The Well-Rested Woman: 60 Soothing Suggestions for Getting a Good Night's Sleep - Softcover

Kinosian, Janet

Softcover

ISBN 10: 1573248134 ISBN 13: 9781573248136

Publisher: Conari Press, 2002

Synopsis

Written by former insomniac and longtime journalist Janet Kinosian, who cured herself by using these methods, The Well-Rested Woman offers sixty inventive ways to help any woman get a good night's sleep. Change your sleep by incorporating better habits into your daily life, such as:

• Attuning your circadian rhythms
• Uncovering your chronic sleep positions
• Writing a sleep biography
• Crying at night if you want to
• Making friends with your nightmares
• Using Feng Shui to bring on sleep

Filled with inspiring quotes and lists of sleep-promoting herbs and vitamins, The Well-Rested Woman is every woman's ultimate companion to a lifetime of rejuvenating, restful good nights.

About this title

About the Author

Janet Kinosian is an award-winning journalist who has written for The Los Angeles Times, People, and Reader's Digest, among many other established magazines and newspapers. She has an M.A. in counseling psychology and lives and sleeps in Southern California.

Excerpt. © Reprinted by permission. All rights reserved.

The Well-Rested Woman

60 Soothing Suggestions for Getting a Good Night's Sleep

By Janet Kinosian

Red Wheel/Weiser, LLC

Copyright © 2002 Janet Kinosian
All rights reserved.

ISBN: 978-1-57324-813-6

Contents

Preface
CHAPTER 1 WHAT IS SLEEP? ORDER AND DISORDER
CHAPTER 2 WOMEN AND SLEEP: SPECIAL ISSUES
CHAPTER 3 CREATING THE RIGHT ENVIRONMENT
CHAPTER 4 DE-STRESSING THE MIND
CHAPTER 5 FINE-TUNING THE BODY
CHAPTER 6 SOOTHING THE SOUL
CHAPTER 7 SLEEP HAZARDS
CHAPTER 8 IF YOU NEED MORE HELP
Acknowledgments & Thanks
Resources
About the Author

CHAPTER 1

WHAT IS SLEEP?ORDER AND DISORDER

If sleep does not secure anabsolutely vital function, then it is thebiggest mistake the evolutionaryprocess ever made.

—Dr. Allan Rechtschaffen,University of Chicago

It's no secret that women today are in dire need of some restful nights. Modernlife seems to conspire in subtle and not so subtle ways to lop off precioushours of sleep from many women's lives. You may wonder, Am I getting enoughsleep? Probably not, if you work, run a household, go to school full time,supervise your family's lives, or simply make time just for yourself among theschedules you're juggling.

Even if you do think you're getting the amount of sleep you should, you maywonder why you feel so tired and un-refreshed much of the time. This is notsurprising. More than half of the women surveyed in a recent National SleepFoundation Women and Sleep Poll reported insomnia symptoms sometime during everymonth. Various studies and polls indicate that nearly 30 million American womenclaim they long every day for a good night's sleep.

And despite what we sometimes think, a good night's sleep isn't a rare andexotic experience that occurs on high mountain tops and then only for thoselucky enough to find it. Good sleep is an innate biological need—a need the bodymakes sure it fulfills, even with only a few healthy sleep habits.

In evolutionary terms, it was only minutes ago that science took notice of whathappens when someone closes their eyes. Before the 1950s—when medicine firststarted unraveling the sleeping brain's mysteries—sleep was seen as aphysiological, unmysterious, and natural daily happening, a true nonevent (itwas only in 1996 that the American Medical Association recognized sleep medicineas a secondary specialty). Until the early '90s, women were often excluded fromsleep studies because it was believed that their hormones would skew data. Sowomen don't have a strong scientific history of help with sleep difficulties:health-care providers, medical information, and general self-help books didn'taddress the problem.

Much of this is changing, thankfully, and sleep researchers are beginning tostudy female sleep patterns and how they change over the course of a woman'slife. Factors such as hormones, age, fertility, work, children, health, andlifestyle all affect your sleep, as do physical syndromes such as depression andpain, which affect women more than men. As the studies continue, you can lookforward to more solid information on what's going on inside your body as yousleep, and how best to take advantage of the hours you do sleep.

