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September 14, 2019 • 51 mins

As a followup to our recent episode on sleep (and not getting it), here's a classic episode on the question of why women are far likelier to suffer from insomnia than men.

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Episode Transcript

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Speaker 1 (00:05):
Hey, this is Annie oh in Samantha, and welcome to stuff.
I never told your protection if I heard ideas how
stuff first? Did they get you? You kind of like
you're going to start laughing A little bit? Did, but
I held it to be and then you called it
because it's fun. Always trying to mess up on my No.

(00:29):
I love a good in sponts in spontaneous, impromptu, spontaneous,
that's what I was trying to do. I liked it.
You can find in spontaneous laughter. Yes, yes, always good
to fix up the intros, you know. Yeah, I appreciate
it for our Classic Today listeners. As you probably know,
we recently did an episode on sleeping or the difficulty

(00:53):
the lack thereof. Yes, and it's a proposed for me
because last night I think I got one or two
hours what I did, I only got five hours last night,
surpresently because I stayed up doing word searches. I got
a new book. I got really excited and just started
kept going and typically it helps me go to sleep.
Now I got rebbed up. Oh man, I gotta I
gotta hang out with you. I don't bother you, but

(01:16):
I gotta see this word search thing go down. I
feel really old when I talked about it, because I
mentioned it with the Daily Slight guys, then they were
like what. I just think it's a very unique hobby.
I like it. I like it, and I want we'll
hang out and maybe so you'll do crafting of your
costumes and I'll do word searches as we have some

(01:37):
kind of Marvel or Harry Potter movie going on, or
I'm gonna talk about heathers again. Okay, if we want heathers,
you have to pay attention. You're making this into I'm
trying to make it Marvel. You're trying to do heathers.
We're gonna have a weird crossover thing, could you imagine.
I find it very funny that word searches does not
like help your sleep. It makes sure. Typically I usually

(01:58):
do it to calm down and just get my mind
off things, so I need I'm one of those that
if I'm sitting listening through a lecture or something, I
need to be doodling. Um. I hear and process things
that way because I need to. And it's of course
nonsensical patterns or something that I'm just or outlining things.
But it's also one of those that I hear things

(02:20):
and associate things together. I don't know why, but the
words such asn't one of those as well, that I
could just sit and kind of blank out but pay
attention at the same time. I don't know what I
get that. That's the kind of like hiking. Yeah, because
I can like move and blank. Oh see, I have
to pay attention or I die, literally like I fall.
If we've talked about the rolling down the hill things,

(02:40):
I've twisted my ankle so many times, so many times. Sucks.
It's bad, and it becomes a bigger problem when you
are sleep deprived. Oh yeah, that's what we're talking about.
Get back to that. Yes, um. As we mentioned inside,
we recently did insomnia, which is kind of what both
of us are alluding to suffering from. Right, um, is

(03:02):
a big problem among women. It's a bigger problem among
women than men. And our past, our predecessors, Kristin, Caroline,
the legends, the legends, we going there. Yeah, and that's
unfortunate for me because Caroline is one of my closest

(03:23):
friends and I'm like, damn it, that shadow is so
huge it just lingers everywhere. Well, we keep bringing back
the classics, so it's true, but it's worth it. It is.
It is that absolutely is. They did an entire episode
devoted to the female insomniac, so we thought we would
share it with you today. Enjoy. Welcome to stuff Mom

(03:46):
Never told you. From how stupp works dot com. Salman,
Welcome to the podcast. I'm Caroline and I'm Kristin, and
today I really wanted to bring our listeners and authentic
and genuine experience. Kristen, I am coming into this topic

(04:08):
of insomnia completely sleep deprived. Oh no, I I do
suffer abouts of crazy insomnia. Nothing like chronic, nothing long term,
nothing health issue related. It's more anxiety. I tend to
suffer from anxiety on and off, and it causes these
spirals of sleeplessness because whatever makes me anxious, whether it's

