Comments Off on Why do more women struggle with insomnia than men?
by Vicki Cohn
Sleeping is an essential part of our lives. It helps us recharge for the next day. Research in this area has helped understand various sleep disorders.
But most research has dodged the question of how different women’s sleep patterns are compared to men.
Why is insomnia more common in women?
The National Sleep Foundation survey, one of the first surveys in this field, found that 46% of women reported troubles with sleep almost every night. Other studies also conclude that insomnia is 40% more prevalent among women.
A prominent reason for this difference is biological, where hormone production during pregnancy, postpartum, menopause and menstruation changes. But social and cultural reasons, like work and family, also play a role, according to the survey.
Gender and sleep
Gender differences have important scientific consequences. For instance, almost a decade ago, the Food and Drug Administration reduced the recommended dose of zolpidem, a drug similar to Ambien, by half for women to treat insomnia. This came after the discovery that women metabolized the drug much slower than men — which led to gender-specific guidelines.
“It was important to raise the issue of sex differences — which is biological differences between women and men — to point out that there are differences in sleep in both the sexes,” said Dr. Monica Mallampalli, the senior scientific adviser for Healthywomen.org and a board member for Alliance of Sleep Apnea Partners.
For example, obstructive sleep apnea, a sleep disorder in which breathing repeatedly stops and starts, is typically found in men. But women also experience it, Mallampalli explained.Report ad
“Usually, they’re misdiagnosed or undiagnosed, and the symptoms that they present are very different than what a typical man would present,” she said, adding, “it’s also mostly hormonal.” Fibromyalgia, a condition that causes pain all over the body, has also been linked to insomnia, peaking at puberty and menopause for women, both periods of hormonal change.
What are the types of sleep problems women face?
1. Depression, anxiety and stress
Sleep is often tied to mental health and women are proven to be more likely to suffer through depression and anxiety. Studies show that women are more likely to ruminate about their concerns which can hamper their ability to fall asleep or go back to sleep.
2. Pregnancy
According to a study, around 30% of women say they rarely sleep and more than 50% have insomnia-like symptoms. Neck and back pain paired with difficulty finding a comfortable sleeping position can disturb the quality of sleep. These problems can persist after childbirth.
This syndrome creates a strong under to move limbs, especially legs, when lying down. Restless leg syndrome is also more common in men than women. Mallampalli adds that this syndrome is commonly seen in pregnant women.
How do you improve your quality of sleep?
Environmental stimuli such as a bright light in the bedroom, traffic noises, music, television, room temperature, pets and bedpartners can all affect sleep. The Society for Women’s Health Research created a Women & Sleep guide which suggests darkening rooms with blackout shades and drapes, turning off electronics in the room and double-paning windows for noise cancellation.
Earplugs, eye masks and white noise machines are also extremely helpful. Caffeine and electronic gadgets should be avoided at night time, as well as stimuli like nicotine and alcohol, according to researchers.
Mallampalli, who was involved in creating this guide, believes that by spreading awareness, more women will be able to advocate for themselves and ask their physical care physicians about sleep health. And this is how a change can begin.
Using a bedroom air filter that traps fine particles of pollution with diameters smaller than 2.5 micrometers can significantly improve breathing in asthmatic children, a new study in JAMA Pediatricsfound.
The research documents that physiological improvements occur in the childrens’ airways when air filters are in use, and it suggests that with consistent use, the filters may help prevent, not just alleviate, asthmatic flare-ups.
While using the filters daily for two weeks, children in the study experienced decreased airway resistance and lung inflammation and increased airway elasticity, among other benefits.
“Pharmaceutical companies have spent large amounts to develop drugs that can work on lower airways, but they are very expensive. Our results show that using an air purifier to reduce the exposure of lower airways to pollutants could help asthmatic children breathe easier without those costly drugs,” Junfeng Zhang, professor of global and environmental health at Duke University’s Nicholas School of the Environment, says in a statement.
“This warrants a clinical trial to confirm findings,” he says.
Fine particulate matter (PM2.5) is a ubiquitous air pollutant originating from fossil fuel emissions, wildfires and other biomass burning, industrial sources, and gasoline- and diesel-powered vehicles. Thirty times smaller in diameter than a human hair, the particles are easily inhaled and can penetrate deep into the small, or lower, airways where they can trigger or exacerbate asthma symptoms. Inhalers don’t help, since they are only designed to open upper airways, according to the researchers.
