How to Get Better Sleep for Women’s Health

Sometimes, it’s easier to take your supplements or hit the gym than it is to dial in your sleep. Yet, if you aren’t sleeping well, it’s working against your weight loss, hormone balance, and other health goals.

But how do you prioritize sleep when life is busy and stressful? This article will take a deep dive into everything you need to know about sleep, including integrative strategies for improving sleep hygiene and quality.

Keep reading to learn more about:

• Sleep stages and timing
• Why sleep is critical for a healthy body and hormones
• Sleep strategies from an integrative medicine perspective, including mindset shifts, supplements, and more

Let’s get started!

Sleep Basics – Quantity and Quality

Human sleep habits align with the 24-hour day. The inputs of light and dark influence our hormones, setting the circadian rhythm. Cortisol spikes in the morning in response to sunlight, making us feel awake and alert. As cortisol declines later in the day, sunset and darkness promote a rise in melatonin, making us feel drowsy and ready for bed.

The amount of sleep you need depends on your life phase, genetics, and normal day-to-day variations. Adults need 7 to 9 hours of sleep per night, older adults need 7 to 8 hours, and infants, children, and teens need more.

The average sleep duration in the U.S. was 7.4 hours in 1985; by 2004 it was 7.18 hours, with over 28% of people getting less than 6 hours of sleep. Data from 2014 suggests more than one-third of adults fail to reach the minimum 7 hours per night. The decline in time spent sleeping may have to do with technology, social pressures, work productivity goals, and more.

Sleep quantity is only one part of the equation; sleep quality is also essential. Ideally, you want to cycle through the four stages of sleep 4 to 6 times per night, with each sleep cycle around 90 minutes.

The sleep phases are:

• Stage 1 - Non-rapid eye movement (NREM) N1 – light sleep
• Stage 2-  NREM N2 – deeper sleep
• Stage 3 - NREM N3 – deepest sleep
• Rapid eye movement (REM)

You spend most of your sleep time in Stage 2 sleep, where memories are formed. Deep sleep is critical for the body’s growth and repair of tissues, immune strengthening, and building of bone and muscle. REM sleep is associated with dreaming and increases with each sleep cycle.

Sleep and Chronic Disease, Weight, and Hormonal Health

Sleep is critical for detoxification, repair, and an overall well-functioning body. When you have a poor night of sleep, it’s easy to see how it affects your mood, energy, hunger, productivity, focus, and other aspects of how you feel and function.

Poor sleep is associated with:

• Increased accidents
• Increased inflammation
• Increased risk for chronic diseases, including heart disease, type 2 diabetes, and dementia
• Increased all-cause mortality
• Weight gain

In a small study of healthy reproductive-age women, lower sleep duration was associated with increased energy intake (i.e., eating more calories) and weight and fat gain. The day following only 4 hours of sleep, they ate an average of 415 more calories!

Another small study found a single night of partial sleep deprivation (4 hours of sleep) increased insulin resistance, where cells lose sensitivity to insulin signals. Over time, insulin resistance leads to metabolic syndrome, obesity, and diabetes.

Interestingly, women in the luteal phase of their menstrual cycle and perimenopause also have increased insulin resistance, making sleep (and blood sugar balance) even more critical.

Loss of ovarian hormones in perimenopause and menopause can cause sleep disturbance, as estrogen and progesterone play key roles in the circadian rhythm and sleep modulation. Increased cortisol levels from stress and poor sleep also impact weight, sleep, and various symptoms. In practice, I often see changes in hormonal patterns contributing to sleep issues.

Integrative Sleep Approaches

The goal with sleep is to get enough, high-quality sleep so you wake up refreshed and function well during the day. You want energy for movement, cooking, and the rest of your daily health habits. And then, you want to feel tired in the evening, falling asleep easily and staying asleep throughout the night. If you wake up, which is common at the end of a complete sleep cycle, it should be easy to fall back asleep.

Here are some ideas for supporting sleep from an integrative perspective:

1. Prioritize sleep – The first step is understanding why sleep is essential for your health and well-being. Making sleep a priority will improve everything in your life, from your hormone health and metabolism to how patient you are with your kids. Adopt the mindset of protecting your sleep and saying no to things that negatively impact it.

2. Adopt good sleep hygiene habits – Sleep hygiene refers to all the daily behaviors that impact sleep. Beneficial sleep hygiene includes:

2. 1. Exposure to natural sunlight early in the day
   2. Daily exercise and movement
   3. Limiting caffeine to the morning hours
   4. Reducing or eliminating alcohol
   5. Eating well-balanced meals at regular times
   6. Letting your digestion rest for 2-3 hours before bed
   7. Dimming the lights in the evening
   8. Limiting use of screens before bed
   9. Establishing a relaxing bedtime routine that includes reading, journaling, stretching, bathing, meditation, a gratitude practice, etc.
   10. Setting a phone/email/social media curfew and sticking to it
   11. Going to bed at a consistent time each night
   12. Making your bedroom cool, dark, and comfortable

3. Consider herbs and supplements. Understanding the root cause of your sleep issues can help you dial in a supportive lifestyle and supplement plan to help you fall asleep, and TārāMD can help.

