CHAPTER 10: Women’s Sleep Throughout the Lifespan

Introduction Sleep is essential for health and well-being. Consequences of acute and chronic sleep deprivation can be severe, ranging from impaired daytime functioning to compromised physical and emotional health.

Introduction Sleep Primer – REM and non-REM sleep alternate throughout the night. – Average sleep cycle lasts between 90 and 110 minutes. – Average sleep need for adults is about 8 hours per night.

Sleep and the Menstrual Cycle Subjective and Objective Sleep Changes – Sleep disruption may coincide with menstrual cycles. PMS, Premenstrual Dysphoric Disorder (PMDD), Dysmenorrhea – Sleep disruption and lower sleep quality have been associated with these conditions.

Sleep and the Menstrual Cycle Treatments to Alleviate Premenstrual Sleep Disturbance: – NSAIDs or antidepressants – Napping (<30 minutes) – Evening bright light therapy – Partial and total sleep deprivation Oral Contraceptives (OCs) and Sleep – Sleep architecture of women taking OCs appears to differ from that of naturally ovulating women.

Sleep During Pregnancy and Postpartum Sleep disturbances during pregnancy can be due to: – Changes in hormones – Physical symptoms (nausea, backaches, increased frequency of urination) – Breathing difficulty, shortness of breath – Leg cramps, restless leg syndrome

Sleep During Pregnancy and Postpartum Sleep disturbances during postpartum period can be due to: – Hormonal fluctuations – Infant care – Breastfeeding – Bed-sharing

Sleep During Pregnancy and Postpartum Sleep Strategies for Expecting and New Mothers – Medication (but be aware of harmful side effects) – Prolonging hospital stay – Attempting to sleep when baby sleeps – Mindfulness approaches – Dietary recommendations – Continuous positive airway pressure (CPAP) therapy for women with sleep apnea

Sleep and Menopause Insomnia is one of the foremost complaints of peri- and postmenopausal women. Important factors to consider: – Hormonal changes – Hot flashes – Role of cognitions – Circadian changes

Mood and Sleep Depressed mood and psychological distress are significant predictors of sleep disturbance.

Sleep and Aging Several factors may predispose aging women to sleep disorders: – Sleep architecture and circadian rhythms – Sleep disorders and their correlates – Polypharmacy

Sleep Challenges Shift work Chronic insomnia Obstructive sleep apnea

Future Directions Future research should address the independent contributions of circadian, hormonal, and psychosocial factors and their interaction. Socioeconmic status (SES), employment status, and racial and ethnic identity have been relatively unexplored. Translational research is needed to determine efficient ways to disseminate sleep knowledge across diverse populations of women.