All the unique hormone-related events women experience in their lifetimes certainly contribute to the tendency for women to have higher rates of insomnia than men.
– Dr. Kirsten Grove, family medicine and obstetrics physician, ThedaCare Physicians-Berlin
One in four women report having sleep problems that include trouble falling asleep, staying asleep, or returning to sleep, the U.S. Office of Women’s Health reports.
“Insomnia is one the most common symptoms people discuss with their primary care provider,” says Dr. Kirsten Grove, a family medicine and obstetrics provider at ThedaCare Physicians-Berlin.
Risks of Insomnia
Untreated insomnia can affect quality of life, cognitive function, and performance. It can also lead to an increased risk of self-medicating, mental health struggles, suicidal ideation, and cardiovascular problems, Dr. Grove says.
Sleep disorders are defined as insomnia when people report an inability to go to sleep or return to sleep, wake up too early, or feel unrested for at least three nights a week for a minimum of three months. Other criteria for insomnia include persistent sleep difficulty, adequate sleep opportunity, and daytime dysfunction.
“Those are all the factors that need to be present for us to reach an insomnia diagnosis,” Dr. Grove says.
When patients report insomnia, Dr. Grove looks for other health problems that may be contributing to sleeplessness. These can include psychiatric issues such as depression and anxiety. Use of caffeine, stimulants, alcohol, or drugs also can lead to insomnia.
Women and Sleep Difficulties
The National Sleep Foundation (NSF) reports that women have a 40% greater chance of experiencing insomnia than men.
“All the unique hormone-related events women experience in their lifetimes contribute to the tendency for women to have higher rates of insomnia than men,” Dr. Grove says. “Hormonal changes with menstrual cycles, pregnancy, perimenopause, menopause, and post-menopause can disrupt sleep.”
In addition, 25% of pregnant women report sleep problems in their first trimester. That increases to 66% in the third trimester.
“In the first trimester it’s issues like nausea and extreme fatigue. By the third trimester, it’s frequent urination, heartburn, and back pain that cause sleeplessness.”
For postpartum women, it’s a different set of issues that contribute to poor sleep. These include awakening to feed or care for the baby, hormonal shifts, postpartum depression, and physical and emotional adjustment after pregnancy. In general, it takes three to six months for a mother’s sleep to normalize after childbirth.
Establishing a Healthy Routine
Practicing good sleep hygiene is one of the most important steps for people experiencing insomnia. The NSF offers these suggestions for improving sleep hygiene:
- Go to bed and wake up at the same times every day, including weekends and holidays.
- Limit the use of alcohol or caffeine in the hours before bedtime.
- Avoid screen time for an hour before going to bed.
- Include relaxation techniques as part of your bedtime routine.
- Create a cozy bedroom environment. Invest in a good mattress and quality bedding.
- Keep the room at a comfortable temperature, and limit noise and light pollution.
Dr. Grove also noted that regular exercise, including yoga, can help alleviate sleep problems. “Our bodies need a certain amount of movement every day, and a regular exercise routine provides that. Yoga seems to be especially helpful to some people.”
Treating Insomnia
If people have taken steps to improve their sleep and are still having insomnia after three months, it’s time to see a provider, Dr. Grove says.
Cognitive behavioral therapy can be an effective long-term treatment for insomnia, Dr. Grove says. This type of counseling focuses on treating behavioral and cognitive issues that can contribute to sleep problems.
Dr. Grove, however, cautions against relying on medication to resolve insomnia. “What often happens is that people get started on insomnia medication and continue on it without follow-up or attention to underlying causes,” she says. “Sometimes prescription medications are indicated, but they’re rarely our first line of treatment.”
Don’t dismiss insomnia, Dr. Grove says. “Good sleep is an important component of good health. Women who have long-term insomnia may be more at risk than men for mood problems, heart disease, stroke, and obesity. Insomnia can pose a serious health risk and should be treated.”
If you’re experiencing insomnia, your primary care provider is there to help.
Visit MyThedaCare to make an appointment.
