Why Missing Sleep Is Worse for Women Than Men

But a problem like sleep apnea — a common and potentially dangerous sleep disorder where a person’s breathing stops and starts many times overnight — can have dire cardiovascular consequences, causing heart rate and blood pressure to elevate. Although it’s most common in overweight men, sleep specialists emphasize that the disorder affects women, too, and people of all sizes and shapes.

For persistent sleep issues, it’s important to see a health professional who can help.

“Starting with a primary care physician [PCP] is good, but I don’t want patients to jump [right] to medications,” says Safia Khan, M.D., a sleep medicine specialist and program director of the Sleep Medicine Fellowship Program at UT Southwestern in Dallas, who coedited A Clinical Casebook of Sleep Disorders in Women. “If that’s what their PCP is offering, then they should request referral to a sleep specialist.”

Khan says PCPs are perfectly capable of assessing patients’ sleep problems. The issue is typically one of time: If a patient has multiple conditions they’re seeing the doctor for, it’s unlikely the doctor is going to have enough time to dig deep into evaluating why they can’t sleep. Khan suggests that patients schedule an appointment specifically to see their doctor about sleep issues – so there’s time to do more than prescribe a sleep aid, and they can deeply evaluate the causes of sleep woes.

Solutions to help women sleep better

Treatments for sleep problems are as varied as the issues, or disorders, themselves. But for specific symptoms related to menopause or hormonal changes, some women turn to hormone replacement therapy (HRT).

“There have been studies showing improvement with sleep and other vasomotor symptoms (like night sweats) with hormone replacement therapy,” Soltis says. “That being said, some studies have shown hormone replacement therapy to be associated with an increased risk of heart disease, stroke, certain cancers and blood clots.”

Ultimately, Soltis says, the decision to pursue HRT has to be made on an individual basis with your doctor. When having that conversation, it’s important to assess the potential risks versus benefits of HRT, which, she notes, may vary based on age, duration of treatment and other medical conditions.

If hot flashes are disturbing your sleep, there are some strategies that help, such as limiting alcohol, caffeine and spicy foods. Also, the FDA approved a new pill this year, Veozah, to treat hot flashes, so talk to your doctor about whether this new medication may help. 

For more intractable and deeper cultural or societal issues, such as women often taking on a greater share of caregiving, experts say help from others — family, friends, medical professionals and support groups — is key. Sharing caregiving responsibilities is critical to support the health and sleep of caregivers as well as those they’re supporting.

Soltis stresses that every situation is different and needs to be approached accordingly. For example, for more complicated situations, such as a spouse with dementia or other serious health concerns, part of the solution could involve having outside caregivers come into the home to take shifts overnight, she says, so the partner can get much-needed rest.

How to choose a sleep specialist

If you are thinking about seeing a specialist, just know that there’s no cookie-cutter sleep doctor. Rather: With sleep medicine, physicians may come from all different backgrounds, Soltis says. A sleep medicine provider could be a neurologist, like Soltis, or a pulmonologist, anesthesiologist, family doctor or have a background in behavioral health, psychology or psychiatry.

If a person has chronic obstructive pulmonary disorder (COPD) or other significant breathing issues that affect sleep, a pulmonologist may be a good fit. If you are having abnormal behaviors like kicking, punching or acting out dreams at night, or have an issue that you think might be restless leg syndrome or narcolepsy? Maybe a neurologist is a good choice. Longstanding history of anxiety or depression that’s hard to control? A sleep psychiatrist might be the right professional for you.

Sara Nowakowski, an associate professor at Baylor College of Medicine in Houston who has studied the impact of sleep issues on women’s health and a licensed clinical psychologist board-certified in behavioral sleep medicine, says many people aren’t even aware that sleep professionals like her exist. She helps people make behavior changes, like recommending that patients get out of bed when they can’t sleep and creating a sleep schedule – and employs cognitive behavioral therapy for insomnia.

Nowakowski notes that around half – or more – of all postmenopausal women report sleep issues. “But it doesn’t mean it has to be that way,” she says.

Getting help can turn sleep troubles around.

But if you’re still not sure where to start, besides a recommendation from your primary care doctor, Soltis points out that many doctors have online bios detailing their areas of interest and conditions they see frequently.

Improving your sleep hygiene

Even the most inspired sleuthing to get to the root cause of your sleep woes with help from a professional can’t overcome bad sleep habits. You still have to prioritize getting rest.

That includes making time for sleep – but not too much. Don’t sleep less than six hours or more than 10. If you can’t fall asleep, do your best to not stress or worry about it, which could make the problem get worse. Get out of bed, do something calming like reading, then go back to bed when your eyes get heavy.

Also, ensure your bedroom is conducive to sleep by keeping it cool and dark. Dim lights before bedtime – and give your smartphone the side-eye. 

“Phones are a huge distraction,” Khan reminds. Get an old-fashioned alarm clock if it’s disrupting your sleep and you’re scrolling your feed every time you should be dozing off. She says she often asks her patients about their screen time.

She recommends starting your cellphone diet by breaking away from that screen during the day and doing more physical activity. Both time away from the cellphone and being more active during the day can help you ease into a more restful night.

Because ultimately what happens in the middle of the night will follow you around for the rest of the day – if not the rest your life.

“Disrupted sleep affects us in a lot of different ways, and affects a lot of different body systems,” Soltis says, reiterating just how important it is for overall health.