The good news: A woman's sleep structure is fundamentally the same as a man's,but women have some distinct advantages. First, we experience more slow-wave ordeep sleep, also called stage 3 and 4 sleep, throughout our lives. Slow-wavedeep sleep is the most restorative sleep level. In addition, our sleep systemsage more slowly than do men's: while the amount of male slow-wave sleepdiminishes after age twenty, female deep sleep has a slower decline, beginningafter age thirty.

So if you hold the evolutionary gene for more restorative, deep sleep, why thendo you not feel more deeply restored when you awake in the morning? If youguessed that modern lifestyle plays a role, that's a good guess. No longer is"Early to bed and early to rise" a guarantee of being well rested. To help findthat good rest, take a brief look at what sleep is and what physical purpose itserves, what sleep disorders are and how you can deal with them.

WHY DO WE SLEEP?

Sleep research specialists still don't know exactly why we sleep, and medicinehas not yet given us a central reason or function for it, though a variety ofintriguing theories about sleep exist. We sleep to restore, rest, and repairvital physiological functions; to help activate the immune system; to programinformation and memory. One theory holds that sleep evolved as a means to removeour distant ancestors from harm and keep them safe during the dark hours ofnight.

Just how many hours of sleep do you need? Many people believe the traditionaleight to be the most healthful number, yet most researchers claim this is myth.They believe you need only the number of sleep hours that make you feelconsistently refreshed in the morning and fully alert during the day: if thatnumber is five, then that's your physiological preference. You alone decide howmuch sleep your body needs. That nightly amount of needed sleep remainsamazingly constant over a lifetime.

Whatever the biological reasons for sleep, we spend approximately a third of ourlives in this state. For the average seventy-five-year-old, that means abouttwenty-three years of life spent sleeping.

THE STRUCTURE OF SLEEP

To understand sleep difficulties and disorders, it's important to understandsleep's two main stages: non-rapid eye movement sleep (NREM) and rapid eyemovement sleep (REM) sleep.

NREM SLEEP

Non-rapid eye movement sleep is a four-stage cycle:

Stage 1 is the drowsy, relaxed, intermediary stage between waking and sleep. Youare, in fact, half-awake, half-asleep, and your waking beta brain waves modulateto slower alpha and theta waves. Your body becomes more relaxed, but you're veryeasily awakened from this stage.

After several minutes in stage 1, you enter stage 2 sleep. Your brain wavestravel more slowly, intermittently mixing with what sleep researchers call"sleep spindles"; your breathing and heart rate stabilize, your muscles relax.Researchers use the first onset of a sleep spindle in an EEG(electroencephalogram) to mark the actual onset of sleep. It's still easy toawaken from this stage.

Stage 3 sleep produces slower theta waves and even slower delta waves. Yourbreathing slows, your heart rate slows more, and muscles become extremelyrelaxed. Most people reach this stage within 30 minutes after falling asleep. Inthis sleep stage the body releases growth hormone and regenerates, restores, andrepairs organs and tissues. If awakened, you'll feel quite groggy.

Slow delta waves dominate stage 4 sleep, the deepest sleep stage. This is thestage of sleep you must enter in order to feel rejuvenated and well rested. It'svery difficult to awaken someone from this stage of sleep; if you are awakened,you'll feel groggy, even disoriented. Stage 4 is reached about an hour afterfalling asleep, and it's by far the most important sleep stage.

REM Sleep

After the 90 minutes or so it takes to cycle through all four stages, you enterrapid eye movement sleep, a dream state that recurs every 70-90 minutes,lengthening throughout the night. Nearly 80 percent of dreams occur during REMsleep; your eyes dart back and forth as if you were watching a dream videoscreen, yet your body is incapable of muscular activity, so you can't act outyour dreams. Meanwhile, heart and respiratory rates may speed up, and rapidbrain waves, similar to those of a near-awake brain, occur.

After your first REM period, you awaken for a second or two—though you probablynever notice it—and then cycle back through stages 2, 3, and 4 again, beforeentering another REM phase. Most deep stage 3 and 4 sleep occurs during theearly part of the night; the REM periods lengthen so that your final one, justbefore you awaken, can last between 30 minutes and 1 hour. A good sleeper cyclesthrough four to six of these cycles. It's quite normal to awaken briefly for afew seconds as you shift from stage to stage; most sleepers don't recall wakingup.

