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CHAPTER 10: Women’s Sleep Throughout the Lifespan Introduction • Sleep is essential for health and well-being. • Consequences of acute and chronic sleep deprivation can be severe, ranging from impaired daytime functioning to compromised physical and emotional health. Introduction • Sleep Primer – REM and non-REM sleep alternate throughout the night. – Average sleep cycle lasts between 90 and 110 minutes. – Average sleep need for adults is about 8 hours per night. Sleep and the Menstrual Cycle • Subjective and Objective Sleep Changes – Sleep disruption may coincide with menstrual cycles. • PMS, Premenstrual Dysphoric Disorder (PMDD), Dysmenorrhea – Sleep disruption and lower sleep quality have been associated with these conditions. Sleep and the Menstrual Cycle • Treatments to Alleviate Premenstrual Sleep Disturbance: – NSAIDs or antidepressants – Napping (<30 minutes) – Evening bright light therapy – Partial and total sleep deprivation • Oral Contraceptives (OCs) and Sleep – Sleep architecture of women taking OCs appears to differ from that of naturally ovulating women. Sleep During Pregnancy and Postpartum • Sleep disturbances during pregnancy can be due to: – Changes in hormones – Physical symptoms (nausea, backaches, increased frequency of urination) – Breathing difficulty, shortness of breath – Leg cramps, restless leg syndrome Sleep During Pregnancy and Postpartum • Sleep disturbances during postpartum period can be due to: – Hormonal fluctuations – Infant care – Breastfeeding – Bed-sharing Sleep During Pregnancy and Postpartum • Sleep Strategies for Expecting and New Mothers – Medication (but be aware of harmful side effects) – Prolonging hospital stay – Attempting to sleep when baby sleeps – Mindfulness approaches – Dietary recommendations – Continuous positive airway pressure (CPAP) therapy for women with sleep apnea Sleep and Menopause • Insomnia is one of the foremost complaints of peri- and postmenopausal women. • Important factors to consider: – Hormonal changes – Hot flashes – Role of cognitions – Circadian changes Mood and Sleep • Depressed mood and psychological distress are significant predictors of sleep disturbance. Sleep and Aging • Several factors may predispose aging women to sleep disorders: – Sleep architecture and circadian rhythms – Sleep disorders and their correlates – Polypharmacy Sleep Challenges • Shift work • Chronic insomnia • Obstructive sleep apnea Future Directions • Future research should address the independent contributions of circadian, hormonal, and psychosocial factors and their interaction. • Socioeconmic status (SES), employment status, and racial and ethnic identity have been relatively unexplored. • Translational research is needed to determine efficient ways to disseminate sleep knowledge across diverse populations of women.