Sleep Disorders in Women (cont.)
Sleep Disorders in Women Causes
- The changing hormonal levels during the menstrual cycle can disturb sleep and cause daytime sleepiness. Hormonal effects can be direct, by changing sleep patterns, or indirect, by affecting mood and emotional state. As many as 80% of women report premenstrual symptoms.
- Decreasing menopausal estrogen levels may cause hot flashes that disturb sleep. About two thirds of menopausal women have sleep problems. Lower menopausal estrogen levels are linked with increased snoring risk and sleep-disordered breathing.
- In today's society, many women cope with the roles of wife, mother, caregiver for parents, and worker. With less time for themselves, they often reduce sleep. The sleep deprivation and stress are linked with long-term insomnia.
- Work and lifestyle can also contribute to primary sleep disorders. Women who work in rotating and night shifts are likely to experience sleep problems. Inactivity and lack of exercise can lead to trouble falling asleep. Women with erratic schedules or altered weekend sleep patterns are more likely to have trouble resetting their body clock to normal.
- Caffeine, nicotine, or other stimulating drugs near bedtime may prevent a woman from falling asleep. Alcohol may cause sleep fragmentation and nightmares.
- Depression and anxiety are more prevalent in women than in men and can contribute to sleep disorders. In some women, these are related to the menstrual cycle. Anxiety may impair falling asleep, and depression may cause early morning awakening.
- Sleep-disordered breathing is common in postmenopausal women. Multiple breathing cessations during sleep occur with sleep apnea. The resulting breathing difficulty disturbs sleep and may cause daytime fatigue. Sleep apnea is linked to high blood pressure and cardiovascular disease.
- Snoring often indicates partial airway obstruction. Snoring is linked with high blood pressure and increased risk for sleep apnea. Snoring increases during pregnancy, particularly during the last trimester. It is linked to pregnancy-related high blood pressure, pre-eclampsia, and low infant birth weight. Pregnant women do not have a higher risk of sleep-disordered breathing.
- Sleep disorders are more common in older women.
- Being overweight or obese increases a woman's risk of having a sleep disorder.
Carmel Armon, MD, MHS, MSc
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