A good night's sleep is as easy as slipping under the covers and closing your eyes — right? If only. More than half of American women say they sleep well only a few nights a week, reports a National Sleep Foundation survey.
"Sleep issues are common for women over 40 — and usually very solvable," says sleep specialist Rubin Naiman, PhD, a clinical assistant professor of medicine at the University of Arizona's Center for Integrative Medicine. "With simple lifestyle changes, you can improve the quality of sleep, as well as mood and overall well-being."
Here's how he helped three women get the shut-eye they need for optimal health and happiness.
Sleep thief: Hyperactive brain
Margot Tohn, 44, is a self-described overachiever: On top of running her own publishing company, she takes care of her ailing father, volunteers for several charity organizations, and tries to play tennis with friends or go to the opera once a week. Her list of to-dos and obligations never ends, yet she often feels as though she's not doing enough. Even after she turns in for the night, her mind is still going, running through what she accomplished that day and planning for the next. She doesn't actually get to sleep until 1 to 2 a.m., then wakes at about 5:30, feeling anxious to get started. By the afternoon, Margot feels irritable and in desperate need of a nap.
Our expert says: "This sleep problem is primarily psychological," explains Naiman. "Margot is entirely too hard on herself, and all that ruminating creates anxiety, which shifts the brain into high-alert mode instead of allowing it to wind down." When she starts to criticize herself or feel guilty about not running an errand right away for her family, for example, she needs to stop and think: Am I really hurting anyone by not doing this immediately? Taking a second to think rationally will help her calm down. The other problem is that Margot's day is too jam-packed, adds Naiman. "She has no alone time to process her thoughts, so her mind essentially makes up for it at night." This pre-bed routine will help her mind and body relax:
- Unplug an hour before bed. That includes the television, computer, cell phone, and any other glowing tech tools. Research shows that the brain misreads artificial light as daylight, so it doesn't release melatonin, a sleep-regulating chemical, which is normally triggered by darkness.
- Take a warm shower or bath. Your body temperature goes down when you get out, which makes you feel sleepy. That's because it mimics what occurs deep inside the body at night, when internal temperature drops to its lowest level.
- Meditate or pray for 10 minutes. Several studies show that it can help reduce anxiety, release negative thinking, and improve sleep. Sit quietly in a comfortable position and repeat a phrase you find relaxing, such as Keep letting go.
How it worked: "Though I'm not sleeping for 8 hours a night yet, the quality of my sleep has definitely improved because I'm much more energized during the day. The relaxation routine took me a little while to get used to: I never meditated before, so at first, I could sit quietly for only about 2 minutes at a time. I eventually worked up to 10 minutes, and it does help ease my mind. I also take a hot shower at night and do a few stretches before I go to bed, which relaxes my body. Plus, I started to realize that my all-or-nothing attitude wasn't doing me any favors, so on nights when I get home late, I make sure to do my pre-bed routine for even just 10 to 20 minutes, instead of forgoing it entirely because I don't have a full hour."
Key move: Keep a journal."I make a list each night of 10 things I am grateful for — from good friends to a good hair day. I feel less anxious when I take a few minutes to focus on how much I'm blessed."
Sleep thief: Waking up four times a night
Virginia Camasca, 40, has battled insomnia for 5 years, trying all sorts of things, from herbs to special diets, with no success. At night, she spends up to an hour trying to get comfortable before eventually dozing off, but then she wakes up several times before the alarm rings — often to use the bathroom, sometimes just because. She used to dream frequently but now rarely does, which some research suggests is a sign of poor quality sleep. But when she tried taking the sleep supplement melatonin, she had nightmares. Virginia's insomnia leaves her stressed-out and so exhausted that sometimes she even dozes at work.
Our experts says: "Virginia is stuck in a vicious cycle — the more she agonizes about not sleeping, the harder it is for her to nod off," says Naiman. Stress keeps the mind active and triggers the release of chemicals that rouse the nervous system — all of which sabotage slumber. There's no doubt Virginia is waking up too often, but once or twice during the night is normal. Knowing that may alleviate some of the negative feelings she has toward nighttime. A more relaxed mindset — and the following tips — will up the odds she gets better quality sleep:
- Limit liquids after 6 p.m. The reason she wakes up so often to use the bathroom is simply because she drinks too much fluid during the second half of the day. After 6 p.m., have just one to two glasses of water; also do 10 to 20 Kegel exercises daily, which strengthen the bladder. (To do Kegels, clench only the muscles that control the flow of urine.)
