Women’s Sleep Habits Linked to Mood

When mom doesn’t get enough sleep, the whole family suffers. In women, there’s a definite connection between sleep and mood. Worry, stress and anxiety can interfere with sleep, and sleep problems can increase depression and anxiety symptoms. According to a 2007 National Sleep Foundation study on women’s sleep habits, the relationship between sleep and mood is bi-directional. More than half of the women surveyed in the NSF poll said they had felt unhappy, sad or depressed in the past month, and one-third (36%) had felt hopeless about the future. Most reported problems sleeping, and 40% had been diagnosed with a sleep disorder.

Biology affects a woman’s sleep habits. The NSF study analyzed sleep patterns at each stage of a woman’s life:

• Menstruation. Menstruating women slept longest, averaging 7 hours, 32 minutes of shut-eye; however, 67% reported insomnia several nights a week. One-third experienced sleep problems during their cycle.
• Pregnancy. Women got more sleep during pregnancy than at any other time — approximately 8 hours, 14 minutes per night — although 84% complained of insomnia several nights a week and 30% said they never got a good night’s sleep.
• Post Partum. Women slept least — an average 7 hours, 46 minutes — after childbirth. Nearly half (47%) reported never getting a good night’s sleep, and 84% experienced chronic insomnia, 90% related to child care. Two in every 10 women experienced post partum blues or depression.
• Perimenopausal. During menopausal transition, women got the least amount of sleep (7 hours, 12 minutes). More than half (59%) reported insomnia a few nights each week; and 43% experienced a sleep disorder, hot flashes or night sweats that interfered with sleep.
• Postmenopausal. Postmenopausal women slept an average 7 hours, 19 minutes but had the highest incidence of sleep disorders (50%) and insomnia (61%). Forty-one percent used a sleep aid several nights a week.

Because of the link between sleep and mood, psychiatric treatment that addresses both issues through cognitive-behavioral therapy and psychodynamic therapy can be most effective. A board-certified psychiatrist like Dr. Tracey Marks with considerable experience treating sleep disorders can help you find workable and lasting solutions to sleep better and enjoy life more.

Why Women Have Trouble Sleeping

Less than half of American women get a good night’s sleep on a regular basis with stay-at-home moms least likely to enjoy adequate pillow time. According to a 2007 National Sleep Foundation (NSF) poll quizzing women about their sleep habits, 67% of American women experience frequent trouble sleeping and 43% report that daytime tiredness interferes with their normal daily activities. More likely to experience sleep problems than men, women said lack of sleep permeated every aspect of their lives, blaming inadequate sleep for everything from high stress levels to being late for work to being too tired for sex.

Women of all ages reported experiencing sleep problems which the poll found changed and increased in severity as women moved through the various biological stages of life. Lifestyle also played a role in sleep experience and daytime alertness. Stay-at-home moms, 74% of whom reported experiencing insomnia at least a few nights each week, exhibited the highest level of overall sleep problems. Fifty-nine percent of stay-at-home moms said they regularly woke up feeling unrefreshed. Working mothers (72%) and single working women (68%) also experienced periodic insomnia that affected job performance.

The majority of women polled seemed to accept chronic tiredness as a normal state for women. Eighty percent of women said they just kept going if they became sleepy during the day, 65% using caffeinated beverages to boost their alertness. Despite chronic tiredness, the NSF poll found that women didn’t head for bed sooner when they could. In the hour before they went to bed, instead of turning in early, 87% watched television, 60% finished household chores, 37% interacted with their children or family, 36% were on the Internet, and 21% were engaged in job-related activities.

“Women of all ages are burning the candle at both ends and as a result they are sleepless and stressed out,” said Richard Gelula, NSF chief executive officer in a NSF press release announcing poll results. “Poor sleep impacts every aspect of a woman’s life, as well as her health.”

“Women who spend less than seven hours in bed at night are more likely to doze off during the day, report symptoms of depression, drive drowsy and use coping mechanisms just to make it through their day,” said NSF task force member Dr. Kathryn Lee, professor of family health care nursing at the University of California, San Francisco.