The scientists conducted the double-blind crossover study in a Shanghai suburb during a period of moderately high PM2.5 pollution in 2017. They gave 43 children with mild to moderate asthma two air filters to use in their bedrooms. One was a high-efficiency particulate air (HEPA) filter capable of removing PM2.5; the other was a sham filter. Each filter was used for two weeks in random order with a two-week interval in between. Neither the children nor their families knew which filter was which.
Results showed that PM2.5 concentrations inside the children’s bedrooms were a third to two-thirds lower when the real air filters were in use than when the sham ones were being used, Michael H. Bergin, professor of civil and environmental engineering at Duke’s Pratt School of Engineering, says in a statement.
This drop coincided with significant improvements in how easily air flowed in and out of the children’s small airways and lungs, Bergin says. These improvements included a 24% average reduction in total airway resistance, a 43.5% average reduction in small airway resistance, a 73.1% average increase in airway elasticity, and a 27.6% average reduction in exhaled nitric oxide, a biomarker of lung inflammation.
Although the benefits lasted only as long as the real air filters were in use, “it’s probable that if children use the filters on an ongoing daily basis they will see continued benefits,” Zhang says.
If clinical trials confirm the new study’s findings, the filters could serve as a practical preventive measure for asthma management in polluted outdoor or indoor environments worldwide, he says. They could also be lifesavers in areas near wildfires.
“Look at the high PM2.5 pollution levels that occurred in San Francisco last year as a result of smoke from the California wildfires, and at the air-quality problems happening this year from the bushfires in Australia,” he says. “People should really consider using one of these devices during wildfires.”
Almost one-in-five British people report they don’t get enough sleep each night. The problem is so bad that in total the UK public are losing around a night’s worth of shut-eye each week.
There are a lot of popular beliefs about foods and drinks helping people get a good night’s rest, but many of them are not based on scientific evidence. Here’s what we know.
Chemistry of food and sleep
Our diet has an influence upon sleep patterns by affecting the sleep hormone melatonin. For example, foods rich in the essential amino acid tryptophan are commonly cited as helping sleep, as tryptophan helps produce melatonin. Additionally, some vitamins and minerals may help sleep, such as vitamin D, magnesium and zinc.
Oily fish: Evidence suggests the more oily fish, such as salmon or herring, you eat the better you sleep. Oily fish contain healthy fats such as omega-3 oils which have been shown to improve sleep in children and are involved in serotonin release. Serotonin, a brain chemical linked to mood, also regulates the sleep-wake cycle which may also explain how eating oily fish can help.
Tart cherries: A number of studies have looked at consumption of tart cherries, usually in the form of a drink, and sleep. Evidence suggests that tart cherries improves sleep in older adults, probably due to their ability to increase melatonin levels. And tart cherries are also rich in nutrients, including magnesium, which also may improve your sleep.
Kiwi fruit: The evidence for kiwi fruit helping you sleep is mixed. One study suggested four weeks of kiwi fruit consumption improved multiple sleep measures, while another, admittedly in sufferers of insomnia, found no effect. Based on these findings it is not clear yet that eating kiwi fruit will benefit sleep for most people.
Oysters: In 1888 W F Nelsom wrote “He who sups on oysters is wont on that night to sleep placidly…”. There is some evidence to back up this statement, with zinc-rich foods, including oysters, being reported to benefit sleep. However, on balance eating oysters before bedtime is unlikely to be beneficial to your night’s sleep.
Alcohol and other drinks
Alcohol causes brain activity to slow down and has sedative effects that can induce feelings of relaxation and sleepiness> But consuming alcohol is actually linked to poor sleep quality and duration. Although drinking alcohol may cause more rapid sleep onset, this can affect the different stages of sleep, decreasing overall sleep quality. If you want a good night’s sleep, avoiding alcohol is sound advice. But are there any non-alcoholic drinks that might help?
Warm milk: Research conducted in the 1970s suggested that a glass of warm milk before bed could improve sleep quality. This research was performed in a very small group however, and little research has been done since. Drinking milk does increase melatonin levels which could help. But there isn’t enough evidence to support the claim that a glass of warm milk definitely makes you nod off.
Bone broth: Bone broth commonly crops up in online articles as a food that can aid sleep. This may be due its high content of the amino acid glycine. Glycine has been shown to improve sleep in rodents and humans, possibly by lowering body temperature. There are however no studies specifically looking at bone broth consumption and sleep.
