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Reminder Assistant Editor LONGMEADOW An audience made up of pierced college freshman through white-haired grandmothers gathered last Wednesday evening in Breck Suite inside Wright Hall at Bay Path College to listen to Dr. Asim Roy, of Baystate Neurology, speak on the topic of sleep disorders unique to women. "Why Can't I Sleep?" was a fast-paced hour-long lecture covering everything from what is considered normal sleep to how pregnancy affects sleep patterns to how to cope with insomnia, the most prevalent sleep issue for women. Roy explained all the medical terms associated with the study of sleep, including rapid eye movement (REM) sleep, the circadian cycle and the ultradian rhythm. REM sleep is a kind of sleep that occurs at intervals during the night and is characterized by rapid eye movements, more dreaming and bodily movement, and faster pulse and breathing. The circadian cycle is a normal 24-hour period -- every human has a sleep/wake cycle that lasts a bit longer than 24 hours, according to Roy. How do we offset the imbalance? "Bright lights," Roy said. "Sunlight is very potent." The ultradian rhythm, however, usually lasts between 90 and 110 minutes during sleep, alternating between REM and non-REM sleep. These rhythms and cycles change as we age, however, according to Roy. "Transitional, or lighter, sleep becomes more frequent as we get older," he explained. The amount of sleep also decreases with age. The cycles also lead to bouts of sleepiness during specific times in the day, like the early morning and around 2 p.m. "Some people call it the post-lunch coma, but it's actually just your body's normal rhythm," Roy stated. To figure out if one is getting enough sleep, Roy explained how to determine sleep efficiency: divide the total time asleep by the total time in bed. In lab tests, an ideal percentage of sleep efficiency is about 85 percent, but Roy said at home it should be between 90 and 95 percent. The Hormone Factor Most research on sleep and sleep disorders so far has been done on men, Roy said. That is why there hasn't been too much research into how female hormones affect the sleep of women. Estrogen has been found to affect REM sleep, while progesterone can affect non-REM sleep. Roy's presentation showed there was also a wide variation of sleep issues concerning menstrual cycles. Approximately 15 percent of all women are more sensitive to sleep issues during the end of their cycles. A disorder known as menstruation-linked periodic insomnia starts affecting some women six to 10 days before their menses starts. "There are tons of changes that occur during pregnancy, especially physically," Roy commented. He explained that during the first trimester, there is a large increase in progesterone that results in more daytime sleepiness. The second trimester is considered the best time during pregnancy from a sleep standpoint. The third trimester, however, brings about the most physical changes and a reported 97 percent of women fail to sleep through the night. "A lack of sleep could lead to premature labor," Roy said. Hormones affect sleep as women go through menopause as well, according to Roy. Many women receive less than six hours of sleep a night during this time and have more difficulty falling asleep. The Insomnia Issue A 1998 National Sleep Foundation (NSF) poll found that 74 percent of women got less than eight hours of sleep a night, and 53 percent reported either often or always experiencing insomnia. "Insomnia is a broad category," Roy stated. "It's difficulty falling asleep, frequent night awakenings or having non-restorative sleep." He explained how predisposing, precipitating and perpetuating factors can all lead to insomnia. Predisposing factors include certain medications, other medical conditions, environmental influences like shift work, etc. Precipitating factors are things that accumulate, like acute stress and perpetuating factors include excessive time in bed, an irregular schedule, napping, caffeine, alcohol, drugs or anxiety. Roy explained the common form of insomnia for women is learned or behavorial insomnia. Some people say they get better sleep at a hotel or a relative's home because they're in a different environment, he said. Sometimes an insomniac can trick his or her mind into thinking the bedroom is a new environment by rearranging the layout of the room for better or easier sleep. Another NSF study found 60 percent of working women have difficulty falling asleep and 40 percent of full-time female workers get less than 6.5 hours of sleep a night. A prolonged period of sleep deprivation like this can lead to infertility, miscarriages and low birth weights, especially for shift workers. Sleep Treatments The first step to fixing sleep disorders is to treat their underlying causes, Roy said. Patients can do this with sedatives, bright light phototherapy or behavorial management, which can be tough for "night owl" college students. "People don't want to take the time to change their behavior," Roy said. He offered some tips on how women of all ages can receive better sleep: no caffeine and no exercise for three to four hours before bed, use the bed for sleep and sex only, go to bed only when sleepy, avoid naps and set reasonable goals. "If you've been getting five hours of sleep for years, then aiming for nine hours of sleep is not going to happen," Roy said. Drugs such as Ambien, Lunesta and Sonata are all short term treatments, according to Roy, and a recent study estimated nearly $780 million are spent annually on alcohol for sleep induction only. He said alcohol seems to help initially but causes more problems the longer it is used. The Study of Sleep Continues "There are a lot of issues with women and sleep but there's a lot of work to be done," Roy concluded. Jill Wigglesworth, a freshman at Bay Path, attended the lecture for extra credit for her psychology class. "I learned some new things," she said. "I learned depression and bipolar disorders can affect sleep more than I thought they did." Senior Sue Hooja commented she learned a lot from the lecture as well, saying she will definitely use some of the information during her internship. "Essentially, the goal of the presentation is to educate women about the sleep disorders that affect them," Roy told Reminder Publications. "It's about exposing them to the information and encouraging them to talk to their doctors about the issues." Roy visited Bay Path as part of the college's Kaleidoscope series, a semester-long series of events that fosters openness, curiosity and dialogue about issues and topics in the community, country and world. For more information on the series, visit www.baypath.edu. |
