Trying To Get To Sleep —

Women Tossing And Turning To Get Some Rest

By Kendra Bobowick

The sandman’s efforts tend to trickle through the fingers of more women than men, say sleep deprivation specialists.

Women are more inclined to be hampered by a variety of sleep problems that fall under the catch-all label of insomnia, explained Marya Chaisson, MD, director of the Sleep Wellness Center at Griffin Hospital in Derby.

“Men and women differ,” she said. More women — roughly 63 percent compared to the men’s 54 percent — complain about lack of sleep, she said.

Menstrual cycles, pregnancy, and menopause tip the scales toward sleeplessness for women, explained Dr Chaisson. Also counting against them are factors arising later in life.

Arthritis and sleep apnea — disordered and abnormal breathing often characterized by snoring or cessation of airflow — commonly plague women over 65 years old, Dr Chaisson said.

Sleep apnea is a problem for one out of four women over the age of 65, she said.

“It has to do with hormonal changes an falling hormone levels,” Dr Chaisson said.

Biological factors unique to females are just part of the barriers between many women and a decent night’s sleep.

Dr Chaisson added environmental setbacks and lifestyles to her list of sleep inhibitors.

“If you are a new mother with a child you have to get up based on the child’s schedule,” Dr Chaisson explained.

Lifestyle, which includes activity level, also plays a part in sleep quality, she explained.

“Sleep hygiene,” is one key to improved rest.

“Start by maintaining a regular sleep time and a regular wake time, even on days off and weekends,” Dr Chaisson said. “Try to go to bed when you are drowsy.”

Offering more detail, she said that drowsiness and a regular sleep time do not have to differ. “Most people fall into a pattern,” she said.

Other everyday efforts can also add up to a more productive 40 winks. Avoid daytime napping, said Dr Chaisson. Also, she said, “We recommend establishing a presleep schedule.”

She agreed that adults need to take the advice they often give children, which is to calm down and get ready for bedtime, for example.

Exercise regularly, and avoid caffeine and nicotine at least six hours before sleep, and avoid alcohol, she said.

Dr Chaisson also advised, “Sleeping pills should be used conservatively.”

Solutions for sleeping are elusive, as Dr Chaisson explained, “Nothing is easily remedied, but [sleep] hygiene is a good place to start.”

Recognize the problem. Most common is sleep apnea, she said. Sufferers, “do not feel refreshed upon waking or are excessively tired during the day and have trouble with normal activities,” she said.

Long-term sleep deprivation can be devastating, she explained. “It can have a huge impact.”

Sleep apnea specifically is characterized by snoring and abnormal breathing. The problem could cause nocturnal awakening. “Some people can have 300 to 400 respiratory events per night,” she said.

Prolonged deprivation can detract from a sufferer’s quality of life Dr Chaisson said.

“It can change your outlook on life and goes hand-in-hand with depression,” she said. “It affects life, work performance, home life.”

Sleeping problems may also go unrecognized, she explained.

“People regularly attribute fatigue to other issues — to their job, or their busy lifestyles, but they generally don’t think about sleep disorders,” Dr Chaisson said.

A spouse often notes problems, for instance.

With luck the person can take helpful steps before calling the doctor.

Dr Chaisson lists weight loss, exercise, and good sleep hygiene as places to start.

Underlying factors may combine with poor sleep to form a vicious cycle, she said. Anxiety and depression are culprits.

“If somebody has an anxiety disorder they have trouble falling asleep and if they have insomnia it can create horrific anxiety. The two disorders are commonly intertwined,” she said.

She stressed that anyone with questions, who is fatigued and wondering about sleep issues should not hesitate to seek help. The Sleep Wellness Center staff will do evaluations for patients. Often the staff finds sleep disorders and often they find underlying problems, she said.

 

Other Experts…

Based on information released by Danbury Hospital, one-third of the population cannot sleep, mostly women and older Americans.

Ten percent of these people have chronic problems that last six months or more, causing them to be tired, irritable, less productive at work, and even depressed and anxious.

Sleeplessness, whether caused by temporary stress or chronic illness, is so common that a panel of experts from the Sleep Disorders Center at Danbury Hospital drew a crowd for a recent Medical Town Meeting to the community, “Sleepless in Connecticut — Wake Up To The Facts About Insomnia.”

“Sleeping pills are getting a lot of attention lately,” said Andrew Tucker, PhD, insomnia specialist. “There’s a big marketing campaign, but there’s also a lot of debate on how safe and effective they are.”

In addition to all the new sleeping pills, a lot of research is underway on sleep problems, according to Arthur Speilman, PhD, director of research and consultant to the center, associate professor at City College of New York, and author of The Insomnia Answer. “The field is burgeoning and growing, and that’s exciting.”

The panel discussed the advantages and disadvantages of sleeping pills, among other types of treatments. While prescriptions are generally considered safe and effective, they also can interact with other medications and cause people to develop a psychological dependency, according to the panel.

Doctors recommend cognitive-behavioral therapy (CBT). An eight-week program of talk therapy, CBT has better long-term results and no side effects.

They also recommended using a sleep log to chart what time of night is a problem for you, how long you sleep and when you awaken. A log can also help a doctor better evaluate your particular problem.

Some people may be more vulnerable to sleeplessness, especially overly emotional people. According to Dr Tucker. “People don’t usually complain of insomnia, but rather, of being tired, having mood swings, having trouble on the job, and having social and family issues.” They also complain of having no energy, and can be irritable, anxious and depressed.

He also recommends that insomniacs try alternative measures, like practicing yoga, relaxation and guided imagery techniques, or taking melatonin.

Blue light therapy can also help reset someone’s sleep clock.

For more information on sleep disorders, contact your doctor or visit www.danburyhospital.org and look for the Sleep Disorders Center.

Other references can be found at www.griffinhealth.org and healthysleep.com.

The Sleep Wellness Center at Griffin Hospital is a comprehensive program that brings state-of-the-art sleep medicine the community.

The center offers help for people with sleep disorders such as insomnia, sleep apnea, snoring, restless legs and narcolepsy. The center is located on the first floor of Griffin Hospital and includes three well-appointed rooms where patients are studied.

Services provided under the program include sleep hygiene counseling, dietary and exercise programs, relaxation therapy, respiratory therapy, compliance programs, and sleep disorders support groups.

The diagnostic and treatment costs vary depending on the sleep or wakefulness disorder. The costs for evaluation are generally covered by insurance. To schedule an appointment, call the office at (203) 732-7571 Monday through Friday, 8 am to 4 pm, or arrange for evaluation through a physician.

 

Waiting For Sleep

One resident who wishes to keep her identity private, tells her story of sleep deprivation. Her trouble began at a young age.

“I have had sleep issues since I can remember,” she said. “As a kid, I lay in bed waiting, hoping for sleep to come.

“Some nights I fell right to sleep, other nights it took hours. Some nights I slept all night through and some nights I would wake up every hour and doze back off or woke up at 3 am and couldn’t get back to sleep.”

She has attempted several methods of getting some sleep.

“Over the years I have taken various medications, like Valium, Tylenol pm, amytriptyline [prescribed for sleep/temporomandibular joint dysfunction (TMJ)/bruxism].”

She has also made her own attempts at alleviating sleeplessness. “Alcohol also figured into the equation,” she said.

Finally relief came after she completed a sleep study, after which she adjusted her sleep hygiene.

“I take nothing now and go to sleep quickly, and stay asleep until 6 am when I need to get up,” she said.