Herbal teas: The range of herbal teas aimed at the sleep market has grown and grown. Evidence for valerian, a common ingredient, to aid sleep is inconclusive. Decaffeinated green tea has been reported to improve sleep quality, which might be linked to the relaxing qualities of L-theanine, an amino acid it contains, but in general, avoiding caffeinated teas is a wise choice. If you like herbal teas, then they can be part of a relaxing pre-bedtime routine – but they are unlikely to improve your sleep quality.
A bedtime routine
Having a bedroom environment and daily routines that promote consistent, uninterrupted sleep are important. These include keeping to the same time to head off to bed, making your bedroom free of disruptions and having a relaxing pre-sleep routine. But many of the foods that have claimed benefits for sleep have little or no evidence behind them, to the point there are no legally recognized health claims for food assisting sleep approved in the UK or Europe.
If any one of these things helps you to sleep well, there’s no reason to stop. But just remember the other basics of a good nights sleep too, including relaxing before bed and avoiding too much blue light from electronic devices.
Comments Off on All the best sleep products we tested in 2021
by Vicki Cohn
We thought to jumpstart the New Year we would share this exhaustive list of fantastic sleep aids. We stumbled across this article from CNN and found it shareworthy.
CNN Underscored is constantly testing products — be it coffee makers or office chairs — to find the absolute best in each respective category.
Our testing process is rigorous, consisting of hours of research (consulting experts, reading editorial reviews and perusing user ratings) to find the top products in each category. Once we settle on a testing pool, we spend weeks — if not months — testing and retesting each product multiple times in real-world settings. All this in an effort to settle on the absolute best products.
This year, we tested dozens of sleep-related products — from bedding to alarm clocks — to find the best products you need to get the rest you need.
Bedding
Down comforters
Shutterstock
Best down comforter overall: Brooklinen Down Comforter (starting at $159; brooklinen.com)
Have you ever wished you could sleep on the clouds? Well, the Brooklinen Down Comforter is the closest thing to that. From the moment we took it out of the packaging, we had a hunch that this would be a favorite. And we were right.
The comforter comes in three different weight options: lightweight, all-season and ultra warm. We tested the all-season comforter, and despite it being the middle of winter with temperatures dropping indoors and out, we found it to perfectly balance snuggly warmth with breathability. Though on the heavier end of the spectrum (it boasts a 700 fill power and baffle box design), we never found the comforter to trap too much heat or cause nighttime sweating. The comforter, with its 100% cotton sateen shell, was one of the softest we tested — and the one we kept coming back to cuddle into most nights.
Best down comforter for warmth: The Company Store Legends Hotel Alberta Down Comforter (starting at $299; thecompanystore.com)
When it comes to warmth and coziness, the Legends Hotel Alberta Down Comforter from The Company Store is unrivaled.
Full disclosure: This comforter is for truly frosty climates, or especially cold sleepers. Though available in three different weights — light, medium and extra, all of which sport a baffle box construction — we tested and recommend the extra warmth option (which has a 650 fill power). While our main tester, who tends to sleep hot, found this lofty comforter slightly too heavy to sleep with throughout the night, a cold-sleeping family member absolutely loved the warmth the Legends Hotel Alberta Down Comforter provided.
Best down-alternative comforter: Buffy Cloud Comforter (starting at $109.65; buffy.co)
The Buffy Cloud Comforter was like no other comforter we tested. This down-alternative comforter was by far the best alternative version we tested — and the only one we’d recommend, as the other down alternatives we tested lacked in both quality of construction and comfort.
Although this was a new type of material for us — as we typically sleep with a down comforter in our nontesting days — we thought the fabric was very soft and lightweight but still heavy enough to keep us warm throughout the night. The comforter was also very quiet, emitting no crinkling sounds when shifting sleeping positions.
Best overall flannel sheets: Garnet Hill Hemstitched Supima Flannel Bedding ($197 for a queen set; garnethill.com)
Luxurious without feeling overly thick or too weighty, Garnet Hilloffers a delectably comfortable flannel sheet at a mid-to-high end price point, starting at $197 for a queen set (which includes two pillowcases, a fitted sheet and a flat sheet). These flannels come in lots of varieties of color and size, and instill confidence you’re getting a quality product that’ll last for years to come.
