Sleep, for Women
Editor's Note: This is the first article in CommPRO's new "wellness" series.
Felice Gersh, M.D.
Without adequate sleep, no systems within your body can function optimally, resulting in far more than a pervasive sense of significant fatigue. Lack of sleep causes problems with mood and concentration. It lowers fertility and immune function. It changes the way your metabolism works, increasing your risks for obesity, heart disease, and diabetes. Chronic lack of sleep even affects your skin, accelerating aging.
I have great sympathy for women struggling with sleep deprivation because for decades, that was my life. I spent the first 25 years of my OB/GYN practice doing thousands of deliveries, many at night. And then, around the time that I tapered off doing deliveries, I went through menopause and experienced hot flashes, night sweats, and reduced sleep quality. Through it all, I lived my life and accomplished many things, but it wasn’t easy; it wasn’t pleasant; and I know I paid a hefty price for those many hours of lost sleep.
My own experiences with sleeplessness piqued my medical curiosity. I have spent countless hours, many of them late at night, scouring medical journals to understand the biology of sleep, so I can help my patients and myself achieve the restorative sleep that every human body needs every night.
The sleep-wake cycle is part of a 24-hour human circadian rhythm that encompasses all of the daily rhythms of the human body. Virtually all systems and functions in the body are rhythmic, including the digestive system, the immune system, the nervous system, metabolism, and the reproductive system. Every hormone has a unique 24-hour rhythm, and together, these hormonal rhythms coordinate with all of the rhythms throughout the body. Proper sleep is a key regulator of this finely synchronized 24-hour dance.
Proper sleep means that you get the right amount of sleep during the right hours of the night.
Tip #1: Go to bed and get up at the same time every day, even on weekends.
Every adult woman needs between seven and eight hours of sleep every night. There is some personal variation, but statistically, any more or less is linked to increased risk of mortality. Additionally, you need to sleep during the same seven to eight-hour window every night. Ideally, you should go to bed between 10 PM and 11 PM and wake up between 6 AM and 7 AM.
So many people have a reasonably good sleep schedule during the week, and then when the weekend hits, they celebrate by staying up late and sleeping in. We call this “social jetlag.” As far as your body is concerned, this is the same as getting on a plane and flying across several time zones every weekend. Don’t do this, as every very day that you spend in such a jetlagged state increases insulin resistance, weight gain, and your risk of developing diabetes, while damaging your cardiovascular system.
Tip #2: Start your sleep routine in the morning with sunshine and exercise.
Sleeping and waking are two halves of the same cycle. The seeds for great sleep are planted in the morning. The sun regulates your internal clock, which lives in a part of your brain connected to your optic nerve that monitors sunshine. Every morning, you need 15 to 30 minutes of bright, unfiltered sunshine to set your internal clock. Go for a walk if you can, or at least eat breakfast in front of a bright, sunny window. Daytime exercise improves nighttime slumber, so aim for at least 30 minutes of movement per day. More is better, and higher intensity is better than mellow. But any movement is better than no movement.
Tip #3: Develop a relaxing night routine that starts two hours before bedtime.
Your body transitions slowly into sleep over the several hours before you actually lie down in bed. Just as you need bright light to wake up, you need dim light to wind down. So, in the evening, limit bright lights, especially screens that emit blue light. Stop eating, preferably by 7 PM, so your digestive tract can prepare for sleep. Do something physically and emotionally relaxing — take a hot bath, meditate, or do guided imagery.
I often recommend melatonin supplements to help your body transition into sleep mode when consistent difficulties exist. For most patients, I recommend 0.5mg of melatonin about two before bedtime and an additional 2mg extended release melatonin at bedtime. Never take more than 3mg per night without a doctor’s recommendation.
Tip #4: Make your bedroom a sanctuary for sleep.
Your bedroom should be a cool, dark, comfortable place for sleep. Your body needs almost absolute darkness to make melatonin, the sleep hormone, properly. If your bedroom isn’t dark, wear a sleep mask to prevent light from filtering through your eyelids. Keep a small fan next to your bed to provide gentle white noise and cooling relief if you get hot at night. I also recommend using a high-quality essential oils diffuser. Lavender, sweet orange, and bergamot are all great for sleep.
Tip #5: Treat sleep-limiting medical conditions.
Don’t let chronic medical conditions sabotage your sleep. Magnesium deficiency is extremely common and disturbs sleep, so I recommend that everyone take magnesium supplement. Sleep apnea is a very common sleep disorder. Snoring is often associated sleep apnea, but you can have sleep apnea even if you never snore. Discuss your risk factors with your healthcare provider to see if you should be tested. If you are in pain or otherwise uncomfortable, you won’t be able to sleep well, so work with your doctor to address GERD, anxiety, and chronic pain. Menopause also frequently causes disturbed sleep. I am a strong advocate for human-identical hormone replacement for most women entering menopause. Again, work with your doctor to discuss your specific needs and to get a prescription for the correct dosage.
Sleep is essential for your health, yet for something so natural and necessary, it certainly can feel challenging to get adequate quantities of restorative, luxurious sleep. My 5 tips for great sleep have helped me and my patients sleep well. I hope they help you get the sleep you need, so you wake up every morning feeling rejuvenated and ready for a new day.
About the Author: Felice Gersh, M.D. is a multi-award winning physician with dual board certifications in OB-GYN and Integrative Medicine. She is the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine. She taught obstetrics and gynecology at Keck USC School of Medicine for 12 years as an Assistant Clinical Professor, where she received the highly coveted Outstanding Volunteer Clinical Faculty Award. She now serves as an Affiliate Faculty Member at the Fellowship in Integrative Medicine, through the University of Arizona School of Medicine, where she lectures and regularly grades the case presentations written by the Fellowship students for their final exams. Felice Gersh, M.D. is the bestselling author of PCOS SOS and the PCOS SOS Fertility Fast Track. Notably, Dr. Gersh has articles published in prestigious medical journals, is a prolific lecturer, nationally and internationally, and has been featured in multiple films and documentary series, including The Real Skinny on Fat with Montel Williams and Fasting with Valter Longo, Ph.D..
