Sleep and the Midlife Woman

Sleep and Menopause

A recent poll by the National Sleep Foundation bears out what you have probably long suspected: The highest incidence of sleep disorders is found in postmenopausal women. Shelby Harris, PsyD, a cognitive behavior therapist at the Sleep-Wake Disorders Center at Montefiore Medical Center, in New York, finds similar results in her practice. The patients with insomnia and other sleep disorders are about 50 percent midlife women for whom perimenopause and menopause, and their related hormonal changes, have triggered sleep trouble.

"We do see at the clinic an increasing number of women approaching or entering menopause who have insomnia and other disorders," says Michael J. Thorpy, MD, director of the Montefiore center.

As women get older, hormonal shifts lead to an increase in sleep problems, says Carol Ash, medical director of Sleep for Life at the Somerset Medical Center in Hillsborough, New Jersey. According to Ash, the hormone progesterone helps protect younger women from breathing disorders such as sleep apnea and snoring, which often occur in men. As female hormones decrease through perimenopause and menopause, women become more susceptible to these typically male sleep disorders, says Joyce Walsleben, PhD, a sleep expert at the New York University Medical Center.

Inadequate sleep does age us, by depriving our bodies of oxygen, elevating our blood pressure, and increasing our levels of stress hormones. And getting unsatisfying sleep is unhealthy in many other ways too. It weakens the immune system and increases the risk of high blood pressure and heart disease.

So given all this -- and the fact that for most people, peak performance depends on eight hours of sleep -- there should be plenty of support for correcting the problem, right? Well, unfortunately there isn't. "It's foolish, but we view people sleeping as being unmotivated or lazy," Walsleben says.

Ash compares the image of sleep deprivation with that of smoking years ago. "Back then, it was cool to smoke," she says. "Now we recognize that it's not at all cool; it's risky. We're beginning to understand that about insufficient sleep."

Any way you look at it, lack of sleep is a problem that must be addressed. Easier said than done though. Because the problem is complex, it can be hard to pin down its causes and, therefore, a cure. A few suggestions follow. We also take you inside the Sleep-Wake Disorders Center to find out more about what's keeping us up.

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