Best lighter-weight option: West Elm Organic Flannel Solid Sheet Set ($170 for a queen set; westelm.com)
Very close to our overall favorite because it is both supremely cozy and the most lightweight of all the sets we tested is West Elm’s organic flannel sheet, which starts at $170 for a queen set. These sheets didn’t come out on top because they’re available in only two colors and cannot be ordered a la carte like Garnet Hill’s sheets.
Best cold-weather sheets: L.L.Bean Ultrasoft Comfort Flannel Sheet Set ($119 for a queen set; llbean.com)
If you’re sleeping in really cold weather and you want to feel positively bundled, L.L.Bean makes a weighty flannel sheet for you — at a competitive price point for the level of craftsmanship therein at $119 for a queen set.
Best bargain: Pinzon Signature Cotton Heavyweight Velvet Flannel Sheet Set ($70.99 for a queen set; amazon.com)
Also delivering an excellent and very warm night of sleep, Pinzon by Amazon turns out a substantial flannel sheet at just $70.99 for a queen set. That’s half the price of some of the other higher-end brands, but you won’t feel like you’re sacrificing quality.
Best linen sheets overall: Parachute Linen Sheet Set (starting at $149; parachute.com)
Making the bed with these sheets was effortless. We’ve struggled with tight-fitting cotton sheets before, wondering why bed-making must be truly laborious. The Parachute linens were roomy but not baggy. They fit the bed comfortably, like a lovingly worn-in linen button-down. On the summer night we first tested these, the sheets were soft but also firm. If this sounds uncomfortable, it was the converse: cool, light and luxurious. Our first mental note was that we felt like we were sleeping on a cloud.
Runner-up linen sheets: Citizenry (starting at $230; the-citizenry.com)
These are a sturdier, thicker option than some of the ones we tested, and thus feel like they’ll transition well into colder weather. Without an air conditioner unit blasting directly onto us in the heat of summer, these sheets almost felt heavy — so they wouldn’t be our first recommendation for hot sleepers. In a more temperature-controlled room, though, they felt so cozy we didn’t want to leave the bed.
After even the first washing, these beauties softened significantly, rendering them even more snuggly.
Softest linen sheets: Brooklinen (starting at $269; brooklinen.com)
These sheets are the definition of soft. So comfortable. So enveloping. So melty. (They’re crafted from 100% French and Belgian linen, made in Portugal, and Oeko-Tex-certified for chemical safety.) We sort of dissolved into them in a very pleasing way. They felt like they had been washed and rewashed dozens of times, already achieving that texture, and from a sleeping experience alone, they were our favorite.
Best affordable linen sheets: Amazon Simple&Opulence 100% Washed Linen Sheet Set (starting at $114; amazon.com)
For less than $150, this is a very satisfying set of linens. While the sheets were slightly less luxurious-feeling and special than some of the other sets with special details or touches, these rank as high-quality, durable bedding more than worth their weight.
Best duvet cover overall: Casper Sateen Duvet Cover (starting at $99; casper.com)
Hands down, the Casper Sateen Duvet Cover was the best duvet cover we tested. From the moment we took it out of the bag, we knew this one would be a winner. Between the zipper closure at the bottom to the hidden holes on the corners to more easily attach the cover to the duvet, the design of this duvet cover blew the others we tested out of the water — all for a middle-of-the-road price tag.
Best duvet cover for warmth: L.L.Bean Ultrasoft Comfort Flannel Comforter Cover (starting at $64.95; llbean.com)
For the colder months, or for those looking to outfit their cozy cabin, the L.L.Bean Ultrasoft Comfort Flannel Comforter Cover will give you the utmost softest feel while adding some warmth, as it was made from the thickest material we tested. And at less than $100 for a king-size cover, its quality and comfort surpass the price.
Best luxury duvet cover: Boll & Branch Signature Eyelet Duvet Cover Set (starting at $358; bollandbranch.com)
Want something a little more than plain Jane when it comes to design? If so, the Boll & Branch Signature Eyelet Duvet Cover is the perfect middle ground: It’s elegant but adds some design elements with borders. A full overlay also covers the bottom buttons, completing the design border. The quality is superb, with all stitching, ties and buttons fully secure. Note that this duvet cover isn’t cheap — in fact, it’s the most expensive of all we tested — but it’s one of the few luxury brands that also includes shams, making it easy to ensure that your bedding will match.
