During World Menopause Awareness Month, the AASM encourages women to prioritize healthy sleep. Good sleep isn’t just about feeling rested — it’s essential for overall health and well-being.

Why does menopause affect sleep?

Hormonal changes during menopause can interfere with your ability to fall asleep and stay asleep. Hot flashes and night sweats often wake you up at night, making restful sleep harder to achieve. If you’re waking up tired and struggling to stay focused during the day, it may be time to take a closer look at your sleep habits.

What happens when you don’t sleep enough?

Poor sleep isn’t just frustrating — it can also affect your health. Chronic sleep loss increases the risk of serious conditions like heart disease, diabetes and obesity. It can also impair cognitive function, affect concentration and cause headaches. You may notice mood swings or feel more irritable and fatigued throughout the day.

Tips for better sleep during menopause

The good news? Small adjustments can improve your sleep. Here are some practical tips from the AASM:

• Use cooling sheets and lightweight blankets: Sleep with light layers that are easy to remove to help you stay cool at night.
• Avoid caffeine and alcohol: Both can worsen hot flashes, so it’s best to avoid them near bedtime.
• Stick to a schedule: Go to bed and wake up at the same time every day, even on weekends.
• Make your bedroom a sleep-friendly space: Keep the room quiet, dark and cool. Use your bed only for sleep, not for watching TV or working.
• Unwind before bed: Develop a calming nighttime routine, like reading, meditating or taking a warm shower.

Take action

Sleep is essential for everyone, but it becomes even more important for women trying to maneuver the unpredictable hormonal fluctuations of menopause. If you’re still struggling to sleep well despite these changes, don’t hesitate to talk to your doctor.

Related

• Sleep and growing older
• Increasing physical activity may improve sleep for menopausal women
• Sleep and women

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It turns out, incompatible sleep habits are a common issue. But what does this mean for couples?

What is a “sleep divorce”?

You might’ve heard the term “sleep divorce.” It sounds serious, right? But it’s not about ending a relationship. It’s about getting good sleep.

According to Dr. Seema Khosla, the medical director of the North Dakota Center for Sleep and a medical advisor for MedBridge Healthcare, sleep divorce simply means sleeping in separate beds or even different bedrooms. “It’s about prioritizing sleep health and addressing the sleep issues that may be eroding a relationship,” said Dr. Khosla. Issues like snoring, tossing and turning, or different sleep schedules can make sleep difficult for both partners.

Rather than being a sign of relationship trouble, this arrangement lets couples talk honestly about habits that disrupt sleep. The goal? Uninterrupted, restorative rest.

Changes couples are making

People are also making other changes to accommodate their partners. One-third of U.S. adults (33%) said they go to sleep at a different time than desired. One in 10 (11%) have switched to using a silent alarm to avoid disturbing their partner. In addition, 10% of people have tried the trendy “Scandinavian sleep method,” in which each person sleeps with their own blanket or comforter.

Why sleep matters

It’s not just about how you sleep — it’s about how long. The AASM recommends seven or more hours of sleep for adults. Getting enough sleep boosts health, energy and productivity.

“We know that getting a good night’s sleep is important for both health and happiness,” said Dr. Khosla. “So, if you’re continually sacrificing sleep quality and quantity — due to your partner’s persistent snoring, for example — then it may be time to discuss your sleeping arrangements.”

Small adjustments or even separate beds might be all it takes for a good night’s sleep.

Find support for better sleep

If sleep troubles are affecting you or your partner, you don’t have to deal with it alone. To find an AASM-accredited sleep center near you, check out www.sleepeducation.org/sleep-center.

Related:

• For Valentine’s Day, a good night’s sleep may be the best gift
• Do viral sleep trends actually work?
• Is Fido a bed hog or a cuddle buddy?

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Sleep changes by trimester

During pregnancy, a woman’s body undergoes various changes that can disrupt sleep. In fact, according to one survey, 97% of pregnant women reported symptoms of disrupted sleep.

The first trimester may bring increased sleepiness, accompanied by disruptions caused by nausea, vomiting, backache and frequent urination.

However, many women experience improved sleep and daytime alertness in the second trimester. Yet, this period may also introduce new challenges, such as snoring, which, when accompanied by breathing pauses or daytime sleepiness, could signal obstructive sleep apnea — a condition linked to heightened risks of preeclampsia and gestational diabetes.

The third trimester can be the most challenging for sleep. Common causes of sleep disruption include fetal movements, increased urination, heartburn, positional discomfort, back pain, snoring and restless legs syndrome. Additionally, the likelihood of having insomnia increases in the third trimester, with research suggesting over 40% of pregnant women experience the sleep disorder.

