Sleep Study

  • Sleep Health, Sleep Study

    For some women, a connection may exist between poor sleep and hormones

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    Original Post | Washington Post Health

    By Leigh WeingusSeptember 18, 2021 at 9:00 a.m. EDT

    I’ve struggled with sleep since I was a teenager, and have spent almost as long trying to fix it. I’ve absorbed countless books and articles on getting better sleep that instructed me to go blue-light free at least two hours before bedtime, take nightly baths to lower my body temperature, keep my phone far from my bedroom and avoid caffeine after 12 p.m.

    In between all my diligent sleep hygiene work, I couldn’t help but feel like there was a larger force at play. My sleep seemed to change throughout my menstrual cycle, for example, getting worse in the days before my period and significantly better afterward. When I was pregnant, I experienced the best sleep of my life, and when I stopped breastfeeding, I didn’t sleep for days.

    Hormones and Women Sleep

    I finally started to ask myself: When we talk about getting better sleep, why aren’t we talking more about hormones?

    According to the National Sleep Foundation, the lifetime risk of insomnia is 40 percent higher for women than it is for men. Blaming this discrepancy entirely on hormones oversimplifies it — women also tend to take on the bulk of household worrying and emotional labor, and they tend to experience higher levels of anxiety.

    But according to Mary Jane Minkin, an obstetrician-gynecologist and clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale School of Medicine, anecdotal evidence and studies suggest that hormones likely play a role.

    If you look at the curve of hormonal secretion throughout the average menstrual cycle, Minkin says, you’ll see varying levels of estrogen and progesterone throughout the month, with a big drop of estrogen occurring right before menstruation.https://414a56c8c82860bb2b57ff47754d945d.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

    “Many people will tell me that a day or two before their period, their sleep is terrible,” Minkin says.

    When a woman enters perimenopause, she starts to experience more fluctuations and produces less estrogen and progesterone throughout the month, which may wreak havoc on her sleep. The true correlation between these hormone dips and fluctuations and insomnia needs to be studied more extensively, Minkin and other experts say, and understanding this connection is confused by how a lack of estrogen is associated with hot flashes, which can disrupt sleep.

    Studies of women on hormone replacement therapy (HRT) and sleep strongly suggest a connection between female hormones and insomnia, Minkin and other experts say.

    HRT is often prescribed to women going through menopause (and the years after it) to help them deal with unpleasant side effects of that transition, which include sleep problems, Minkin says. Some types of HRT include only estrogen, while others have a combination of estrogen and progesterone. High levels of estrogen and progesterone occur naturally during pregnancy, which may explain why some pregnant women like me often experience blissful sleep, Minkin says.

    “During pregnancy, guess what? Your levels of estrogen and progesterone are very high,” Minkin says.

    Although postmenopausal women have very low levels of estrogen and progesterone, once the process of menopause is complete, they often begin to sleep better. “We think hormone fluctuations can be more bothersome to some women than their actual hormone levels,” Minkin says.

    She adds that if a postmenopausal woman does struggle with insomnia, low hormone levels could be the culprit, so it’s a good idea to talk with a medical professional about HRT options. A 2008 randomized, controlled study of some 2,000 postmenopausal women in the United Kingdom found “small but significant” improvements in sleep after a year of HRT vs. those taking a placebo.

    Hadine Joffe, a psychiatry professor who is executive director of the Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital at Harvard, says hormonal fluctuations may be a cause of insomnia for some women. But for others, she says, sleep disruptions might be anxiety-related, or caused by noisy neighbors or a snoring bed partner.

    She says that while some women experience amazing sleep during pregnancy, many others report terrible insomnia during that time of life. Her advice? If you want to figure out whether any connection exists for you, track it.

    “Try a [sleep] app or even a conventional sleep diary,” Joffe says. “If you track your sleep for several months, you may start to notice a pattern emerge, like more waking in the middle of the night right before your period.”

    If you do notice a pattern, she says, that information may be helpful going forward.

    “If you know there are two or three days in every month when you don’t sleep well, make sure that’s a time when you practice the best possible sleep hygiene, avoid alcohol, and if you have a partner you share family responsibilities with, you can ask them to get up with the baby or toddler,” Joffe says.