Friday: How women’s sleep patterns change with age

More Sleep Can Improve ADHD Symptoms

A common behavior disorder that affects 8% to 10% of U.S. school-aged children, ADHD – attention deficit hyperactivity disorder — has been linked to children’s failure to get enough sleep. In a new study (see our April 29 post), researchers at the University of Helsinki in Finland found that children who typically received less than 7.7 hours of sleep per night were significantly more likely to develop ADHD than children who slept longer. The study is the first to pinpoint length of sleep alone as a source of behavioral symptoms.

Interestingly, the study found that parents regularly over-reported the amount of sleep their children received compared to objectively measured results, suggesting both that most parents are unaware of their children’s actual wake-sleep cycles or that a “social desirability bias” promotes over-reporting. Despite such discrepancies, study results clearly found a direct, measurable, causal link between short sleep cycles and increased symptoms of ADHD.

“Even though we hypothesized that sleep duration would affect behavioral symptoms, we were somewhat surprised that the effect was so very, very clear,” principal researcher Dr. E. Juulia Paavonen told Medscape Psychiatry in an April 28, 2009, online article about the study.

The study found the lowest risk of developing ADHD symptoms among children who regularly received an average night’s sleep characterized by at least 7.7 to 9.4 hours of uninterrupted sleep per night. Parents who are able to help their children establish and maintain adequate sleep cycles of 8 to 10 hours of uninterrupted sleep per night may be able to significantly reduce their children’s risk of developing ADHD. In children who already exhibit symptoms of the disorder, maintaining adequate sleep patterns may help to control and/or alleviate symptoms, researchers believe. In an independent European study, lengthening children’s sleep cycles by just 30 minutes per night was found to significantly improve cognitive and attention behavior with observable improvement exhibited in less than one week.

Here are some things parents can do to help their children get the sleep they need:

• Establish a regular bedtime.
• Decrease activity about 30 minutes before bedtime.
• Ban TVs, video games and other over-stimulating activities from the bedroom.
• The bedroom should be comfortable — well ventilated and slightly cool with a nightlight.
• Establish a soothing bedtime routine — bath, brushing teeth, toileting, story time, prayers.

ADHD Linked to Lack of Sleep in Kids

Lack of sleep in children increases their risk of developing attention deficit hyperactivity disorder (ADHD), according to new research published in the April 27, 2009 online edition of Pediatrics. In a study of 7- and 8-year-olds conducted by researchers at the University of Helsinki in Finland, children who received less than 7.7 hours of sleep per night were at significantly increased risk of developing hyperactive/inattentive disorders compared to children who slept longer. The Finish study is the first to identify length of sleep alone as a source of behavioral difficulties.

“There is a large amount of literature linking sleeping difficulties to behavioral symptoms,” principal researcher E. Juulia Paavonen, M.D., Ph.D. told Medscape Psychiatry in an April 28, 2009, online article about the study. “However, this study shows short sleep duration itself is related to behavioral symptoms, independent of sleeping difficulties.”

The study provides a potential key for the treatment of rising attention and cognitive performance issues among U.S. children. As many as one-third of American children do not receive an adequate amount of sleep.  While previous studies have indicated a probable link between sleep disorders, such as sleep apnea, and the behavioral symptoms associated with ADHD, none of those studies included behavioral assessments. The Finish study is the first to specifically assess the effects of sleep length on behavioral issues in children and show a definite causal effect between lack of sleep and decreased attention span and cognitive performance.

The study evaluated the sleep habits and duration of 280 boys and girls with a mean age of 8.1 years. Assisted by the children’s parents, sleep journals logged when children went to bed, woke up and were allowed to leave their beds over seven-day intervals. Problems such as illness that could affect sleep quality were also recorded. Hyperactivity, impulsivity and inattention symptoms were evaluated using the maternal ratings from the ADHD Rating Scale. Socioeconomic status, parental education and other demographic data were also considered. The majority of the test group (80.7%) were categorized as average sleepers, getting 7.7 to 9.4 hours of sleep per night. Short sleepers (9.3%) received less than 7.7 hours of sleep, while long sleepers (10%) got more than 9.4 hours of sleep.