Risk factors and sleep disorders

The risks of developing both obstructive sleep apnea and restless legs syndrome increase during pregnancy. Anxiety and hormonal fluctuations can contribute to insomnia, further complicating sleep patterns.

Gestational diabetes, characterized by elevated blood sugar levels, can develop during pregnancy. One study found women with gestational diabetes are nearly seven times more likely to have obstructive sleep apnea compared to other pregnant women.

Restless legs syndrome, a condition involving uncomfortable sensations in the legs and an irresistible urge to move them, affects around 20% of pregnant women, peaking in the third trimester. Iron deficiency is a common cause and this syndrome raises the risk of complications such as preeclampsia, gestational hypertension, Cesarean delivery and depressed mood.

Sleep problems during pregnancy may affect more than just the mother. One study found that infants born to mothers with sleep-disordered breathing — snoring, apnea, and other breathing difficulties during sleep — are more likely to develop complications such as jaundice, low blood sugar, seizures, or death during the newborn period. Sleep-disordered breathing occurs in an estimated 11 to 20% of pregnant women.

Tips for better sleep during pregnancy

Ensuring adequate sleep is crucial for both the mother’s physical and mental well-being. Follow healthy sleep habits, such as maintaining a consistent sleep schedule and limiting daytime naps, to navigate sleep challenges during pregnancy. Additionally, consider leg massages to alleviate cramps or restless legs sensations.

Next steps

If significant sleep disruptions occur during pregnancy, talk to an obstetrician or primary care professional. Tell your doctor if you begin to snore or have restless legs sensations during pregnancy, as these may indicate underlying sleep disorders that require attention.

Medical review by Seema Khosla, MD

Related:

• Restless legs syndrome and poor sleep in pregnant women
• Gestational diabetes increases risk of sleep apnea seven-fold
• Treating sleep-disordered breathing in pregnancy may improve fetal health
• Binge eating causes sleep issues during, after pregnancy
• Poor sleep in pregnant mothers linked to preterm deliveries

Authored by: Kate Robards

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PCOS is the most common cause of female infertility. It affects as many as 5 million U.S. women of reproductive age. But PCOS affects women long after their child-bearing years too.

Studies have found links between PCOS and other health problems, including sleep apnea.

The connection between PCOS and sleep apnea

Obstructive sleep apnea (OSA) is a common and serious sleep disorder that causes you to stop breathing during sleep. When you have OSA, your airway becomes blocked repeatedly during sleep. This limits the amount of air reaching your lungs.

One study reports that the risk for OSA is at least 5-to-10-fold higher in women with PCOS compared to those without PCOS.

Long-term, untreated sleep apnea can contribute to a range of health problems, including type 2 diabetes.

This is important because women with PCOS are often insulin resistant, which increases their risk for developing type 2 diabetes. In fact, more than half of women with PCOS develop type 2 diabetes by age 40.

Research has found that women with PCOS may be more likely to experience poor sleep quality or chronic daytime sleepiness. These may be symptoms of OSA.

If you feel tired or unrefreshed after waking up even though you have had a full night of sleep, it may be due to OSA. During the day, you may feel fatigued, have difficulty concentrating or may even unintentionally fall asleep. This is because your body is waking up many times during the night when you have OSA.

Untreated sleep apnea may worsen other PCOS symptoms. Researchers have suggested that treating OSA may positively impact the health and quality of life with PCOS by reducing the risk of health problems such as type 2 diabetes, obesity, and cardiovascular disease.

The leading treatment for sleep apnea is continuous positive airway pressure (CPAP) therapy.

If you’re experiencing symptoms of OSA, contact an accredited sleep center near you for an evaluation.

Medical review by Reeba Mathew, MD, FCCP

Related:

• Sleep & women
• Sleep-disordered breathing & intimacy
• The sound of silence: women keep quiet about snoring, sleep apnea
• Women with OSA and cardiac symptoms have high incidence of cardiac dysfunction

Authored by:

Kate Robards

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What is seasonal affective disorder?

SAD is a type of depression that occurs at the same time each year. Often beginning in late fall or early winter, SAD is treatable and usually resolves within a few months.

How do know if you have SAD? The symptoms are like those of depression. Many people experience sadness, hopelessness, a loss of interest in activities, fatigue, and social withdrawal.

More than 10 million people in the U.S. may have seasonal depression, and it’s more common in women, young people, and those who live far from the equator. Shorter days and fewer hours of sunlight may cause a hormonal imbalance that makes you feel depressed.

How does SAD affect sleep?

If you have SAD, you may experience sleep problems. People with SAD often feel excessively sleepy during the day and sleep longer than usual at night. According to research, people with SAD sleep two hours longer or more per night in the winter compared with the summer.