    Sometimes targeted treatment for those days can help, too, she adds. For example, supplementing with a few milligrams of melatonin before bedtime — the hormone our brains naturally produce in response to darkness — can help signal to the brain that it’s time to sleep. Or if you have a prescription for a sleep aid, this could be the time to use it, she says.

    While it’s not always possible due to work or family responsibilities, Kin Yuen, a sleep medicine specialist at Stanford Medicine, suggests trying your best to honor your natural daily hormone fluctuations to help keep your sleep on track. To do this, you’ll have to try to figure out when your body naturally releases cortisol (the hormone we produce in the morning that helps us wake up) and melatonin (the hormone we produce at night to help us fall asleep).

    By figuring out when you have the most energy — are you an “early bird” who wakes up full of energy, or a “night owl” who still feels sluggish at 9 a.m.? — you can better pinpoint when your body naturally releases these hormones. If you adjust your schedule to honor these rhythms, you may experience fewer sleep disruptions even in the face of constantly fluctuating female hormones, Yuen says.

    Finally, while HRT is not prescribed for women who have not yet gone through menopause, both Minkin and Joffe say that if someone is sure that their insomnia is hormone-related — preferably by having kept a diary for a while and after having tried other techniques without success — it’s worth talking to their doctor about taking a birth control pill.

    “Hormonal birth control can smooth out the ups and downs that just aren’t good for some people’s brains,” Joffe says. “It has to be the right treatment for the right person, but it can help.”

    Of course, there are side effects to birth control. Some women report nausea, headaches and lower libido. Although rare, more serious side effects have been reported, too, such as blood clots.

    But for many women suffering from what seems to be hormonally related insomnia, the benefits may outweigh the risks.

    Minkin says that even for patients going through menopause, if they are otherwise healthy, she’ll often prescribe birth control pills. Birth control pills have higher levels of hormones than traditional HRT, and if a woman has used them in the past and hasn’t experienced negative side effects, this can be a good indication that they will work well for her.

    “The only drawback is that we have no way of knowing when a woman is done with menopause, because the pill will artificially give her a period,” Minkin says. “So in order to find out if she’s done with menopause, she has to stop the pill.”

    At this point, Minkin and other experts say more research needs to be done to truly understand how the ebbs and flows of female hormones impact sleep.

    Sleep diaries, trackers and apps can be powerful tools to help a woman understand whether a connection exists for her, and they can help her act accordingly, the experts say.

    The pandemic is ruining our sleep. Experts say ‘coronasomnia’ could imperil public health.

    It’s not just the pandemic. The moon may be messing with your sleep, too.

    Poor sleeping, no energy, low libido: Is it aging?

  • Sleep Health, Sleep Study

    Marijuana may make sleep worse, especially for regular users, study finds

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    By Sandee LaMotte, CNN | Original Article

    (CNN)It’s a common assumption among marijuana users: Using weed will help you fall asleep and stay asleep. Scientists, however, aren’t so sure that’s true.

    This is an understudied but important area, as many people are increasingly turning to cannabis products as sleep aids,” said sleep specialist Wendy Troxel, a senior behavioral scientist at RAND Corporation, who was not involved in the study.

    “But we really lack solid evidence demonstrating whether cannabis helps or hurts sleep,” Troxel added.

    Use of weed may actually harm sleep, a new study has found. The research, published Monday in a BMJ journal, revealed adults who use weed 20 or more days during the last month were 64% more likely to sleep less than six hours a night and 76% more likely to sleep longer than nine hours a night.

    Optimal sleep for adults is defined by the US Centers for Disease Control and Prevention as seven to eight hours a night.Moderate consumption — using weed less than 20 days during the past month — didn’t create short sleep problems, but people were 47% more likely to snooze nine or more hours a night, the study also found.

    No clear evidence either way

    The study analyzed use of marijuana for sleep among 21,729 adults between the ages of 20 and 59. The data was gathered by the National Health and Nutrition Examination Survey, and is considered representative of over 146 million Americans.

