type of the medications that, by regulating those two hormones, can achieve improvement in a sleeping pattern, in a sleep balance as well as the mood and other cognitive functions such as brain fog, forgetfulness and irritability, increased levels of anxiety.
It's very important to be able to achieve a good routine. So, if it is known to the woman that having the bath regime helps her to achieve a better sleep, then working out some a routine, and having a bath before going to bed may help, then that that is the way forward. Women are advised not to nap before going to bed because obviously sleeplessness will cause low energy and fatigue throughout the day. So, there is this need for a nap, but that small nap during the day may affect the proper sleep during the night. So, they are discouraged to have a nap before going to bed. It is advised to have some relaxation, avoid looking at the screens and the cameras before going to bed.
Well, a book very often is mentioned as a replacement for a sleeping pill. If the problem is too bad and it's not helped by HRT and antidepressants, sleeping tablets can be an option, just to help towards working out some pattern. But obviously, it is not advised to be on them for a very long time.
Exercising is very important to achieve a good sleep. In fact, the recommendation is at least 150 minutes of exercise in a week.
Obviously, if there are additional factors such as increase in weight and putting on weight in a central way, then the recommendation 150 minutes of exercise is plus two sessions of heavy weights and exhausting the body muscle does help to achieve a good sleep over diet, aromatherapy, osteopathy, exercising, such as relaxing yoga, mind concentration, Pilates swimming. Those things are the ones that relax mind and the body and help to achieve reasonable sleep at this stage to be able to function the day after.
Shift work, work or family-related stress and even coronasomnia – sleeplessness made worse by the challenges of COVID-19 – can all affect the amount of sleep we get. However, it’s not just about the amount of sleep you get. Quality of sleep is as important and female health issues are a key reason why women often wake up feeling tired and continue to suffer from fatigue during the day.
How does a lack of sleep affect women?
Women experience insomnia - an inability to fall asleep or stay asleep - for many reasons, but most are associated with changes in hormone levels during menstruation, pregnancy and menopause. These can affect your circadian rhythm and cause sleeplessness.
Chronic insomnia can contribute to heart disease, high blood pressure and other long-term physical, mental and psychiatric conditions so it’s important to address any sleep issues as soon as they arise.
Periods and poor sleep
Pre-menstrual syndrome (PMS) can affect your sleep, especially if you’re more sensitive to hormonal changes. Physical symptoms, such as breast tenderness, cramping and bloating associated with your period can keep you awake – as can feelings of depression, anxiety or irritability commonly associated with PMS.
Pregnancy
It’s common to feel tired during the first 12 weeks of pregnancy as hormone changes can make you feel emotional and nauseous and interrupt your sleep. In later pregnancy you might experience restless legs, pain and incontinence as well as strange dreams which leave you anxious.
These sleep problems can continue even after the baby is born when hormone levels drop and - alongside getting up in the night to see to childcare, which leads to disturbed sleep – you can be left feeling exhausted.
Menopause and beyond
Fatigue is a common experience during menopause and postmenopause. Menopausal women are more likely to experience night sweats and hot flushes at night, both of which disrupt sleep.
Women are also more likely to suffer with conditions such as sleep apnoea as they get older. Plus, some conditions associated with chronic pain (such as migraine, arthritis and restless legs syndrome) or those affected by ageing (such as incontinence and joint pain) are more likely to be experienced by women and can also keep you awake at night.
How can I improve my sleep?
Lead a healthy lifestyle
As well as ensuring you have a healthy diet, stay hydrated and do regular exercise, setting a regular sleep habit can help you fall asleep and stay asleep.
Time naps right
If you enjoy an afternoon nap, try to take it early enough that it won’t interfere with your night-time sleep. Having a quick ‘power nap’ before 3pm can help with the feelings of tiredness but won’t keep you awake at night.
Take time for yourself throughout the day
If you’re not able to take a siesta, because you work or you have childcare responsibilities, take ten minutes out of your schedule for yourself. Take a walk around the block, walk up and down the stairs or meditate. Your health professional can recommend relaxation techniques, or there are plenty of apps and website with exercises to try.
Avoid eating late
Leave plenty of time between your last meal and your bedtime to reduce the risk of acid reflux during the night and avoid spicy food, caffeine and alcohol after about 6pm.
Go to bed and wake up at the same time everyday
You might be tempted to stay up late sometimes, but it’s important that you keep a consistent bedtime – even on a weekend. Set your alarm for the same time everyday and try to go to sleep at the same time every night.
Create a relaxing sleep routine
Try to relax before bedtime, avoid any stressful activities and only go to bed when you’re tired, so you’re not trying to sleep when you’re wide awake. Avoid spending time in front of your phone or computer an hour before going to sleep as blue light can keep you awake.
Continue your relaxation techniques until you fall asleep. If you find that you can’t fall asleep within 20 minutes, don’t lie there worrying about being unable to sleep; try restarting your routine to give yourself another chance to wind down.
Keep cool
When you get into bed, wear breathable cotton pyjamas or a nightshirt to help keep you cool and ensure the temperature of the room is low and comfortable.
Lack of sleep is affecting my work
A lack of sleep can affect your performance and productivity at work and sour relationships with colleagues – all of which can end up making you unhappy in your job. Don’t be afraid to approach your manager, HR department or occupational health adviser who can offer help and support.
Lack of sleep is affecting my mental health
If sleeplessness is affecting your mental health and stopping you from enjoying your usual activities, don’t suffer in silence. Talk with a partner or friend or find out whether there’s an online or face-to-face group in your area. And make an appointment with your health professional – a GP or midwife – who will be able to recommend lifestyle changes and/or medication.
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Published on 21 November 2022