You may have difficulty waking from a long sleep or feel the need to nap repeatedly throughout the day. Napping may not provide relief from feeling sleepy, though.

Also, nightmares are common among people with SAD. One study found that 16% of participants with SAD had frequent nightmares compared with 2.4% of participants without SAD.

Healthy sleep is essential to your overall health. It helps you balance your mood and emotions. Without healthy sleep, you’re more likely to struggle with feelings of depression and anxiety.

How to combat SAD

Although SAD usually resolves within a few months when the seasons change, there are treatment options available. The most common treatment is light therapy. During light therapy, a bright artificial light mimics sunshine exposure that’s missing during winter months. Research shows that daily light therapy may reduce depressive symptoms as much as 83% after one month.

Added attention to self-care also may help. Going outdoors, getting regular exercise, eating energy-boosting foods, and engaging in social interactions may reduce symptoms.

Establishing healthy sleep habits can help if you have difficulty sleeping as a result of seasonal depression. Adjusting your daily behaviors and routines can impact your quality of sleep. Follow these sleep hygiene tips to improve your ability to fall asleep and stay asleep.

If light therapy and self-care don’t resolve your symptoms, cognitive behavioral therapy or use of antidepressant medications are also treatment options.

If you continue to experience poor sleep along with symptoms of depression, seek help from your health care provider.

Medical review by Lawrence Epstein, MD

Authored by:

Kate Robards

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A recent study found that 36 percent of women in their third trimester had restless legs syndrome (RLS). Half of the women with RLS had moderate to severe symptoms.

The study involved 1,563 pregnant women in their third trimester of pregnancy. Those with RLS were twice as likely to report poor sleep quality and poor daytime function. Pregnant women with RLS were also more likely to have extreme daytime sleepiness. Results are published in the July 15 issue of the Journal of Clinical Sleep Medicine.

Restless legs syndrome is a sleep disorder that causes an intense desire to move your legs. The unpleasant, tingling sensation of RLS can make it hard to fall asleep at night. Women are almost two times as likely as men to develop the disorder.

Data from the study show that RLS is strongly associated with poor sleep quality, daytime sleepiness, and poor daytime function. These symptoms are frequent complaints during pregnancy.

Doctors may overlook patient complaints of poor sleep, lead author Galit Levi Dunietz, PhD, said in a press release. This study suggests that such symptoms could be signs of RLS. Identifying and treating RLS during pregnancy can help minimize uncomfortable symptoms, Dunietz noted.

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New research involved 97 women with advanced breast cancer. The women had an average age of 55 years.

They wore a wrist actigraph for three days. The device records activity patterns to identify sleep and wakefulness. Overall, participants spent about eight hours in bed at night, but slept for only 6.5 hours.

Results show that higher SE was significantly associated with lower death over the next six years. Average survival was 68.9 months for efficient sleepers. The average survival rate was 33.2 months for participants with poor SE. Further study found a 10 percent increase in SE reduced the risk of death by 32 percent.

“Good sleep seems to have a strongly protective effect, even with advanced breast cancer,” said Dr. Oxana Palesh.  She is assistant professor in the Department of Psychiatry and Behavioral Sciences at Stanford University and research director of the Stanford Cancer Survivorship.

The National Cancer Institute projects about 40,000 will die from breast cancer in the U.S. this year.

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The research team, led by Primary Investigator Elma Baron, MD, presented their data this spring at the International Investigative Dermatology Meeting in Edinburgh, Scotland in an abstract titled “Effects of Sleep Quality on Skin Aging and Function.”

“Our study is the first to conclusively demonstrate that inadequate sleep is correlated with reduced skin health and accelerates skin aging. Sleep deprived women show signs of premature skin aging and a decrease in their skin’s ability to recover after sun exposure,” said Dr. Baron, Director of the Skin Study Center at UH Case Medical Center and Associate Professor of Dermatology at Case Western Reserve University School of Medicine. “Insufficient sleep has become a worldwide epidemic. While chronic sleep deprivation has been linked to medical problems such as obesity, diabetes, cancer and immune deficiency, its effects on skin function have previously been unknown.”

Skin functions as an important barrier from external stressors such as environmental toxins and sun-induced DNA damage. The research team set out to determine if skin function and appearance is also impacted by sleep quality, which is vital to the growth and renewal of the body’s immune and physiological systems.

The study involved 60 pre-menopausal women between the ages of 30 and 49, with half of participants falling into the poor quality sleep category. The classification was made on the basis of average duration of sleep and the Pittsburgh Sleep Quality Index (PSQI), a standard questionnaire-based assessment of sleep quality. The study involved a visual skin evaluation and participation in several non-invasive skin challenge tests including UV light exposure and skin barrier disruption. Additionally, participants filled out a sleep log for one week to quantify sleep duration.

