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.
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 things 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, which 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 certainly 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 be very disruptive to sleep.”
In addition, 25% of pregnant women report sleep problems in their first trimester, and that increases to 66% in the third trimester.
“In the first trimester it’s things like nausea and extreme fatigue. By the third trimester its frequent urination, heartburn and back pain that cause sleeplessness.”
For postpartum women, awakening to feed or care for the baby, hormonal shifts, postpartum depression, and physical and emotional adjustment after pregnancy all contribute to increased rates of poor sleep. In general, it takes three to six months for a mother’s sleep to normalize after childbirth.
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.”
People experiencing insomnia should try to improve their sleep hygiene and limit their use of alcohol and caffeine. If they have taken those steps 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. Sometimes prescription medications are indicated but are rarely our first line of treatment,” she says.
The bottom line is that insomnia should not be dismissed, 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.