Next time: Study recommendations: What parents can do.

Night Owls Stay More Alert Longer

Each person has an internal biological clock that determines his own personal sleep/wake cycle. Called circadian rhythm, your individual 24-hour clock determines whether you’re an early riser or a night owl (see our April 24 post). Interestingly, new research conducted by researchers in Brussels, Belgium indicates that people who wake later in the morning, 9 a.m. as opposed to 5 or 6 a.m., remain more alert for longer periods during the day, even if they turn in early.

In tests comparing the sleep cycles of early birds and night owls, MRI brain scans were taken to measure brain activity at different times throughout the day and night. Night owls were slower than early risers to exhibit sleep pressure (the urge to sleep) as the day progressed, remaining alert for one to two hours longer per day than early risers. Eventually though, the study found that night owls paid a price for their late hours. Out of synch with society’s daily schedule (children, school, job schedules, etc.), night owls tended to rack up a sleep deficit as the week progressed, requiring additional sleep on the weekends to recover.

Similar studies in the U.S. have shown that teenagers who typically prefer staying up late and sleeping in might do better in school if the school day started later and went longer. Some school districts are considering switching high school schedules to accommodate teenage circadian rhythms. In recent trials, starting high school classes at 9 a.m. and ending at 5 p.m. to 6 p.m. resulted in more alert students and improved academic performance.

While the exact role of sleep is still under debate, director of the Belgium study, Philippe Peigneux, professor of clinical neuropsychology at the Free University of Brussels explained in an article posted to The Why? Files website that researchers are convinced that an activity at which you spend fully one-third to one-quarter of your life — sleep — must have multiple functions critical to the health of mind and body. “When you fall asleep, you are not conscious of the external world, but sleep helps restore your ability to be alert the next day. Sleep is believed to be important for thermal regulation and memory consolidation, and many other functions,” he said. Continuing research will determine what other roles sleep plays in good health.

Night Owls vs. Early Birds: Who Sleeps Best?

Some people are night owls, others rise with the birds. Each person moves to his own circadian rhythm; his internal biological clock determining when he’s most alert and when he can’t keep his eyes open. While nurses, night watchmen, third shift workers and others who work at night can learn to retune their body clocks, it’s difficult to go against Mother Nature. A new study shows that while the early bird may get the worm, early risers get sleepier faster as they move through the day than people who get up later in the morning.

“The circadian signal is low in the morning, and increases during the day, helping to counteract the accumulation of sleep pressure,” explained Philippe Peigneux, professor of clinical neuropsychology at the Free University of Brussels in Belgium in an article posted to The Why? Files website. “At the end of the day, you have a lot of sleep pressure, and because the circadian signal starts diminishing at that time, eventually sleep can take place.”

While circadian rhythm is unique to each individual, it follows a basic 24-hour pattern of wakefulness and sleep that sets the individual’s body clock. Signals from the suprachiasmatic nucleus of the brain controlling the rise and fall of body temperature, immune activity, and signal wakefulness and sleep. The new study measured the balance between sleep pressure, the body’s need to sleep, and the body’s alerting signal that triggers wakefulness in two groups of people with natural circadian rhythms at opposite ends of the sleep spectrum: early birds and night owls. Overseen by Peigneux, the study was conducted by Ph.D. student Christina Schmidt of the University of Liege. Schmidt tracked test subjects in a sleep lab for two nights, periodically scanning brain wave activity to measure sleep pressure and alertness.

The study found that when we awaken both sleep pressure and the body’s alerting signal are low. From the point of wakefulness, both brain signals increase gradually throughout the day, reaching a peak about 15 hours later when the alert signal quickly falls off, allowing the body to become drowsy. At the same time, sleep pressure peaks, becoming greatest just prior to and during the first two hours of sleep before tapering off dramatically 8 to 10 hours later. While study results indicated that both early birds and night owls experienced similar quantities and quality of sleep, early birds exhibited more slow brain waves throughout the day, indicating a greater need for sleep than night owls.

More on Monday

Is Lack of Sleep Making Us Crazy?

