One in four women report having sleep problems – that is, trouble falling asleep, staying asleep or returning to sleep, according to the U.S. Office of Women’s Health.
“Insomnia is one the most common symptoms people see their primary care provider for help with,” said Kirsten Grove, D.O., a Family Medicine and Obstetrics Physician at ThedaCare Physicians-Berlin. “Untreated insomnia can impact a person’s quality of life, cognitive function and performance. It is also associated with worsening mental health and suicidal ideation, and there are also cardiovascular health risks for people who aren’t getting adequate sleep. It is not a problem people should ignore and hope it will go away eventually.”
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.
Dr. Grove added persistent sleep difficulty, adequate sleep opportunity and daytime dysfunction also need to be involved.
“Those are all the things that are often present for us to reach an insomnia diagnosis,” she said.
When patients report with insomnia problems, Dr. Grove looks for co-morbidities that may be contributing to sleeplessness.
“Those can include psychiatric issues, such as depression or anxiety, as well as other medical conditions,” she explained. “Almost any health condition can be associated with insomnia. We also look for things like medications that can affect sleep, and any substances patients are using – such as caffeine, stimulants, alcohol or drugs.”
Women and Sleep Difficulties
The National Sleep Foundation (NSF) reports that women have a 40% greater chance of experiencing insomnia than men.
“All of 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 said. “Hormonal changes with menstrual cycles, pregnancy, perimenopause, menopause and post-menopause and the symptoms associated with those times, such as hot flashes, can be very disruptive to sleep.”
Talking about pregnancy, Dr. Grove added that 25% of pregnant women report sleep problems in the first trimester and that increases to 66% in the third trimester.
“In the first trimester it’s things like nausea and extreme fatigue that often cause sleep issues,” she said. “By the third trimester its frequent urination, heartburn and back pain that cause sleeplessness.”
She noted that restless leg syndrome also seems to be more of a problem during pregnancy, which can contribute to keeping women awake.
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 postpartum women. In general, it takes three to six months for a mother’s sleep to normalize after childbirth.
Resolving Insomnia
One of the first things recommended for someone experiencing insomnia is to practice good sleep hygiene; that is, to review and adjust their sleep habits and environment. The NSF offers these suggestions for improving sleep hygiene:
- Maintain a consistent sleep schedule. 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. Stop using cell phones, tablets or computers. Some providers recommend avoiding watching television as well.
- Include relaxation techniques as part of your bedtime routine.
- Create a cozy bedroom environment. Have a good mattress, quality bedding, keep the room at a comfortable temperature and limit noise and light pollution. Also, keep TVs out of the bedroom.
Dr. Grove also noted that regular exercise, including yoga, often helps resolve sleep problems.
“Our bodies need a certain amount of movement every day, and a regular exercise routine provides that,” she said. “Yoga seems to be especially helpful to some people.”
Beyond those efforts, Dr. Grove said if someone has improved their sleep hygiene, avoided alcohol and/or caffeine and is still having insomnia problems for three months or more, it’s time to see their provider.
“Good sleep is an important component of good health,” she said. “Anyone regularly experiencing insomnia should focus on good sleep hygiene. If that doesn’t help, they should see their provider. Care teams are available to talk through the issues, and try to uncover the source of the issue. We’re here to help you get a good sleep and be your best self.”
About ThedaCare
For more than 110 years, ThedaCare® has been committed to improving the health and well-being of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to more than 600,000 residents in 17 counties and employs approximately 7,000 health care professionals. ThedaCare has 180 points of care, including eight hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their unique, best lives. ThedaCare also partners with communities to understand needs, finding solutions together, and encouraging health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care.
