Not-so-sweet Dreams

Health and Wellness

by Greg Mauldin, M.D.

October 25, 2007

Sleep is a precious commodity. And most women would agree that quality is just as important as quantity in defining a good night's sleep. Studies by the National Sleep Foundation found that women are more likely than men to have difficulty falling asleep and that they experience more daytime sleepiness.

Unfortunately, few women understand the unique connection between a good night's sleep and their biological challenges. Menstrual cycles, pregnancy, hormonal changes, perimenopause and menopause all significantly affect whether or not a woman can look forward to a good night's sleep.

It's important that your doctor knows about the quality of your sleep to understand how hormonal changes may be affecting sleep patterns. For women older than 50, it's more likely that the cause is Obstructive Sleep Apnea (OSA), a serious condition that is estimated to affect one in four women older than 65.

Apnea, literally defined as "to cease breathing," is characterized by pauses in breathing during sleep. A troubling fact is that most women suffering from sleep apnea have no clue this is happening. The awakening is so slight, she simply falls back to sleep, causing this cycle to repeat 30 or more times per hour.

Sleep apnea occurs when the airway collapses during sleep due to extra tissue in the back of the throat, lack of proper muscle tone around the airway, nasal obstruction, or certain facial or jaw attributes.

More than just annoying OSA not only causes unsatisfying sleep but also can lead to serious health problems due to the lack of oxygen getting through to vital organs. It can put severe stress on the cardiovascular system, leading to the release of hormones that cause hardening of the arteries, which leads to serious health problems such as heart disease and stroke.

But OSA is easy to diagnose with the right tests, and treatment is extremely effective. If you suspect you may have a sleep disorder, talk to your primary care physician, who can refer you to have a sleep study.What about treatment?

The most common treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP). CPAP helps people with OSA breathe more easily during sleep by pushing a constant, gentle stream of air into the back of the throat, allowing the airway to stay open.

When CPAP is used at home every night during sleep, the majority of patients have instant improvement in sleep quality. And the majority of insurance plans cover both the sleep study as well as at-home treatment of OSA.

Five signs that you might have a sleep disord er

Snoring

Snoring is a leading symptom of sleep apnea. Why? Because the noise that comes from snoring means that air is having a hard time getting down into your lungs, the same scenario that leads to OSA.

Larger than normal neck size

A larger sized neck (17 inches or greater in a man, or 16 inches or greater in a woman) can cause the airway to be partially blocked. When more physical mass is in the neck area, it is more difficult for air to get through.

Obesity

Overweight people have more throat tissue to block the airway during sleep. A destructive cycle is also at work against obese patients – sleep apnea can disrupt rapid eye movement (REM) sleep, which increases the risk for obesity. More obesity equals more tissue to block the airway, worsening the risk of apnea.

Waking unrefreshed after sleep or daytime sleepiness

When your body struggles for air all night, you'll start waking up drained. Unrefreshing sleep is a symptom that needs to be investigated. Daytime sleepiness can cause lack of concentration, depression, irritability, and the risk of falling asleep while at work, on the phone or driving.

Gasping for air during sleep

If your sleep partner has told you that you stop breathing during sleep or sometimes gasp for air, it's time to see your physician.


Five secrets to a good sleep

• Avoid caffeine, nicotine and alcohol in the late afternoon and evening.
• Exercise regularly, but not at least three hours before bedtime.
• Don't nap during the day.
• Make your sleep environment pleasant, comfortable and quiet.
• If you can't go to sleep after 30 minutes, get up and involve yourself in a relaxing activity such as reading or listening to music.

Source: The National Sleep Foundation