“Economic insomnia” is one more complication of America’s financial meltdown, and psychiatric experts warn that it could be making us crazy. People are losing sleep worrying about job loss, foreclosure and bankruptcy. The longer the recession continues, the greater the chance that the financial boogeyman will creep out of the closet and steal away our ability to provide basic necessities for our families. Nearly everyone knows someone who has lost their job to economic demons, and most of us have had to make lifestyle changes. Worry is making for a lot of restless nights. Researchers warn that lack 0f sleep increases the risk of depression and other serious psychiatric conditions.

“When you are tired, when you’re worn out, then everything becomes more of a challenge for you,” Dr. Adam Moscovitch, medical director of the Canadian Sleep Institute in Toronto, told Calgary Herald reporter Sharon Kirkey in an April 12, 2009 online article. ”Your confidence is affected, your ability to trust yourself. So there is a higher likelihood you’ll be ruminating about, are you doing things right? It significantly affects, from the psychologic standpoint, the [risk] of mental illness developing.”

Researchers have proven that lack of sleep has a negative impact on physical and mental health. People who get six hours of sleep or less per night increase their risk of high blood pressure, heart attack and stroke. Chronic sleeplessness weakens the immune system, causes changes in appetite, interferes with sexual interest, decreases the ability to concentrate, and negatively affects function and judgment. Growing evidence indicates that not getting enough sleep can also trigger mental illness, particularly depression, anxiety and mood disorders.

In a 20-year study of 591 young adults published in 2008 in the journal Sleep, Dr. Daniel Buysse of the University of Pittsburgh found that insomnia lasting two weeks or longer often triggered depression. The link between sleep and mental health appears to reside in the amygdala, the brain area that governs emotions. Harvard Medical School and the University of California-Berkeley researchers found that sleeplessness stimulates the amygdala, causing increased brain activity associated with depression, anxiety and other mental illnesses. 

Because of the risk to mental and physical health, chronic insomnia that persists for weeks or months at a time should never be ignored. If worry is regularly interfering with your sleep, talk to your health professional today.

Sleep Habits that Promote Good Health

A good night’s sleep is just as important to good health as healthy eating and regular exercise. Doctors recommend 7 to 8 hours of uninterrupted sleep for adults and up to 10 to 12 hours for children and teens. While most people experience trouble sleeping from time to time, chronic sleep loss can have a negative effect on physical and mental health and is reason to consult your physician. Developing good sleep habits can help combat those occasional sleepless nights and ensure that you wake up refreshed and energized.

To insure that you get a good night’s sleep, National Sleep Foundation experts recommend practicing the following healthy sleep habits:

• Use your bed and bedroom exclusively for sleep and sex so that you associate getting into bed with going to sleep.
• Follow a regular bedtime routine to prepare your body and mind for sleep. Bedtime routines allow time to separate daily stresses from sleep time. Establishing a regular pattern of events that lead to sleep — brushing teeth, washing face, soaking in a hot bath, putting on lotion, reading in bed, listening to soothing music, etc. — cues your body and mind to relax and prepare for sleep.
• Set a regular time for going to bed and getting up and stick to it. Repetition will train your body and mind to a healthy sleep/wake cycle.
• Do not eat or drink within 3 to 4 hours of bedtime. Avoid stimulants like tea, coffee, nicotine and alcohol. You want your body to be concentrating on sleep, not digestion.
• Exercise regularly but not within six hours of bedtime. Exercise is energizing and your body will need time to relax.
• Invest in a comfortable mattress and pillows. Mattresses wear out after about 10 years. To ensure a comfortable and restful sleep, a mattress should be firm enough to properly support your body. If you wake up achy or your mattress sags, it’s time to buy a new one. 
• Create a sleep-promoting environment. Most people sleep best in dark, cool rooms; so close the blinds and turn the thermostat down a few degrees at night.
• Avoid disturbing noises. If you live in a noisy neighborhood, close the windows at night. A bedside fan or white-noise machine creates a steady, soothing sound that blocks noise and helps many people sleep comfortably.

« Previous Page — Next Page »