    Young adult cannabis consumers nearly twice as likely to suffer from a heart attack, research showsIn addition to issues with short and long sleep, people in the study who used weed within the last 30 days were also more likely to say they have trouble falling asleep or staying asleep, and were more likely to say they have discussed sleep problems with a health care provider, Diep said.”The problem with our study is that we can’t really say that it’s causal, meaning we can’t know for sure whether this was simply individuals who were having difficulty sleeping, and that’s why they use the cannabis or the cannabis caused it,” he added.Prior studies have also found a connection between the two components of marijuana, CBD and THC, and poor sleep. CBD, or cannabidiol, is a key component of medical marijuana, while THC, or tetrahydrocannabinol, is the main psychoactive compound in cannabis that produces the high sensation.A 2018 randomized, double-blind, placebo-controlled study — the gold standard — found no benefit from CBD on sleep in healthy volunteers. Other studies have also found high rates of insomnia when withdrawing from nightly use of marijuana.”At this time there still isn’t any clear evidence that cannabis is helping sleep,” said Dr. Bhanu Prakash Kolla, a sleep medicine specialist in the Center for Sleep Medicine at the Mayo Clinic in Rochester, Minnesota, who was not involved in any of the studies.”We know that when people initiate use there is some benefit in the immediate short term but there is quick tolerance to this effect,” Kolla said. “There currently is no good quality evidence to suggest that cannabis will help improve sleep quality or duration.”

    Confounding factors

    Still, people continue to believe that weed is helping their sleep. Surveys of marijuana users show they do indeed rely on the drug for better sleep.”The issue is that there’s a disconnect between these anecdotal reports of people reporting therapeutic benefits and the evidence behind it in terms of the data,” Diep said.

    Sleep training for adults prevents depression, study finds One possible reason, Kolla said, is that when people stop using cannabis after a period of regular use, the withdrawal effects from weed can cause sleep disruptions. That leads people to believe “the cannabis was in fact helping (sleep), while what they are actually experiencing are withdrawal symptoms.” Another factor to consider is the increased potency of weed today as compared to when many of the studies on cannabis and sleep were conducted, said Dr. Karim Ladha, staff anesthesiologist and clinician-scientist in the department of anesthesiology and pain medicine at the University of Toronto.” A lot of the older data related to cannabis is based on lower doses of THC than what patients are using now, and there’s very little research related to CBD,” Ladha said.” Studies tell us about what happens at a population level, but on an individual level that discussion is much more personal,” he said. “The studies just give us the possibilities that (marijuana) could hurt your sleep, but it may help and so we just don’t know until you try it.”

    That’s why additional studies need to be done, he added.”Patients are spending money and time and resources to obtain cannabis right now to help with sleep,” Ladha said. “I think as the medical community, we need to do everything we can to make sure that we enable our patients to make the best possible decisions for their health.”

  • Sleep Apnea, Sleep Study

    A Sleep Study’s Eye-Opening Findings

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    Posted by Sleep Review Staff | Aug 4, 2021 

    A new MIT study looks at how the length of time a person sleeps may impact their sense of well-being.

    Subjectively, getting more sleep seems to provide big benefits: Many people find it gives them increased energy, emotional control, and an improved sense of well-being. But a new study co-authored by MIT economists complicates this picture, suggesting that more sleep, by itself, isn’t necessarily sufficient to bring about those kinds of appealing improvements.

    The study is based on a distinctive field experiment of low-income workers in Chennai, India, where the researchers studied residents at home during their normal everyday routines — and managed to increase participants’ sleep by about half an hour per night, a very substantial gain. And yet, sleeping more at night did not improve people’s work productivity, earnings, financial choices, sense of well-being, or even their blood pressure. The only thing it did, apparently, was to lower the number of hours they worked.

    “To our surprise, these night-sleep interventions had no positive effects whatsoever on any of the outcomes we measured,” says Frank Schilbach, an MIT economist and co-author of a new paper detailing the study’s findings.

    Get the full story at news.mit.edu.

