Unique Biology of Women

The Unique Biology of Women and Sleep

Everybody craves a good night sleep. Sleep is necessary for everybody to feel rested and energetic throughout the day. It is known that there is a significant difference between men and women, in relation to their sleep. It is very common for women to complain of poor sleep quantity and sleep quality and to feel more tired during the day. Excessive daytime sleepiness can lead to decreased performance, diminished vigilance, and lapses in concentration.

One explanation for this gender difference may be attributed to the unique biological conditions of the menstrual cycle and pregnancy in women, due to the hormonal changes that occur throughout the month and their lifespan. These hormonal changes can influence sleep, as well as circadian rhythms in women.

Sleep and the Menstrual Cycle

Changes in women occur at different times in the menstrual cycle and can affect sleep quality and sleep quantity. The National Sleep Foundation (www.sleepfoundation.org) has polled thousands of women and found that half of menstruating women report bloating that disrupts their sleep. They also reported disrupted sleep for two to three days each cycle, typically in the first few days of the menstrual period.

Hormones Can Influence Sleep

Diminished sleep quality and quantity in women can be related to rising and falling hormone levels around menstrual cycle. The hormone Estrogen, has been linked to increased Rapid Eye Movement (REM) Sleep, or dream sleep. Progesterone, on the other hand, increases around ovulation and has been linked to causing increased fatigue and sleepiness. Other factors related to hormones may also have an effect on stress and mood- both of which can disrupt sleep quality.

Symptoms of Premenstrual Syndrome (PMS) may occur in the later part of the menstrual cycle. Known sleep-related symptoms include the following:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Early morning awakening
  • Waking up unrefreshed

How Can I Deal With My Monthly Cycle?

  1. Generally, premenstrual insomnia disappears a few days after menstruation begins.
  2. The associated tension and irritability that some women can experience can result in lingering sleep problems and possibly become chronic insomnia. To help prevent this, maintain a regular sleep-wake schedule, avoid stress when possible, and maintain a healthy diet.
  3. Because of underlying circadian disturbances in women with premenstrual symptoms, bright light therapy has been reported to be effective in preventing early morning awakening in women with this complaint.

Sleep Disordered Breathing and Hormones in Women

Sleep Disordered Breathing (SDB) has also been found to be linked to fluctuating hormone levels in women. Snoring and Sleep Apnea occur due to the collapsability of the upper airway muscle tissue. The tone, or strength, of the muscle tissue is related to hormone levels. When muscle tone diminishes, the upper airway becomes more collapsible, which can lead to snoring and sleep apnea. Additionally, these hormonal changes can also lead to weight gain, which is known to increase the presence of Snoring and Sleep Apnea.

Studies on healthy women with regular menstrual cycles have shown that airway collapsibility was greater during the luteal phase of the menstrual cycle compared to the follicular phase. Progesterone levels are typically higher in women in the luteal phase. This is one of the reasons why Snoring and Sleep Apnea becomes more prevalent after women have gone through Menopause.

How are Snoring and Sleep Apnea Treated?

  1. PAP therapy is the most common and most effective way to treat Obstructive Sleep Apnea and Snoring.
  2. Oral Appliance Therapy is an alternative therapy to treat Sleep Disordered Breathing. An appliance, somewhat similar to a sports guard or orthodontic retainer, is worn in the mouth at night to reposition the jaw forward, preventing the upper airway from collapsing during sleep.
  3. Weight Management is very important in addition, to PAP Therapy and Oral Appliance Therapy.