Sleep proves elusive for many women, but why?

Published Feb. 2, 2018

My Fitbit fitness tracker wants me to get my act together when it comes to a regular bedtime.

"Your circadian rhythm lets your body know when it's time to wake up, eat or fall asleep," the app's sleep-monitoring function advises me. "Keep yours on track by going to bed and getting up at the same time every day."

Uh … okay.

I'd be happy to turn out the lights every night at 11 (sorry Jennifer Leigh and the late-night Jimmys). And I agree it would be fabulous if I could sleep exactly eight hours until my alarm wakes me at 7 a.m.

It just doesn't happen that way. And from what I can tell from my Facebook feed, it isn't happening for many of my female friends, either. Pretty much every day there's at least one woman on there complaining that she couldn't get to sleep, stay asleep or stay awake at work because she didn't get enough Z's.

Of course, both men and women can have trouble sleeping, but the U.S. Department of Health and Human Services says women are more likely to have problems than men. And a 2013 Duke University study found that poor sleep may be more harmful to women both physically and psychologically.

The hormonal shifts we experience throughout our lives can affect sleep cycles, as can our anxiety and simply aging, says Dr. Lisa Whims-Squires, who specializes in sleep medicine and pulmonary diseases and practices at BayCare's Mease Countryside, Mease Dunedin, Morton Plant and Morton Plant North Bay hospitals.

Some of those issues are a normal part of life, Whims-Squires says. (One or two trips to the bathroom a night? Check.) But some are not. If you're getting fewer than five hours of sleep most nights, you could have an underlying health complication — or you might be on your way to future medical problems, she says.

The quality of your sleep is even more important than the quantity, says Dr. Dragos Zanchi, a pulmonary and sleep medicine specialist with Pulmonary & Sleep of Tampa Bay. Poor sleep can affect your focus and how you function at work, he says, as well as how you interact with friends and family.

Which might explain why so many of my Facebook friends seem to be grouchy these days.

Here are some of the things that could be keeping you up at night.

You're pregnant

Pregnancy is when sleep problems start for many women. There's the basic discomfort of that growing belly, of course, and you might have to adapt to a new sleeping position. But you also may experience indigestion or restless legs syndrome, and you could even find yourself snoring for the first time. If your baby's a night owl, he might be waking up just as you're settling in. Or she could be sleeping soundly … right on top of your bladder. The good news is most of these complications will go away soon after your baby is born. In the meantime, try drinking more water during the day and less at night. And you may want to pick up some nasal strips, a pregnancy pillow, a night-light and an over-the-counter antacid (if your obstetrician approves). Make sure you talk to your doctor about all your issues. She might prescribe more iron or folate to help with leg cramps — or order your partner to give you calf massages. e_SClBYou're doing too much

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Society is changing, but women still are more likely to take on the bulk of the caregiving duties in the family — with our children when we're young and with our parents when we're older. Plus, we work. The push to get it all done — and done well — can be exhausting. Unfortunately, that doesn't result in better sleep. We tend to ignore sleep cues — those tired feelings that are telling us to go to bed. And even in the sack, we churn — going over mental lists and obsessing about everything from bills to school bullies. "You're not going to fix anything at night," Whims-Squires says. If you can't shake your worries, she recommends writing them down. "Then shove it out of your head." Progressive relaxation techniques also can help, or try counting backward from 100 by threes. Sleep experts recommend winding down two or three hours before bedtime. And stay off those electronic devices at least two hours in advance — whether it's for work or play. The light affects levels of the sleep-inducing hormone melatonin. e_SClBYou're using alcohol

It's not the answer, and OTC fixes are only for the short-term. Maybe you've been relying on a drink or two to help you get to sleep faster. But alcohol can hurt your sleep overall, Whims-Squires says, because it disrupts and reduces the restorative REM (rapid eye movement) stage of the sleep cycle, which is vital to your health. Over-the-counter drugs can have a short-term role in helping you sleep, Zanchi says, "But what we see is it's sometimes a Band-Aid, delaying diagnosis of a real problem."

You're getting
too much caffeine

We like our cola, coffee and iced tea. But caffeine is a stimulant that can block sleep-inducing chemicals in the brain and increase adrenaline production. Try to get your fix (a small one) during the day, not in the evening or at night.

You're in perimenopause, menopause or postmenopause

Hot flashes and night sweats, which are related to decreased levels of estrogen, may be short-lived or last for years. Many women also experience an increased heart rate and/or feelings of apprehension when a flash is coming on. Your doctor may prescribe hormone replacement therapy or suggest an over-the-counter supplement. You also can try decreasing caffeine, sugar and alcohol, and increasing vitamin E. Keep the temperature in your bedroom cooler, and stash a dry pair of pajamas within reach in case you need to change in the dark. Restless legs syndrome also might pop up around this time, and your doctor may prescribe an iron supplement. Less estrogen also can cause changes in the urinary tract that will make you have to use the bathroom more often. Remember to dim any lights that lead the way so it's easier to get back to sleep. Light is a powerful cue to your body that it's time to wake up and get ready for the day.

You might have
sleep apnea and not
even know it

The National Sleep Foundation estimates that 18 million Americans have sleep apnea, including one in four women over age 65. Apnea is more common in men, but it increases in women after age 50 and can lead to stroke, hypertension, pulmonary vascular disease, cardiovascular disease and arrhythmia. While men often report loud snoring, gasping for air or snorting, many women report symptoms such as fatigue, anxiety and depression. Because the signs are less obvious, we have to pay more attention, Zanchi says. If you can't pinpoint why you're so tired during the day, it may be time to go to a sleep clinic, or talk to your doctor about what you're experiencing at your next wellness visit. e_SClBYou need better
sleep hygiene

Remember when you were a kid and your parents had a whole routine set up around bedtime? You'd take a bath, brush your teeth, climb into your PJ's, read a story. Do that again. Many experts say having a sleep routine is the most important part of getting a good night's rest. And consistency is key. So is having a bedroom that's set up for sleeping — not working, watching TV or working out. e_SClBContact Kim Franke-Folstad at