(04:30):
work or personal stuff, I suddenly lose the ability to sleep.
And then the more tired I get, the more panicked
I get that next night about sleeping, and a vicious
cycle of insomnia is created. Well, Caroline, I you're really
a method podcaster. Do what I do what I can.
It's immersing yourself in the topic, and I'm sure that

(04:52):
there are so many listeners who can relate to that
very cycle of insomnia the you experience. Well, I would
assume there are a lot of listeners out there who
could relate to it, because insomnia is something that I
feel like a lot of people. It's a health issue
that a lot of people talk about, a lot of
people experience. Certainly here in the U S a lot

(05:14):
of people do. And there's a lot of money that
people pour into curing there insomnia. Yeah, just to get
a sense of how bad of a time we have sleeping,
specifically in the US, if you look at what the
so called sleep economy was worth in two thousand seven,
as reported on in the New York Times, we spend

(05:36):
twenty billion dollars a year on sleep aids of different sources,
and sleep deprivation was also estimated to cost US businesses
one hundred fifty billion dollars annually in lost productivity. I
believe it like when you come to work sleep and
I don't mean you, like you Kristen Conger, Like when
Kristen Conger comes to work sleep deprived, but when the

(05:59):
general you comes to work sleep deprived, and me specifically,
and and me, let's be honest, I mean it is
so easy for instance, I don't know to like find
yourself staring out the window and realize you've just been
sitting there for ten minutes not doing anything, Yeah, because
your brain is just shutting down. Um. And the thing is,

(06:20):
they're actually eighty eight known sleep disorders and insomnia. Even
though we're probably all familiar with what it is, in general,
it's one of the least understood scientifically speaking, Like doctors
still aren't entirely sure what causes insomnia. We know what

(06:41):
it does. Yeah, Well, I mean when you when you
look at the causes and effects of insomnia and the
fact that they are underlying health conditions, but it's sort
of it gets into a chicken and the egg thing like, Okay, well,
insomnia can cause things like depression and anxiety, but it's
also caused by depression and anxiety, and it leads to
some some awful things during your day that you have

(07:03):
to deal with. Yeah. And the big reason why we're
talking about insomnia on the podcast is because it overwhelmingly
affects more women than men. So first, why don't we
just talk about insomnia in general, which is a sleep
disorder characterized by difficulty falling and or staying asleep. Yeah,

(07:25):
And some other symptoms include just being sleepy during the day,
feeling tired when you wake up, that feeling like you're
never refreshed, irritability, problems with concentration and memory tension, headaches,
and of course mine, which is like ongoing worries about sleep,
like will I will I ever be able to sleep again? Well,
would you characterize here insomnia then as the acute insomnia

(07:50):
or chronic insomnia? Well, I would say that about that
I had a couple of months ago, I would say
that was definitely acute because it's short term and versus
chronic which is at least three nights a week for
a month or longer. Um, it was awful, and it
was constant, and then it was and then it was
just gone. It fixed itself over a Memorial Day weekend,
thank goodness. And that insomnia that I was suffering from,

(08:12):
that acute insomnia, I'm pretty sure it was primary insomnia
versus secondaries. So primaries like just regular run of the
mill can't sleep because you're feeling crazy, versus secondary which
is actually sleep problems caused by a health condition. So
it's like if insomnia comes into your bedroom just on
its own like, hey, it's just if it's just man,

(08:33):
it is a kool Aid man of insomnia of sleep disorders,
then that's primary. But if it's say, you know, you know,
say depression walks into your bedroom, is like, hey, also
I brought along, Uh, it's really cool friend of mine insomnia, Yeah,
have fun with both of us, then it's secondary. Oh man,
what a great medical doctor. I wouldn't make well In

(08:55):
speaking of secondary insomnia, depression, as I just mentioned, is
often linked to it also things like anxiety and stress,
And according to a recent study that came out from
the American Academy of Sleep Medicine, it's not just the
stress itself, it's also how we react to stress, which
can exacerbate insomnia. Yeah, if you're not dealing with your stress,