WHAT ARE SLEEP DISORDERS?

It's no surprise that sleep disorders are common, what with all the intricatephysical interactions necessary for a good night's sleep. What is surprising ishow many disorders have already been cataloged—about seventy-five—yet millionsof women still shrug off sleepless nights as simple insomnia. That's only partlytrue. Sleep troubles have many names and symptoms, and many possible solutions.

And while there are effective treatments for many of these sleep disorders, it'sa safe bet that neither you nor your health-care provider knows the targetsymptoms for your particular disorder. Studies routinely indicate that only 3-5percent of all people with sleep problems ask their doctors for help. And sincesleep medicine is not currently taught in medical school, you're probably onyour own when it comes to recognizing your symptoms and learning about your ownsleep disorder.

As I'm not a trained sleep specialist, the following information on sleepdisorders is culled from numerous interviews and topical resources, many ofwhich are also available to you (see Resources).

TYPES OF SLEEP DISORDERS

Sleep disorders are grouped into two main categories: dyssomnia and parasomnias.Dyssomnia is characterized by the inability either to fall asleep or to stayasleep, followed by excessive daytime drowsiness. Disorders of this type includeinsomnia, obstructive sleep apnea, restless legs syndrome, periodic limbmovement disorder, narcolepsy, and advanced and delayed sleep phase syndromes.Parasomnias (discussed in later chapters) are characterized by abnormalities insleep behavior, such as night eating syndrome, night terror, sleepwalking,recurrent nightmares, sleep paralysis, bruxism (teeth grinding), and sleeptalking.

INSOMNIA

Insomnia is the most common sleep disorder. You might suffer from one or anycombination of insomnia's three classic types:

1. Sleep-onset insomnia: You have trouble falling asleep; it generally takes youmore than 20 or 30 minutes to fall asleep.

2. Early morning-awakening insomnia: You awaken early in the morning long beforeyou intended and are unable to get back to sleep.

3. Sleep-maintenance insomnia: You can't stay asleep during the night and have oneor more awakenings, with trouble falling back to sleep.

OBSTRUCTIVE SLEEP APNEA

Another common sleep disorder for women, especially as we age, is obstructivesleep apnea. In fact, physicians often miss this diagnosis, since obstructivesleep apnea is more often associated with obese males. It occurs when airflow tothe lungs is briefly blocked, most often in the throat, in repeated episodes ofgasping, sometimes up to hundreds of times a night. Snoring, which does increasefor aging women, is not an apnea indicator; key is the snorting sound made whengasping for air.

Symptoms of obstructive sleep apnea include excessive daytime sleepiness, wakingup unrefreshed and with frequent headaches, and a dry, parched mouth. Sleepapnea factors are obesity, the use of nicotine and alcohol, use of sedatingmedications, hypothyroidism, sleeping on one's back, and excessive airwaytissue.

If you suspect you have sleep apnea, treatments are available and include asmall air pump, or CPAP, that sends you continuous positive airway pressureduring sleep. Sleep apnea is serious and can affect your cardiovascular system,so treatment is important. Speak with your doctor about a possible sleep clinicreferral, as a firm diagnosis is made only with an all-night monitoring.

RLS AND PLMD

Millions of women experience restless legs syndrome (RLS) and its companiondisorder periodic limb movement disorder (PLMD), which center in the lowerlimbs. Almost all women with RLS will have PLMD as well. With restless legssyndrome, you experience odd sensations deep within the leg muscles and knees,described as creepy-crawly, buglike sensations and/or deep itching within theleg muscles—creating forceful urges to move. RLS symptoms often get worse towardevening, preventing restful sleep. There's an urgency to get up and walk off thepainful and peculiar sensations. Treatments range from hot baths, massage, andbiking and stretching exercises to strict caffeine avoidance, and vitamin andmineral supplements such as iron, folic acid, calcium, and vitamin B-12 shots.Pain or tranquilizing medications are often prescribed to help blunt the brain'salerting response to the limb activity.

Periodic limb movement disorder consists of limb spasms that can occur up tohundreds of times a night. The telltale signs of PLMD are crumpled bedcovers atthe foot of the bed, kicking and jerking during sleep, and excessive daytimesleepiness. Sleep-onset insomnia is common, as the limb movements continuouslypull you out of stage 1 and 2 sleep. Treatment is with sedating medications.

