The indiscriminate worries and ruminations that churn through the mind of Cheryl Downs McCoy are matters most working mothers have rifled through at some point: "I need to call that guy about fixing the car. I think I've run out of my daughter's favorite snack. Should I change the batteries in the smoke alarm?"
These are entirely acceptable matters to ponder. But not at 3 in the morning. Yet that is when McCoy, 45, a museum exhibit writer in Oakland, Calif., lies awake, debating and categorizing the details of working motherhood.
"Most of the time I get stuck mulling over the logistics of how everything's going to get done — my brain really digs down the minutiae," said McCoy, who has consulted a sleep therapist and has tried every prescription and over-the-counter soporific, from Ambien to low-dose antidepressants, to assuage her maternal unrest.
For some women, the drug of choice is Lunesta; for others, melatonin.
McCoy knows a mother of two who takes Xanax a few times a week, "but she worries about addiction so some nights she just doesn't sleep at all rather than take it," she said. "I think she saw the irony in not sleeping because she was anxious about taking an anti-anxiety medicine in order to sleep."
Mother's little helper of the new millennium may in fact be the sleeping pill — a prescription not likely to inspire a jaunty pop song anytime soon. Nearly three in 10 women in the United States fess up to using some kind of sleep aid at least a few nights a week, according to "Women and Sleep," a 2007 study by the National Sleep Foundation, a nonprofit research group.
Take, for example, Chris Baldwin, 43, a mother of two. Baldwin goes through extended jags of Tylenol PM only to cut herself off after a fortnight to avert dependency.
"The mornings after I stop, I get a hangover," she said ruefully.
One of the cruel jokes of motherhood is that the sleeplessness of pregnancy, followed by the sleeplessness generated by an infant (a period in which a staggering — truly — 84 percent of women experience insomnia), is not followed by a makeup period of rest. It is merely the setup for what can become a permanent modus operandi.
Sleep medicine practices are dominated by female patients. Dr. Nancy Collop, director of the Emory Sleep Center in Atlanta, said three out of four insomnia patients there are women.
Why all the angst over bedtime, the one part of the day that, barring nightmares, ought to bring deeply needed peace? Many believe that sleep deprivation among women has worsened. In the "Women and Sleep" study, 80 percent of women reported being just too stressed or worried to turn out the proverbial lights.
Collop points to the persistent creep of technology into the after-hours, a time once reserved for physical and psychological winding down. "There's always the worry another email has come in," she said. "Just the light from the electronic book or the iPad screen is stimulating."
According to IMS Health, a health care consulting firm in Danbury, Conn., the use of prescription sleep aids among women peaks from 40 to 59. Last year, the firm said, 15.5 million U.S. women between those ages got a prescription (overwhelmingly for Zolpidem, the generic form of Ambien) to help them sleep, nearly twice the number of men in that age group.
Those figures do not include those who are prescribed anti-anxiety or antidepressant medications, frequently used off-label for insomnia. Nor do they include women who zone out with a glass of wine.
They also do not take into account the many women who have no trouble passing out at 10 p.m. — but zing wide awake at 3:30 a.m. with thoughts like those of Anne Kimball, 46, a mother in Oxford, Pa., as she runs "down the menu, from kid to kid": "Did I send in the permission slip by deadline? Should I chaperone the field trip?''
Or those of Susan Stoga, a mother of two in Barrington, Ill.: "Did I send that email to my client? Is the permission slip for pictures due? Do Carrie's dance shoes still fit?"
"Stupid stuff, when it comes down to it," said Stoga, 46.
Meg Wolitzer, 52, a novelist who half-jokingly named her blog "Written on Ambien," said: "Waking up in the middle of the night is the problem of every woman I know. The minute I had children I was like the mother listening in the woods for the bear."
Some early wakers relish the extra hours.
"I have some pretty creative moments at 3 a.m.," said Stoga of Illinois, who works full time as a marketing consultant. "Many times, I just up and start my day."
Elizabeth Schwartz, 48, a child psychiatrist and mother of four in New York, said her minutes in the wee hours proved useful when she had to retake her medical boards, which is required every 10 years. "The only time I could study was from 4 to 6 in the morning," she said.
McCoy of Oakland said she knew all the "sleep hygiene tricks" but thought she had discovered the key to her wakefulness.
"I'm pretty sure I wake up at 3 because subconsciously, I know I'll have this time to myself," she said. "It's the only time in a 24-hour period when no one needs me or wants me or expects me to do something. Despite the inconvenience, it's a time that's blissfully mine."
Sleep — or not — on that.