Best affordable duvet cover: Mellanni Microfiber (starting at $27; amazon.com)
If you love walking into a hotel room and getting comfy on those sleek-looking beds, you’ll love the Mellanni Microfiber Duvet Cover. With hidden button covers and matching shams and pillows, this comfortable duvet cover will lend an elegant vibe to your bedroom — at just around $30 in total for a five-piece set, an absolute steal in our book.
Best silk pillowcase overall: Fishers Finery 25mm 100% Pure Mulberry Silk Pillowcase ($49.99; amazon.com)
Fishers Finery — made from the finest silk available — felt luxuriously silky, fit our pillows perfectly, offered beautiful nights of sleep and were easy to wash and dry both by hand and in the machine.
Best affordable silk pillowcase: MYK Silk Natural Silk Pillowcase with Cotton Underside ($23.99; amazon.com)
The MYK Silk Natural Silk Pillowcase, featuring lovely silk on one side and white cotton on the other, offered a good fit, restful sleep and for about half the price of the Fishers Finery option — though it’s notably less luxurious-feeling.
Best luxury silk pillowcase: Lunya Washable Silk Pillowcase ($74; lunya.co)
We couldn’t get enough sleeps on the Lunya Washable Silk Pillowcase. Also a silk on one side, cotton on the other option, Lunya’s silk surface case was the most lavish to the touch, and design details made it feel significantly elevated.
Best alarm clock overall: Jall Wooden Digital Alarm Clock ($25; amazon.com)
The Jall Wooden Digital Alarm Clock looks great and has everything you need in an alarm clock. It’s simple to set, read, and use, and can wake you dependably with multiple alarms.
Runner-up: DreamSky Compact Digital Alarm Clock ($18.99; amazon.com)
An easy-to-use alarm clock without any bells and whistles to get in the way, the DreamSky is simple, durable, and highly readable, and will get you out of bed in the morning with a loud beep that isn’t too startling.
Best sunrise alarm clock (and best with radio): Philips Wake-Up Light HF3520 ($99.99; amazon.com)
Able to wake you gently with lights that gradually brighten to mimic the dawn, the Philips Wake-Up Light HF3520 is a great sunrise alarm clock and one of the best all-around alarm clocks we tested, with intuitive programming, a wide range of alarm tones and a radio.
Best alarm clock for heavy sleepers: Sonic Bomb Dual Extra-Loud Alarm Clock With Bed Shaker ($32.07, originally $52.95; amazon.com)
With the most intense, abrasive sound of any alarm we tested, a strobe light, and a vibrating puck that you place under your pillow, the Sonic Bomb can awaken even the heaviest sleepers
Best sound machine overall: Sound+Sleep Mini ($65.63; amazon.com)
The Sound+Sleep Mini contains 48 different sounds, like rain, brooks, fans, ocean sounds, white noise, and many more. The other devices we tested feature some of these soundscapes, but the Mini is one of the only one that has them all. .
The upgrade pick: Hatch Restore ($129.99; amazon.com)
While our overall pick is a classic sound machine, the Hatch Restore resides packs extra features like a large color-changing light on the front, a digital clock display and routines to help you wind down and fall asleep easier.
Let’s get right to our favorite thing about this mask: the adjustable nose wire. Similar to the nose wire in the masks that we have become all too familiar with in the last year, the Mavogel’s nose wire lets you get the perfect light-blocking, lock-in-place fit. Many masks had a slight crack of light around the nose bridge. This mask, though, formed the best seal around the edges, blocking out more light than any other mask we tested.
Picture the pinnacle of social exhaustion: Perhaps, you’ve just spent four hours at a work holiday party, meeting the humans behind a bunch of Zoom squares IRL for the first time. Or, maybe you had a day of reconnecting with family members you haven’t seen in two, time-blurred pandemic years. It would seem that hitting the hay would be the most obvious solution—but once you get into bed, your body seems to say, Not so fast. For introverts, in particular, the draining nature of being social can leave you, paradoxically, chasing sleep.
In general, that counterproductive scenario springs from the difference between feeling fatigued and feeling tired, says psychologist and behavioral sleep-medicine specialist Shelby Harris, PsyD, DBSM, author of The Women’s Guide to Overcoming Insomnia. While the former reflects a total drain of energy (which tends to happen for an introvert after a social event), the latter is more about physical sleepiness, which is that drowsy feeling that allows you to drift off to dreamland.
