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Natural Sleep Doctor Answers: Do Women Need More Sleep?

Starting in puberty, women have more sleep complaints than men. This challenge persists throughout life. Women’s hormones are part of the reason, as they influence sleep throughout a woman’s life cycle, from adolescence through menopause. Let’s talk about these hormonal influences, while also addressing key concerns like insomnia before periods, natural remedies for menopause sleep problems, and more.

The Menstrual Cycle and Sleep

Menstrual Cycle Overview
The menstrual cycle has two primary phases: the follicular phase and the luteal phase, with ovulation occurring at the mid-point. During the follicular phase, estrogen levels rise, peaking around ovulation along with luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In the luteal phase, progesterone is the dominant hormone. Menstruation happens at the end of the cycle, then a new cycle begins.

Sleep Complaints During the Menstrual Cycle
Starting with menarche (the first menstrual period), women often experience sleep disturbances more than their male peers. These sleep issues are particularly prevalent 2-3 days before menstruation begins, commonly referred to as insomnia before periods. Some women suffer from insomnia where it is either taking longer to fall asleep, or they are awake more in the night. Others may experience excessive daytime sleepiness, or find they need an extra hour or two of sleep for the 2-3 nights before their period, and possibly during the first few days. The pain of menstrual cramps can exacerbate sleep problems too. Symptoms vary quite a bit from woman to woman.

One mechanism for this sleep – hormone connection is that female hormones bind directly to some of the circadian and sleep neurons. Since women’s hormones vary over their month, those areas of the brain are receiving different input over the month too.

Pregnancy and Sleep

First Trimester
In the first trimester, fatigue is common, and many women find they need more sleep or frequent naps as the body adjusts to pregnancy. We know that most women who are not pregnant need between 7 to 9 hours of sleep nightly. How much do you do best with? A good way to determine is to wake without an alarm clock for 7-10 nights in a row. Observe how much sleep you get, then schedule that time into your lifestyle. Going into a pregnancy, create time for the extra sleep you may need.

Second Trimester
The second trimester often brings improved sleep and energy levels, making it the most comfortable phase for many women. This is a great time to prepare for the new baby while your energy is good.

Watch for an increase in snoring or apneic pauses in your breathing, and consult with your healthcare provider if this is happening.

Third Trimester
In the third trimester, sleep disruptions increase due to physical discomfort, joint relaxation, and the growing belly. Proper pillow support is crucial; side-sleeping on your left side, with pillows under the upper arm, between the knees, and under the belly can provide relief. Body pillows, especially those designed for pregnancy, can be particularly helpful. These include large ‘C’ shaped pillows, and long rectangular ones.

Pregnancy-Related Sleep Disorders
Two sleep disorders prevalent in late pregnancy are Restless Leg Syndrome (RLS) and Obstructive Sleep Apnea (OSA).

Restless Leg Syndrome: RLS is often linked to iron deficiency, which can worsen as pregnancy progresses due to increased blood volume. This condition causes a feeling that you just must move your legs, or sometimes a skin sensation. It’s worse in the evening, and worse when sitting still. When severe RLS can make it difficult to fall asleep at the beginning of the night, or disrupt sleep after the first sleep cycle.

Obstructive Sleep Apnea: OSA is more common in late pregnancy due to tissue swelling particularly in the airway. This makes it easier for the airway to obstruct. Symptoms include loud snoring and pauses in breathing. Obstructive sleep apnea during pregnancy is associated with other increased health risks for mom and baby. So women should consult their healthcare provider if they suspect OSA, and get treatment.

Postpartum and Child-Rearing Years

After childbirth, sleep disturbances often continue due to nighttime caregiving responsibilities, and being hypervigilant to the children’s needs. Even as children grow to the point that they no longer need care every night, mothers may remain alert during sleep.

Do Women Need More Sleep?

Yes, women often need more sleep than men due to hormonal fluctuations, pregnancy, and the demands of child-rearing. Prioritizing rest and recovery is essential.

