Reader's Corner

EVEN WITH MY EYES SHUT, I know it's the middle of the night. What stirred me? Cramps? A dog's bark? That dream where I forget to attend a single class all year? It doesn't matter. I'm awake, and though one side of my brain keeps hitting the snooze button, the anxious, worry wart side has already pushed back the sheets, put on some coffee, and started rehashing a lifetime's worth of should-haves and what-ifs. Think relaxing thoughts, I tell myself. So of course my mind turns to the tantrum my eldest threw last night. Why did he get so angry? The bruises on his brother's leg – leukemia? How would I cope if something should happen to him? Now I remember work and the long list of calls I need to return, which makes me regret not being able to spend more time with the baby, which reminds me that it's my turn to get up with her, which means… I check the clock: 4:10. Which means I'll be a total wreck in the morning.

Would a man lie awake this way? Not my husband, not tonight. Though we share many stresses, he's not staring at the wall obsessing about them. He's snoring into his pillow. In master bedrooms across the earth, millions of couples are playing out the same scenario: him, sound asleep; her, fretting about whether she'll have enough energy to get through the day. Women are twice as likely as men to complain of sleep problems, specialists say. In a poll by the National Sleep Foundation in USA more than half of the female respondents said they'd repeatedly suffered insomnia symptoms in the previous month; 16 per cent said they got less than six hours of slumber per night during the workweek. Bedtime grows more stressful at midlife; as women reach their forties and fifties, the frequency of sleep trouble zooms up by as much as 40 per cent.

What's surprising isn't the discrepancy between women and men – surely it was Eve who stayed up agonizing over why Cain and Abel weren't getting along – but that for decades sleep experts didn't explore it. In the last few years, however, they've begun making up for lost time.

It turns out the same sex hormones that shape women's waking lives can mess with their slumber. Estrogen stimulates the brain. Progesterone, which tells the uterus to prepare for a fertilized egg, can be as sedating as sleeping pills. Starting in puberty, these hormones are in constant ebb and flow. When the relative balance changes (say, in pregnancy or during the menstrual cycle), sleep disturbances can result. Some researchers believe that the more quickly and sharply your hormone levels fall at the end of your cycle, the more you may toss and turn.

Women with premenstrual syndrome may be at particular risk. During sleep, their brain waves are different from those of women who don't have PMS, several small studies show. When researchers at the University of California at San Francisco compared two such groups, they found the premenstrually miserable got significantly less deep restorative sleep, not just before their periods, when progesterone plummets, but all month long. In another study, women with the most severe PMS were the drowsiest during the day. For some, PMS woes may actually be caused by the inability to sleep deeply enough. The symptoms of PMS are very much like those of sleep deprivation: irritability, fatigue, forgetfulness, difficulty concentrating.

The onset of menopause ushers in a whole new era of broken sleep, triggered chiefly by hot flashes. Sleep researchers at Wayne State University in Detroit suspect the culprit isn't just the discomfort of repeatedly being drenched in sweat but also norepinephrine, the substance that mobilizes the body to flee or fight in the face of danger. Women with hot flashes have much higher levels of circulating norepinephrine all the time – even when they sleep. In one study of menopausal sleep, non-flashers roused more than you might think – every 18 minutes. But women with hot flashes stirred every eight minutes. This restlessness could explain much of the emotional volatility associated with this time of life. If you wake a man every eight minutes, you might find he is a little moody during the day, too.

Then there's depression, which strikes twice as many women as men; it's associated with both sleeping too much and sleeping too little. During repose, scientists have discovered, the brain wave patterns of normal and depressed people tend to be distinct; in addition, some depressed women have more frequent spells of REM sleep, the phase where dreaming occurs, leaving them agitated in the morning. Other studies suggest that for many people, insomnia may be a cause of depression rather than (as long believed) a symptom.

The new research goes beyond biology, underscoring that for countless women what makes their nights wretched are their days. In a study of women aged 37 to 59, researchers found that many who complained of poor slumber had no objective disruptions, when monitored in a lab. But they scored higher than normal on tests of emotional distress. Classic midlife stresses, like divorce, demanding jobs, and aging parents, were to blame.

Women faced with such strains need every bit of stamina they can muster, making an inability to rest that much more debilitating. Fortunately, the new findings don't just explain why you're so tired. They point to solutions beyond the standard package of tried-and-tested truisms. The following genderwise strategies really work. Try them, and sleep tight.

Figure Out What's Normal For You

A lot of women think getting a good night's sleep means sacking out for eight hours of frolicking in dreamland until the alarm buzzes. That misconception may be their main problem because ‘normal' sleep comes in a very wide range. For example, it's normal to rouse every 90 minutes or so, four to five times a night, as you cycle through the sleep stages (from shallow to deep to REM sleep); such interruptions grow more frequent with age and, as long as you're getting back to sleep, they shouldn't worry you.