“For introverts, socializing tends to overstimulate the brain and body, leading some to feel irritable, indecisive, or on edge.” —behavioral sleep-medicine specialist Shelby Harris, PsyD
“For introverts, socializing tends to overstimulate the brain and body, leading some to feel irritable, indecisive, or on edge, or even to get physical symptoms, like a headache or muscle aches,” says Dr. Harris. “While all of that can be extremely exhausting, it doesn’t necessarily lead to feeling sleepy.” By contrast, a social event can actually flood the brain with uppers like dopamine, adrenaline, and cortisol, which, for an introvert, tend to be perceived negatively, says Mike Dow, PsyD, psychotherapist at Field Trip Health, a psychedelic-assisted therapy practice. In fact, these neurotransmitters can keep you reeling long after an event wraps up (cue: the introvert hangover).RELATED STORIESHow To Make Waking Up in the Dark Suck Less, According to…Not an Early Bird or Night Owl? Science Suggests There May Be…
Trying to get to sleep in that state can require a whole lot more than simply getting into bed; after all, the process of falling asleep is nothing like an on-off switch, biologically, says Dr. Harris. For an introvert, especially, easing your mind into sleep mode is best done with a calming pre-bed ritual. Below, the experts share tips for socially exhausted introverts who want nothing more than to get a good night’s sleep.
It’s especially hard for introverts to sleep after a highly social experience, but these 5 tips can help
1. Create a container for your thoughts.
“Introverts are internal processors,” says psychologist Laurie Helgoe, PhD, author of Introvert Power: Why Your Inner Life Is Your Hidden Strength. “They often take inputs from conversations and process them later, which can mean mulling over what someone said, replaying or continuing a conversation, coming up with a better comeback, and the like.”https://556d592cd02b0abe412f5bc25f63d090.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html
Journaling can help put a pause to that spiral by providing a space for you to essentially unload all of your thoughts, and, if you’d like, feel free to return to them later—ideally at a time when you’re not trying desperately to get catch precious zzz’s.
2. Talk back to negative self-talk.
In re-assessing a social event (as introverts are wont to do), you may find that certain percolating thoughts devolve into negative or anxious ones. For example, it’s easy to start over-evaluating and hyper-personalizing, says Dr. Dow. “Maybe you start thinking, ‘Was Cindy looking at me weird? I must have done something wrong.’ And as the night goes on, the thoughts can turn more catastrophic in nature, leading to something like, ‘If I don’t get a good night’s sleep, I’m going to botch this presentation tomorrow, and if that happens, I could get fired,’ and so on,” he says.https://556d592cd02b0abe412f5bc25f63d090.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html
In that case, he suggests employing one of the classic strategies of cognitive behavioral therapy, which is to reconsider thoughts and feelings not as facts but merely as information, which you can choose to disregard. “Access the best parts of yourself to talk back to those inner voices,” he says.
“Because introverts are natural problem-solvers, they can get stuck in focusing on what’s not working,” says Dr. Helgoe. “But a gratitude list can help you balance that problem orientation by reminding you of what is working.” And that, in and of itself, can be incredibly soothing.
4. Practice some non-screen-based relaxation.
While it’s tempting to scroll through Instagram or scan emails in bed to occupy a restless mind, that level of mental stimulation, combined with the melatonin-suppressing blue light, is a recipe for wakefulness. Instead, do anything non-screen-related that feels calming and relaxing, whether that’s reading, knitting, listening to music, or even coloring or doing a simple crossword or jigsaw puzzle, says Dr. Harris. (You can also practice mindfulness meditation, but because this can be challenging to really sink into with an overactive mind, Dr. Harris says it’ll be most beneficial for someone who already has a daytime meditation practice.
If you’re really at a loss for where to start, try connecting with each of the five senses, says Dr. Dow: “Soothe your sense of touch with a bath, your sense of smell with a lavender candle, your sense of sight with dimmed lighting, your sense of hearing with calming music or a meditation track, and your sense of taste with a nighttime tea.”
5. And if you’re tossing and turning, get out of bed.
Trying to make sleep happen often keeps it from, well, happening. So, instead of remaining in bed and trying to will yourself asleep, get up, walk into another room, and return to whatever wind-down exercise you were doing beforehand in dim lighting, says Dr. Harris: “Simply changing what you’re doing and where you’re doing it can often help stop an overactive mind in its tracks.”
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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.
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.
“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.
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