Do you have insomnia?

Insomnia is when you go to bed at a reasonable hour but just can’t nod off because your mind is racing. If you do fall asleep, you wake up after a while and spend the next few hours obsessively watching clock. Perhaps you manage to get five hours of sleep but wake up short of the recommended seven to eight that most of us need. You may even get a full seven hours but wake up feeling like you haven’t slept at all. When this occurs three times a week and goes on for months, you have chronic insomnia.

Insomnia affects one third of Americans but is far more common in women. There are a number of reasons why being a woman sets you up for difficulty sleeping. One factor is that insomnia and depression often go hand-in hand, and more women struggle with depression. It’s a chicken-and-egg situation: Chronic insomnia can lead to depression, but depression can cause insomnia.

Hormones play a part, too. Women who have a tendency to suffer from premenstrual syndrome sometimes don’t sleep from one to three nights during their cycle. Later in life, insomnia peaks for many women around perimenopause, when night sweats keep them tossing and burning all night.

Then there’s motherhood. During pregnancy, especially the third trimester, it’s often more difficult for a woman to sleep. She can’t find a comfortable position and may also be feeling stressed about all of the upcoming changes that are about to happen. After birth, most new moms aren’t getting much sleep because they’re up around the clock with their baby. Some are able to fall back into their old sleep patterns as soon as their baby is sleeping through the night, but others do not. So many patients who say their insomnia developed when they were new mothers and they never recovered.

When to see a doctor

We all suffer from occasional sleepless nights, but how do we know when it’s time to seek professional help? When you can’t function during the day, consult your primary doctor (who in turn might refer you to a sleep specialist) if you’re sleepy to the point that you’re unable to do your job, if the family suffers because you’re stressed or irritable, or if you feel depressed.

Feeling excessively sleepy during the day can also be an indication of sleep apnea. This is a disorder in which you stop breathing multiple times at night. Obstructive sleep apnea occurs when your throat closes up. This can happen because you have a large tongue, soft palate, or uvula (a lobe at the back of your soft palate); if you neck size is larger than 27 inches around; or if you have a deviated nasal septum. Any of these can cause a narrowing of your airway. When your airway is obstructed, you can’t breathe, and when you make an effort to do so, you wake up. Many people don’t even know they have sleep apnea. You might have to rely on your partner to tell you if your snore up a storm, make strange noises, quit breathing, or kick your legs.

Restless leg syndrome can be associated with sleep apnea in some people. But the disorder, typified by unpleasant sensations in the legs and an uncontrollable urge to move them, is sometimes connected with iron deficiency. Menstruating women can have low iron levels. Get a simple blood test, and if it’s low, you can take a supplement.

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