2023-09-22 07:09:33
by Cristina Marrone
Sexual hormones can interfere with night rest from puberty until after menopause, but other factors (biological, psychological, social) also come into play
Difficulty falling asleep or staying asleep is common, especially as you age. And for women the complications can be even greater. These problems can begin during puberty and persist throughout adulthood. Various factors come into play: biological, psychological, social. What is behind sleep-related difficulties in women? During the first years of the menstrual cycle, hormonal changes can cause mood changes (anxiety and depression), physical symptoms (cramps, swelling and breast tenderness) that can interrupt or disturb sleep.
The role of hormones
The hormonal aspect is certainly among the most important – underlines Carlotta Mutti, neurologist at the Sleep Medicine Center at Parma hospital – because sexual hormones, estrogen and progesterone for women and testosterone for men, have widespread receptors at a cerebral level and are able to directly influence sleep architecture. Estrogen, which peaks in the first phase of the menstrual cycle, promotes increased REM sleep. Conversely, progesterone, a hormone that dominates the post-ovulation phase in women, and which remains at very high concentrations during pregnancy, enhances deep sleep and reduces REM sleep. Hormonal fluctuations therefore affect women’s night’s rest, which are practically absent in men, where the concentration of testosterone is much more stable.
The brain of mothers
Despite the protective aspect of progesterone on sleep, during pregnancy disturbances in night rest can be triggered due to nausea, the frequent need to urinate even at night (90% of women in the third trimester are affected), the greater risk of gastroesophageal reflux, fetal movements that can generate micro-awakenings. Once you give birth, the typical sleep interruptions due to caring for the newborn take over.
Symptoms
Hormones come back into play during the years leading up to menopause. Up to 80% of women start having hot flashes in premenopause, and they can last for years. For approximately 20% of women, hot flashes are so frequent and intense that they interrupt sleep. Post-menopausal women are also at increased risk of obstructive sleep apnea and this can also lead to frequent nocturnal awakenings and greater daytime sleepiness. The symptoms may be, among other things, different than in men, who generally snore intensely, wake up with a headache and dry mouth and experience daytime drowsiness. In women the signals are more subtle and may appear insomnia, states of anxiety, nightmares, reports Carlotta Mutti. It is true that sleep apnea is more frequent in menopausal women, but obesity and polycystic ovary are two risk factors that can cause the disorder to arise in earlier periods. Finally, some diseases that interfere with sleep are more typically female. Insomnia affects women more, who often also suffer from restless legs syndrome and nocturnal myoclonus, two conditions also linked to iron deficiency, to which women are subject due to their menstrual cycle, concludes the expert.
Cognitive behavioral therapy
According to international guidelines, cognitive behavioral therapy is the primary treatment for insomnia. This is a psychological support that aims to correct incorrect behavior and reformulate negative thought patterns that undermine night’s rest. The chronicity of bad behaviors leads to the perpetuation of insomnia – says Carlotta Mutti – and it has been proven that targeted psychological support works to break the vicious circle. However behavioral therapy is not supported by the National Health Service. Not everyone can afford psychological support which can require months of therapy. We neurologists give general advice on sleep hygiene, but if it is not enough we often have to resort to drugs. We therefore hope that the treatment can fall within the essential levels of assistance.
September 22, 2023 (modified September 22, 2023 | 07:09)
© ALL RIGHTS RESERVED
#women #sleep #worse #men #lives #time.news