It's possible your body needs only a few hours of z's. (To find out, do a boring task; if you don't yawn, you're sleeping enough.) Likewise, consider your natural rhythms; some of us are born larks, some are owls.

Chart Your Sleep And Menstrual Cycles

That's the best way to figure out whether your sleep disturbance may be linked to hormones. (Try tracking them, even if you've never suffered from PMS. Bouts of fitful rest could also be a sign you're in perimenopause, the years when your production of sex hormones starts to taper off; it can begin as early as age 35.)

If it turns out monthly fluctuations are the culprit, relax. Get through it with the knowledge that it will only last a few days.

Pop A Different Pill

Women are 50 per cent more likely than men to seek out sleeping pills. But the better solution might be a drug that gets to the root of your restlessness. Oral contraceptives, for example, may smooth out the hormonal swings linked to PMS and perimenopause. Estrogen replacement therapy can tame hot flashes. Antidepressants and some antianxiety drugs can overcome insomnia linked to the blues. (On the other hand, the class of anti-depressants that includes Prozac, and Fludac can make women in particular more prone to insomnia. If you're on one of these and suspect it's keeping you up, ask your doctor about tinkering with the dose or switching to a new drug.)

As for sleeping pills, they should be taken only to prevent a sudden sleep disturbance from snowballing into a long-term problem. Some pills go to work quickly and are thus best suited to people who have trouble falling asleep; other kick in after several hours and are better for premature risers. Get the right kind from your doctor and you'll need it for only a few days or weeks. If your insomnia persists, resist the urge to simply ask for a refill; instead, visit a psychotherapist (a sleep specialist would be a better idea, but they are still an unknown species in India), whose prescription will probably include behavioural therapy.

Don't Let Insomnia Become A Habit

Sleep problems tend to take on a life of their own: A couple of fidgety nights soon launch you into panic at the prospect of a lifetime of them. And the more anxious you get, the more likely you are to develop habits that feed the cycle. Now studies show the breaking those patterns may be a sleepyhead's best medicine. Insomniacs aged 55 and older were taught healthy bedtime routines and given short-term therapy aimed at changing harmful attitudes (like the conviction that every daytime woe can be traced to a bad night). The result: Their slumber improved more than that of people treated with sleeping pills, placebos, or pills plus therapy, and two years later the majority were still snoozing soundly, while most of the volunteers in the other groups were back to counting sheep.

The best pointers? If you can't go to sleep right away, then don't go to bed. Trying to will yourself to sleep is stressful, and if you do finally nod off, your slumber is likely to be fragmented. Instead, get up and do some low-key activity like folding laundry (not watching TV) until you feel tried. Don't check the clock, even if that requires moving it out of sight. And no matter how rough your night, don't sleep late to compensate. Rising at your usual hour pressures your body to rest normally the next time you turn in.

Write Off Your Worries

Researchers recently discovered that some people with asthma or arthritis can ease their symptoms by keeping a journal about stressful events. It's a technique sleep therapists have used for years, one that works especially well for the kind of insomnia that often bedevils busy women.

Update your worry book every day – preferably long before bedtime. On one side of a page, record the anxieties that run through your head at night; on the other, list steps you've taken to quell them.

Move Down The Hall

Let's face it: The people who keep us up the most are the ones we love best. Chances are your biggest sleep buster is the buzz saw on the other side of your mattress. In a new study researchers at the University of Minnesota who listened in on chronic snorers discovered that 85 per cent topped 38 decibels, comparable to light highway traffic, and 12 per cent hit 55 decibels – some countries' legal limit for nighttime noise.

Snoring is often caused by apnea, a dangerous but treatable condition that's common in aging men. If your husband's a window rattler and earplugs don't block the racket, haul him to a doctor. Ditto if he's unusually squirmy at night; he could have restless leg syndrome (the name says it all). But if he refuses to go – or if treatment doesn't work – separate beds may be your only choice.

Of course, moving to the spare room can severely strain your relationship, and men often resist. You might try to enlist your doctor's support. Ask him to write a prescription saying that you need to sleep in bed by yourself.

Stop Robbing Yourself

Experts say women have an exhausting tendency to steal from their sleep time to do other things. Sometimes they feel they have no choice; they're working a second shift at home or facing a major deadline at the office. Sometimes they're pursuing a private passion. Frequently, women simply have no other time alone to relax. The pattern starts early: Studies have found that teenage girls wake well before boys do – up to 30 minutes earlier.

Obviously, many women think the trade- off is worthwhile, but sleep specialists disagree. They're convinced inadequate shut-eye contributes to problems from colds to car accidents, poor memory to low spirits. Plus, constant fatigue makes you less efficient; so, to finish tasks, you may pare your snooze time further.

One solution is to combine your quiet time with an activity that promotes respose, like going for a walk at lunch or taking a bath after dinner. But in most cases you'll have to decide: Is cutting into my slumber really worth the cost?

Before you conclude it is, take this a tip. On your next vacation, pay attention to how much you sleep – and how great it feels to have all the rest you need.