Supplements to consider include:

• Nervine and adaptogenic herbs for nervous system and stress support – passionflower, lemon balm, chamomile, lavender, oat seed, skullcap, ashwagandha, rhodiola, holy basil, and valerian root. (Note: these work great in a bedtime herbal tea)

• Other sleep support supplements may include melatonin, GABA, phosphatidyl serine, glycine, taurine, magnesium, CBD, and l-theanine.

Always discuss new supplements and herbs with your healthcare provider, especially if you take any medication or have a medical condition, to ensure safety. At TārāMD, we only recommend quality, practitioner brand supplements personalized for each patient. Read more here.

4. Support hormonal health – Sex hormones, adrenal hormones, thyroid hormones, and others play a role in healthy sleep. Restoring balance can help improve sleep and overall health. Testing hormones to uncover your unique patterns and develop a personalized treatment approach is important. In our practice, we offer integrated solutions that include nutrition and lifestyle changes, bioidentical hormone replacement therapy, and medications to improve hormonal balance and sleep.

If you have difficulty falling asleep, wake in the middle of the night with a ruminating mind, or can’t remember the last time you felt refreshed in the morning, we can get to the bottom of your sleep challenges and help you catch your ZZZs. Better sleep means better health, metabolism, weight, and disease prevention. Before you go one more night, schedule an appointment so we can help.

References

1. Shi, G., Wu, D., Ptáček, L. J., & Fu, Y. H. (2017). Human genetics and sleep behavior.Current opinion in neurobiology, 44, 43–49.
2. Kohyama J. (2021). Which Is More Important for Health: Sleep Quantity or Sleep Quality?.Children (Basel, Switzerland), 8(7), 542.
3. Liu, Y., Wheaton, A. G., Chapman, D. P., Cunningham, T. J., Lu, H., & Croft, J. B. (2016). Prevalence of Healthy Sleep Duration among Adults--United States, 2014. Morbidity and mortality weekly report, 65(6), 137–141.
4. Patel AK, Reddy V, Shumway KR, et al. Physiology, Sleep Stages. [Updated 2022 Sep 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
5. Mullington, J. M., Simpson, N. S., Meier-Ewert, H. K., & Haack, M. (2010). Sleep loss and inflammation.Best practice & research. Clinical endocrinology & metabolism, 24(5), 775–784.
6. Lee, S., Mu, C. X., Wallace, M. L., Andel, R., Almeida, D. M., Buxton, O. M., & Patel, S. R. (2022). Sleep health composites are associated with the risk of heart disease across sex and race.Scientific reports, 12(1), 2023.
7. Cappuccio, F. P., D'Elia, L., Strazzullo, P., & Miller, M. A. (2010). Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis.Diabetes care, 33(2), 414–420.
8. Irwin, M. R., & Vitiello, M. V. (2019). Implications of sleep disturbance and inflammation for Alzheimer's disease dementia.The Lancet. Neurology, 18(3), 296–306.
9. Papatriantafyllou, E., Efthymiou, D., Zoumbaneas, E., Popescu, C. A., & Vassilopoulou, E. (2022). Sleep Deprivation: Effects on Weight Loss and Weight Loss Maintenance.Nutrients, 14(8), 1549.
10. Bosy-Westphal, A., Hinrichs, S., Jauch-Chara, K., Hitze, B., Later, W., Wilms, B., Settler, U., Peters, A., Kiosz, D., & Muller, M. J. (2008). Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women.Obesity facts, 1(5), 266–273.
11. Donga, E., van Dijk, M., van Dijk, J. G., Biermasz, N. R., Lammers, G. J., van Kralingen, K. W., Corssmit, E. P., & Romijn, J. A. (2010). A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects.The Journal of clinical endocrinology and metabolism, 95(6), 2963–2968.
12. Antza, C., Kostopoulos, G., Mostafa, S., Nirantharakumar, K., & Tahrani, A. (2021). The links between sleep duration, obesity and type 2 diabetes mellitus.The Journal of endocrinology, 252(2), 125–141.
13. Gervais, N. J., Mong, J. A., & Lacreuse, A. (2017). Ovarian hormones, sleep and cognition across the adult female lifespan: An integrated perspective.Frontiers in neuroendocrinology, 47, 134–153.