Perimenopause and Menopause

Perimenopausal Sleep Issues
Perimenopause introduces new sleep challenges, primarily due to hot flashes and night sweats caused by fluctuating estrogen and luteinizing hormone levels. These vasomotor symptoms can significantly disrupt sleep.

Menopausal Sleep Concerns
During menopause, the risk of OSA increases as estrogen levels drop, reducing tissue tone in the airway. Postmenopausal women have similar OSA rates to men of the same age. Additionally, Restless Leg Syndrome affects about 52% of postmenopausal women.

Natural Remedies for Menopause Sleep Problems
Lifestyle Changes: Regular exercise, a balanced diet, and stress management techniques like yoga and meditation can alleviate menopause symptoms.

Proper Sleepwear: Wearing breathable, moisture-wicking sleepwear, such as a well-designed women’s sleep shirt, can help manage night sweats.

Aging and Sleep

With age, slow-wave (deep) sleep declines, and melatonin levels decrease, reducing sleep quality and circadian rhythm strength. These changes are experienced by both women and men, and can compound the hormonal sleep challenges women face. 

Addressing Specific Sleep Problems

Insomnia Before Periods
Many women experience insomnia before periods due to hormonal changes and premenstrual symptoms. Implementing good sleep hygiene practices, such as maintaining a consistent sleep schedule and creating a relaxing bedtime routine, can help manage these symptoms. Reducing caffeine and alcohol intake, especially in the days leading up to menstruation, can also improve sleep quality.

Causes of Insomnia in Females
Insomnia in women can be attributed to various factors, including hormonal fluctuations, stress, anxiety, and lifestyle habits. Understanding the underlying causes can help in developing effective strategies to manage and overcome insomnia. Cognitive-behavioral therapy for insomnia (CBT-I) is a proven method to treat chronic insomnia by addressing negative thought patterns and behaviors that contribute to sleep disturbances.

Enhancing Sleep Quality

Creating a Sleep-Friendly Environment
Optimizing the sleep environment can significantly impact sleep quality. Keeping the bedroom cool, dark, and quiet is essential. The best temperature for sleep is typically between 60-67 degrees Fahrenheit. Additionally, using an air purifier for the bedroom can improve air quality and promote better sleep. Knowing where to place an air purifier in the bedroom is important; ideally, it should be placed near the bed to filter the air effectively.

Conclusion

Understanding how hormonal changes impact sleep is crucial for women at all life stages. From managing menstrual cycle-related sleep issues to addressing pregnancy and menopausal sleep challenges, awareness and proactive measures can help improve sleep quality. Check out my appearance on the Work Wives podcast for some more tips to improve your sleep. 

In my work helping women sleep one-to-one in clinic for the last 20 years, I saw that there are some empowering, sleep-promoting lifestyle practices that are simple and effective, yet are just not taught. That’s why I created The Women’s Sleep Course. Please join, so you can have the support of a good night’s rest, night-after-night, so you can feel your best.

Become a Skilled Sleeper

Struggling with sleep disturbances such as sleep apnea or sleep paralysis? Our comprehensive "Skilled Sleeper" course, led by Dr. Catherine Darley, offers expert strategies and insights to help you overcome sleep challenges and enhance your sleep quality. This course includes interactive sessions, personalized advice, and practical tools tailored to your specific sleep needs.

Enroll today to start your journey towards restful, uninterrupted sleep. Gain the knowledge and skills you need to master your sleep patterns and enjoy a healthier, more energized life.



About the Author: Dr. Catherine Darley

Dr. Catherine Darley is a pioneering internationally recognized expert in the use of natural, behavioral and lifestyle medicine for the treatment of sleep disorders. Dr. Darley founded the Institute of Naturopathic Sleep Medicine to fill the need for natural, less invasive solutions to a common problem–poor sleep.  
Learn more about Dr. Darley by visitingAbout Catherine Darley, ND – Institute of Women Health & Integrative Medicine (instituteofwomenshealth.com)

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