We spend a third of our lives in bed, but we continue to underestimate the importance of living this moment in a healthy way. Sleep has an enormous impact on the quantity and quality of our well-being, health and lifespan. Unfortunately, however in many cases it is disturbed by a thousand environmental stresses, the call of the offspring and the demands of care or occupational stress. Women’s sleep is more fragile than that of men because of their innate multitasking. Insomnia is also a disease that often declines to the female, the sister of anxiety and cousin of depression. While a healthy woman in her youth, in the first part of her reproductive cycle, presents fewer biological risks of organic sleep disorders, such as nocturnal apnea or movement disorders in sleep, this changes in particular periods of life such as pregnancy or menopause. Female hormones significantly influence the continuity and efficiency of night sleep, its ability to refresh and protect against cardio-cerebrovascular diseases, as well as cognitive decline.
We talked about it with Dr. Vincenzo Tullo, neurologist and specialist in sleep medicine and headaches at Humanitas.
Sleep disorders during pregnancy
During pregnancy, the restorative power of sleep is threatened by weight gain, snoring, apnoa of the pregnant woman with the possible development of hypertension, conditions that expose to pre-term and assisted childbirth, with detrimental consequences on maternal-fetal well-being. Another pathology in pregnancy often responsible for maternal insomnia is that of the “restless legs”, linked to the lack of iron and other neurotrophic factors proper to this phase and that impacts so much not only the continuity of maternal sleep, but also the maternal-fetal well-being, inducing cardiovascular alterations that are as many risk factors in gestation. This difficult period is followed by puerperium, with the typical humoral alterations of new mothers and a lack of rest due to the new solicitations of the offspring that can lead to what Anglophones call “maternity blues” (third day syndrome or post-partum depression), if not to puerperal psychosis with the known risks for themselves and their offspring.
The effects of menopausal hormones
Menopause is also another period of biological vulnerability, in which the sudden fall of reproductive hormones changes the distribution of body weight and gives women a biological risk of respiratory disorder similar to that of men.
Some of the most important Italian experts in sleep diseases have focused their studies on the different pathologies of sleep in menopause and their repercussions on emotionality and mood, cognitive ability, psychophysical well-being, cardio and cerebrovascular risk and, once again, on the appearance and maintenance of “restless legs” with the hypertensive risk and psychiatric comorbidity connected to it. The different reports of the experts have been collected and reviewed in a single work that has been published in the well-known international scientific journal Maturitas and presented in Rome during the last National Conference Italy Sleep 2019. What emerged was that in menopause, the estimate of depression associated with chronic insomnia is higher than 80%, while that of insomnia associated with vasomotor symptoms (flushing) is 70%, OSA (morphic apnea) is around 3%, with an increase in the risk of hypertension of 40%. The percentage of RLS (restless legs syndrome) in menopause is between 15-20%, while the epidemiological data for all women is less than 4%.