- Set a bedtime and stick to it. Going to bed at different times throws the internal body clock out of whack. It's better if she hit the sack at the same time every night and set the alarm for the same time every morning — even on weekends, suggests Naiman. This will help get her body on a regular pattern, which makes it easier to fall and stay asleep.
- Try a small dose of melatonin. The brain makes this chemical naturally, but it's often in short supply in people with insomnia. Studies have shown that taking a melatonin supplement helps improve sleep, but you need only a small amount: 0.5 mg, 15 minutes before bed. Last time Virginia tried it, she took 3 times as much, and that can cause side effects like nightmares or even depression. Before taking any supplement, talk with your primary care doc.
How it worked: "I started taking melatonin after a checkup with my doctor, and it seemed to work right away, helping me fall asleep faster than I had in forever — and I'm dreaming good dreams again. Keeping a bedtime was tough at first, but now it feels normal to be in bed by 10. And because I have only one glass of water with dinner and did Kegels regularly, I wake up less often to use the bathroom and sometimes sleep straight until the morning. I'm thrilled that I feel so relaxed and healthy. Friends who didn't know I was doing this program tell me I've never looked better. I guess there is such a thing as beauty rest!"
Key move: Hide the time. "I turn my alarm clock away from me so I can't count the minutes I'm awake if I get up in the middle of the night. That way, I'm less stressed if I wake up, so it's easier to drift off again."
Sleep thief: Night sweats and heavy snoring
Tracy Lobdell, 52, has gained more than 50 pounds over the past 5 years — and it's taking a toll on her sleep habits. She snores heavily and suspects she may have sleep apnea, a serious condition that occurs when a person stops breathing for seconds at a time because of airway obstructions, which are often caused or made worse by excess body fat. She recently lost a few pounds by adopting a healthier diet and practicing portion control, but she never has the time or energy to exercise. Tracy is also in the throes of menopause and suffers from hot flashes and night sweats. Plus, her husband and dog — both of whom share her bed — snore, too, and there's barely room for the three of them on their queen-size mattress. The result: Tracy tosses and turns all night and is moody, unproductive, and tired during the day.
Our expert says: "Severe snoring, weight gain, and significant daytime drowsiness all indicate possible sleep apnea," says Naiman. "But even if Tracy doesn't have the condition, snoring can make it difficult for her to get into the deep stages of sleep." Although it's a good idea that she get tested for apnea, Tracy can help ease snoring and other possible apnea symptoms by keeping up the weight loss. To slim down even faster, she should add 30 minutes of aerobic exercise to her routine 5 or 6 days a week, says Naiman. Shedding extra pounds may ease night sweats too. And to sleep more soundly, she should try these bedtime tweaks:
- Switch to the side. Sleeping on the back, as Tracy does now, isn't ideal for heavy snorers or people with apnea — it allows the soft palate to hang in a direction that can obstruct breathing. Sleeping on either side, however, opens up airways to alleviate breathing issues. To help stay in this position, Naiman suggests propping one pillow behind your back and another in front of your waist.
- Make the bed a pet-free zone. Tuck the pooch into a doggie bed in another room. When Tracy shares her sleeping space with her pet, it gives her little room to move, and though she may not realize it, her dog's fidgeting and kicking wakes her throughout the night.
- Keep the bedroom cool. Exactly how cool depends on your preference, but Naiman suggests around 68°F. Wear lightweight pajamas, and cover up with a sheet instead of a blanket. This will help reduce the severity of night sweats.
How it worked: "For the first time in years, I actually feel well rested. I plan to get tested for apnea, but I'm already falling asleep much faster, and my hot flashes are less frequent and severe. I even got used to sleeping on my side. The toughest part for me was making my dog sleep in the other room. I felt guilty, but it really is so much more comfortable. Instead, I let her spend 10 minutes in bed with me in the morning — I think of it as trading quantity for quality. I've continued to lose weight by watching my diet — I've dropped 10 pounds and counting. I haven't made time for exercise yet, but I definitely have more energy now, so it's next on my list."
Key move: Cut back caffeine. "I used to drink about six glasses of iced black and orange tea every day. Dr. Naiman suggested that I switch to decaf or 100 percent iced green tea, which can have half as much caffeine. Now in the mornings I have a little black and orange tea, but in the afternoon, I stick to green. I actually don't miss the caffeine at all."