The researchers found statistically significant differences between good and poor quality sleepers. Using the SCINEXA skin aging scoring system, poor quality sleepers showed increased signs of intrinsic skin aging including fine lines, uneven pigmentation and slackening of skin and reduced elasticity. In this system, a higher score means a more aged appearance. The average score in the good quality sleepers was 2.2 versus 4.4 in poor quality sleepers. They found no significant difference between the groups in signs of extrinsic aging, which are attributed primarily to sun exposure, such as coarse wrinkles and sunburn freckles.

The researchers found that good quality sleepers recovered more efficiently from stressors to the skin. Recovery from sunburn was more sluggish in poor quality sleepers, with erythema (redness) remaining higher over 72 hours, indicating that inflammation is less efficiently resolved. A Transepidermal Water Loss (TEWL) test was used at various time points to determine the ability of the skin to serve as an effective barrier against moisture loss. In measurements 72 hours after a skin barrier stressor (tape-stripping), the recovery of good quality sleepers was 30% higher than poor quality sleepers (14% vs. -6%) demonstrating that they repair the damage more quickly.

Additionally, poor quality sleepers were significantly more likely to have a higher Body Mass Index (BMI). For example, 23 percent of good quality sleepers were obese compared to 44 percent of poor quality sleepers. Not surprisingly, self perception of attractiveness was significantly better in good quality sleepers (mean score of 21 on self evaluation) vs. poor quality sleepers (mean score of 18).

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Although exercise is known to improve sleep for people in general, studies in menopausal women haven’t been conclusive. That’s why the researchers at the Pittsburgh site of the Study of Women’s Health Across the Nation (SWAN) focused exclusively on women with hot flashes or night sweats and also drew the distinction between leisure time and household activity.

The 27 white and 25 African American women in the study, who were 54 to 63 years old, kept diaries rating their sleep and wore sleep monitors. They also completed questionnaires about their physical activity, including routine household and caregiving chores requiring light, moderate, or vigorous effort as well as sports and exercise.

The results showed that the women who had higher levels of activity reported better sleep and fewer nighttime awakenings. The positive effects were mainly associated with household and caregiving activity rather than sports or exercise.

But there were significant racial and body mass differences: The advantages were mainly in women who were white and not obese. More study needs to be done to find out why African American and obese women may not get the same sleep benefits, but it will likely be important to distinguish between leisure and non-leisure time activity to do so, said the authors.

Many medical problems hinder a woman’s ability to sleep well. Treating an underlying medical problem often will lead to improved sleep. These are some of the most common medical problems that affect the sleep of women:

•Acid reflux
•Arthritis
•Asthma
•Back pain
•Epilepsy
•Fibromyalgia
•Multiple sclerosis
•Parkinson’s disease

If you are experiencing any of these problems and feel like they are affecting your sleep, AASM encourages you to talk to your doctors about sleep problems or visit www.sleepeducation.com for a searchable directory of sleep centers.

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The study, published in the March issue of Occupational and Environmental Medicine, included 1,101 women with the most common form of advanced ovarian cancer, 389 women with borderline ovarian cancer and 1,832 women that were part of a healthy comparison group.

Among the women with advanced cancer, about one quarter had ever worked the night shift, compared with a third of the women with early-stage cancer and a fifth of the healthy comparison group.

Night shift work was associated with a 24 percent higher risk of advanced ovarian cancer and a 49 percent higher risk of early-stage ovarian cancer, the researchers found. However, the risk of cancer was 7 percent lower in women who described themselves as night types.

“We found evidence suggesting an association between shift work and ovarian cancer,” the researchers, led by Dr. Parveen Bhatti, an epidemiology researcher at the Fred Hutchinson Cancer Research Center, wrote in the study. “However, there was suggestive evidence of a decreased risk of ovarian cancer among women reporting a preference for activity during evenings rather than mornings.”

Approximately 22,000 women are diagnosed with ovarian cancer every year in the United States, according to the study, and over 15,000 of them will die from the disease. There are very few known risk factors, the researchers wrote in the study, which makes further research to better understand how shift work raises your risk crucial.

The researchers suggested that melatonin, a hormone that is typically produced at night and regulates reproductive hormones such as estrogen, may be to blame for the increased risk. Melatonin suppresses estrogen levels, but is not produced in the presence of ambient light, such as the kind shift workers would be exposed to, according to the study.

To learn more about shift work disorder and other common sleep disorders, visit www.sleepeducation.com.

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