(09:19):
and I'm sure a lot of people out there familiar
with us, I'm certainly familiar with us. If you're not
dealing with your stress and you're using poor coping mechanisms
to try to work around it, like turning to alcohol
instead of stress reduction techniques, We're all guilty of a
glass of peno grigia now and again, and that can
actually contribute to your stress induced insomnia. And there are

(09:41):
also a number of medical conditions such as issues with
chronic pain, breathing difficulties, or needing to urinate frequently that
can provoke insomnia because you know you're having to you know,
it's waking you up constantly during the night. Yeah. And
then of course there are things like poor sleep habits,
medications and things like caffeine, which is an obvious one, nicotine,

(10:04):
and also alcohol. And you know, I think that this
is common knowledge, but it's worth repeating that a lot
of people do kind of turn to alcohol to wind
down at the end of the day. But anyone who
has ever gone to bed after having a little too
much to drink might be familiar with the phenomenon of
waking up suddenly and being like, oh, well, the alcohol
were off, and now I'm not sleeping well at all. Yeah.
Or you might sleep through the night, but it's not

(10:26):
RESTful sleep, it's just drunk sleep. And then which is
not good, I guess. But that's something completely different from insomnia,
but it can contribute well. It can also contribute in
relation to alcohol. Speaking of alcohol, is your good old
handy dandy period. It's so handy and dandy, both so
during your period, your progesterone. Your hormone progesterone is highest

(10:49):
around ovulation and during your luteal or post ovulation phase,
and this hormonal cocktail can actually exacerbate the effects of alcohol.
But we have so much more period stuff to talk
about later. Yeah, because spoiler alert. When it comes to
women and our issues with insomnia, menstruation often is the

(11:11):
culprit hormones. I just picture like a giant crowd of
hormones all waving like penance. They're like at a football game,
like I'm not gonna let you sleep. So, now that
we've established all the myriad ways that we can be
robbed of our sleep, the next question is, well, what
does insomnia do to you? And it's no big surprise

(11:33):
that it's a host of not so fun things like
lower job or school performance, slow reaction times while driving,
higher risks of accidents, probably due to that slower reaction
time while driving. It might also, in a bit of
a cycle, kickoff issues like depression or anxiety, which then

(11:56):
might contribute to more insomnia. Yeah, it is. It's all.
Insomnia is part of just a terrible cycle of awful things.
Because I mean, the more you get it the worst
things get things like high blood pressure. It aggravates weighting
and obesity, heart disease, all this terrible stuff. But at work,
you know, Kristen mentioned it contributes to lower job in

(12:16):
school performance, as one would expect if you're like totally
tired and not firing at all. Cylinders. There was a
study in two thousand six from the Journal of Management,
very straightforward name of a journal that talked about the
effects of insomnia on people at work. And yes, you know,
as you would imagine, it's associated with increased feelings of
hostility and fatigue and decreased feelings of joviality and attentiveness.

(12:40):
But that that is actually worse. These effects are actually
worse for women. Yeah, that finding in the study that
women's attitudes at work were affected more by insomnia is
stood out because there are also some studies that say
that women actually handle sleep deprivation better than men, at
least based on our performance on like computer related tasks

(13:04):
after not getting enough sleep. But I guess that's a
little bit different because that's looking at can you punch
keys on a keyboard versus can you talk to your
manager in the break room and not and not start
crying and yelling yes right well now, And that that
study too that you just mentioned also was showing that
like women seem to suffer more from insomnia and also

(13:27):
believe that they're suffering from more from insomnia, but that
they after like two good solid nights of sleep, recover
better than men do. Oh and on top of that too,
women who are performing lots of housework, which is often
the case because women perform a majority of the housework,

(13:48):
it slows down that recovery period. If you're doing all
this housework, then you have less time to rest and
hopefully recover from that lost sleep. And this issue of
insomnia among women really shouldn't be ignored, and this is
um something that more and more medical research is starting
to highlight because insomnia might be signaling other kinds of