  • Sleep Health, Sleep Study

    Adults Sleeping Under 6 Hours A Night Have Greater Dementia Risk

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    April 21, 2021 | Original Article: MindBodyGreen

    It’s no secret that sleep is essential for a number of our body’s functions—from cellular repair to muscle growth and, of course, brain health. And one study published in the journal Nature Communications just put forward some new evidence on the link between sleep duration and dementia risk in middle-aged adults. Here’s what it found.

    Studying the connection between dementia and sleep.

    This research analyzed existing data from a long-term study on nearly 8,000 British people since 1985, conducted by University College London. As part of the research project, participants reported how long they slept multiple times over 25 years. Some of them also wore sleep-tracking devices to make sure they were giving accurate numbers on their sleep duration.

    A team of researchers then looked for any correlation between poor sleep and a greater risk for dementia down the line.

    Researchers have long suspected that there is a link between sleep and dementia risk, but they’ve been unsure where that link begins. That is, we don’t know if a lack of sleep can predispose people to dementia or if dementia throws off people’s sleep.

    The important thing about this study is that it started following the sleep patterns of people who were in their 50s, presumably before dementia had set in.

    What they found.

    Sure enough, a correlation was found—though the study authors are careful to note their research still can’t prove a direct cause-and-effect relationship between sleep and dementia.

    That said, within the group of almost 8,000 participants, researchers found that middle-aged adults who consistently clocked low sleep durations were 30% more likely to develop dementia—regardless of sociodemographic, behavioral, cardiometabolic, and mental health factors. 

    The study authors considered seven hours to be a normal sleep duration, compared to six hours or less, which was considered short.

    The takeaway:

    While the jury is still out on whether this connection is a direct cause-and-effect, it’s certainly a good reason to consider getting at least seven hours of sleep per night, particularly if you’re in your 50s or 60s and/or have a history of dementia in your family.

    The study authors note that more research is needed to better understand the relationship between sleep and dementia risk, but given how important sleep is for so many bodily functions, there’s really no reason not to aim for a full night of quality sleep, every night.

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  • Sleep Health, Sleep Study

    Short Sleep May Harm Bone Health

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    Written by Catharine Paddock, Ph.D. on November 20, 2019 – Fact checked by Jasmin Collier

    Can insufficient sleep be harmful to bone health? New research in postmenopausal women has found that those who slept for no longer than 5 hours per night were most likely to have lower bone mineral density (BMD) and osteoporosis.

    A team from the University at Buffalo, NY, led the study of 11,084 postmenopausal women, all of whom were participants in the Women’s Health Initiative.

    A recent paper in the Journal of Bone and Mineral Research gives a full account of the findings.

    The investigation follows an earlier one in which the team had linked short sleep to a higher likelihood of bone fracture in women.

    Our study suggests that sleep may negatively impact bone health, adding to the list of the negative health impacts of poor sleep. I hope that it can also serve as a reminder to strive for the recommended 7 or more hours of sleep per night for our physical and mental health.

    Heather M. Ochs-Balcom, Ph.D. Lead Study Coordinator

    Bone remodeling and osteoporosis

    Bone is living tissue that undergoes continuous formation and resorption. The process, known as bone remodeling, removes old bone tissue and replaces it with new bone tissue.

    If you are sleeping less, one possible explanation is that bone remodeling isn’t happening properly.

    Ochs-Balcom

    The term osteoporosis means porous bone and refers to a condition that develops when the quality and density of bone are greatly reduced. Osteoporosis is more common in older adults, with older women having the highest risk of developing it.

    In most people, bone strength and density peak when they are in their late 20s. After that, as they continue to age, the rate of bone resorption gradually overtakes that of formation. The bone density of women reduces more rapidly during the first few years after menopause.

    Worldwide, around 1 in 3 women and 1 in 5 men in their 50s and older are at risk of experiencing bone fracture due to osteoporosis, according to the International Osteoporosis Foundation.

    The most common sites of fracture in people with osteoporosis are the hips, wrists, and spine.

    Spinal fractures can be serious, resulting in severe back pain, structural irregularities, and loss of height. Hip fractures are also of concern, as they often require surgery and can lead to loss of independence. They also carry a raised risk of death.

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