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Women have busy schedules as they balance work and family responsibilities. In addition, many women now find themselves in the "sandwich generation," caring for young children as well as their aging parents. Those factors combined with economic stressors put a large burden on women today. One of the first things to fall by the wayside during a period of stress is sleep. However, sleep is one of the most important aspects of the daily routine that should not be compromised.

"Women should be aware that they cannot take care of anyone else if they are not taking care of themselves first," says Claudia Heina, a board-certified nurse practitioner with The Center for Sleep Medicine, a partnership of Blount Memorial Hospital and East Tennessee Medical Group. Lack of sleep, or poor quality sleep, leads to daytime tiredness, irritability, difficulty controlling various medical problems including diabetes and blood pressure, weight gain and psychological problems like depression and anxiety, Heina points out. "A woman's symptoms really determine when or if she should seek medical advice," Heina says. "Some sleep disorders, such as obstructive sleep apnea, can have severe health consequences if left untreated."

Long-term effects of poor sleep include an increased risk for heart attacks, strokes, decreased immune functioning, disruption of personal relationships and increased risk of motor vehicle accidents. Heina suggests a woman seek medical advice if the problem is causing her anxiety or causing significant disruption to her daytime functioning.

The type of sleep disorder a woman is diagnosed with will determine what steps need to be taken next. "For some disorders like sleep apnea, the recommendation may be CPAP (continuous positive air pressure), special mouth appliances or even weight loss," says Heina. Many women complain that the CPAP masks are too large or that the head straps are rough on their hair. There now is a mask available just for women. "The mask has an adjustable strap and includes a smaller frame with soft wraps to prevent facial imprints," Heina notes.

Sleep changes and an increase in certain sleep disorders may occur during specific times in a woman's life. Heina points out this is particularly true during menopause and pregnancy. "Research shows that a woman's total nocturnal sleep time decreases during the first trimester of pregnancy, stabilizes during the second trimester and again decreases during the third trimester." Women in the third trimester of pregnancy awaken on average three to five times per night, Heina says. Likewise, during menopause, hormonal changes can lead to increased problems with insomnia, in particular, if a woman is dealing with hot flashes at night. Heina points out menopausal women also are at an increased risk for obstructive sleep apnea. "This increased risk may occur due to redistribution of fat in the abdominal and neck areas as hormonal changes take place," she says. Menopausal women should be aware of the symptoms of sleep apnea and discuss any symptoms with their health care provider.

Proper sleep leads to an overall improvement in mental health as well as improvement of physical health. Sleeping well can improve concentration, memory, the ability to cope with stress, and allows women to multi-task more easily.

For information on sleep disorders or CPAP equipment, call The Center for Sleep Medicine at 380-4021.

The Women's Health column is provided by the staff and associates of Blount Memorial Hospital. Call 983-7211.