NARCOLEPSY

Millions of women also suffer from narcolepsy, a long-term central nervoussystem disorder that produces an uncontrollable need to sleep during wakinghours. Its three primary symptoms include (1) excessive, persistent daytimesleepiness and periodically falling asleep during normal waking hours (sleepattacks); (2) episodes of intense muscle weakness, collapsing in a faintlikespell (cataplexy); and (3) REM-phase sleep that occurs throughout the day andnight (hypnogogic hallucinations). These symptoms, however, are often masked byother sleep disorders, such as sleep apnea and restless legs syndrome, asexcessive daytime sleepiness is blamed. Treatments include stimulant medicationsalong with short 20-minute naps, once in the morning and again in the afternoon.(The immediate descent into REM sleep at bedtime is narcolepsy's telltale sign,diagnosed at a sleep clinic.)

Although numerous other sleep disorders have been identified, it's beyond thesepages to illuminate them all. Check Resources at the back of the book forinformation, contact numbers, and places to start your personal research.

SEE A DOCTOR

If you are experiencing sleep troubles—whether a recent onset or chronicinsomnia (persisting for more than several weeks)—the first thing to do is setup an appointment and speak with your physician. This is the best line of actionand the smart thing to do.

But since much of Western, allopathic medicine seems to treat sleep difficultiesas a kind of troublesome prerequisite for daily modern life, you need to beprepared and adamant about what you want: to get to the bottom of your sleepstruggles. Remember that lack of sleep is not an illness but rather a symptom,like a fever.

Most likely your general practitioner has received no more than 1 or 2 hours oflecture time on this critical health issue. Until medicine catches up andprimary care physicians routinely become skilled at diagnosing sleep disorders,your role as a well-informed patient is vital.

You want to rule out any medical causes for your sleep problems. Your doctorwill shine here. Chemical imbalances, hormone problems, medications, and a hostof medical disorders— some of which include asthma, arthritis, migraines,fibromyalgia, thyroid issues, heart disease, and diabetes—have poor sleep as asymptom. Pregnancy and menopause, though not illnesses, also affect women'ssleep/wake patterns. Your doctor can help you sort through all of this.

Since sleep is often affected by medications, your doctor should know about anyprescription medications and also over-the-counter remedies you take. Let herknow about your supplements, diet regime, and your sleep hygiene habits (forexample, whether you nap or eat late, drink caffeine or alcohol), and how andwhen you think your sleep problems appeared. Don't make your physician do allthe detective work; you do it before you get there, and then work together.

Lack of sleep can have either a physical or a psychological cause, or somecombination of the two. Once you and your physician feel confident that aphysical illness and/or medication isn't the culprit, you may be referred to asleep specialist—an M.D. with advanced training in sleep medicine—who monitorsfor sleep disorders such as sleep apnea, restless legs syndrome, periodic limbmovement disorder, and so on, all of which are treatable to some degree.

Be open and honest about your emotional temperature and lifestyle, as well. Areyou under chronic stress? Have you been a lifelong worrywart? Are youexperiencing relationship struggles? Do have a history of eating disorder oraddiction problems? Is there abuse in your background? Are you a workaholic?Have you suffered a major loss recently? Are you going through a divorce orexperiencing some other major life stressor? Are you depressed, frustrated, orunhappy with your life?

Listen carefully to how your doctor responds to you. Does he validate yourexperiences and delve further, or does she minimize your experience and do allthe talking? Be clear in stating what you want: You need help in regaining youroptimal sleep patterns; can he help? If the only response is to take out aprescription pad and offer you sleeping pills, know that this is a temporarysolution that will only mask symptoms and can cause more sleep difficulties thanyou have now. Discuss this concern with your doctor. Then decide what's next onyour search-and-find sleep mission, knowing you'll find your way.

(Continues...)

Excerpted from The Well-Rested Woman by Janet Kinosian. Copyright © 2002 Janet Kinosian. Excerpted by permission of Red Wheel/Weiser, LLC.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Edition details

• Publisher: Conari Press
• Publication date: 2002
• Language: English
• ISBN 10: 1573248134
• ISBN 13: 9781573248136
• Binding: Paperback
• Number of pages: 268