(14:13):
medical or psychiatric problems in lady sleepers. Right yeah, because
women are about twice as likely as men to suffer
from major depression during their lives and it's nearly always
accompanied by difficulties sleeping. And also another big health issue
is obstructive sleep apnea. This is something that my mother
struggles with. She snores, has sleep apnea, and it really

(14:36):
messes up your sleep because you basically wake up gasping
for air. Um. But obstructive sleep apnea is a major
cause of insomnia, as you might imagine, and it's a
major contributor to heart disease. And before menopause, women are
about half as likely to have sleep apnea as men are,
But once they get past menopause they catch up to

(14:59):
men in those lucky ladies. Yeah, and after menopause too,
as we'll talk about more, the rates of insomnia among
women escalate as well. Right, Well, what's dangerous about this
whole sleep apnea depression insomnia link is that because doctors
are kind of programmed to use not the best term,

(15:19):
but kind of programmed to think that it happens more
frequently in men than in women, they might overlook the
signs of sleep appnian women and so, oh, you're just depressed,
you're just tired, But really, she has possibly a serious
health issue going on. I'm programmed to say this. I'm
a doctor, robot Dr Kristen, Yes, Chris and robot um. Well,

(15:40):
now that we've talked about a lot of sort of
external factors that interact with insomnia and promote cycles of insomnia,
in women. Let's really focus in now on sleep and
how that interacts with gender, because there are a lot
of different gendered patterns. It turns out of how we rest,

(16:06):
and we'll talk more about that when we get right
back from a quick break. So to first kick off
this closer look at gender and sleep, I just want
to toss out this historical tidbit from Insomnia, a Cultural

(16:26):
History by Elena's Summers Bremner, who talks about how in
the nineteenth century there was at least one doctor who
claimed that women need more sleep because we're prone to
nervous excitability, while another doctor in the nineteenth century thought
of insomnia as a morbid deficiency of the brain, which

(16:47):
was why women need more sleep. There has for a
long time been a lot of focus on women and sleeping,
but uh, you know, just not for such fantastic reasons.
In the past. There there was also this guy named
s Weir Mitchell Um who in the late nineteenth century
developed what he called this rest cure for women's hysteria,

(17:12):
And essentially he would lock up women in a room
and just force them to do like absolutely nothing whatsoever
to try to just I guess, break them down and
cause them to be less hysterical. Yeah, look, you're expressing
your opinion way too much. We need you to go

(17:32):
in this room and just rest. Yeah, I know, and
rest care sounds so nice. I would love to take
a rest here at the beach. But oh wait, no, no, no,
not that kind of a rest cure because you might
still be talking and expressing opinions at the beach. We
can't have that happening. Yeah yeah, but yeah, so let's
look at let's look at the gendered breakdown of sleep.
Who sleeps more, who needs it more? Do women just

(17:52):
complain or do we actually have something to complain about.
Turns out that women spend fifteen more minutes in bed
than men do, but we sleep eleven minutes less. Yeah. Uh.
And when it comes to napping, guys, at least, according
to research from the Pew Center, you take more naps.

(18:12):
Thirty eight percent of men reported napping versus of women,
So not a major difference there. But when it comes
to who needs more sleep, doctors say women be needing
some sleep because of our hysterical uterus is no caroline, No,

(18:34):
it's actually at least agreeing to professor Jim Horne, who's
director of the Sleep Research Center at Lowborough University in England.
It has to do with our tendency to multitask. Yeah,
women do multitask more than men do. That's on any
blog you'll find out there that'll tell you that. But
apparently women need twenty minutes extra deep sleep in order

(18:59):
to rest our core text. The cortex during the night
needs you to sleep so that it can disengage from
all of your crazy senses and go into recovery mode.
And the more you use your brain during the day,
the more your cortex needs sleep. Although I wonder, and
this is a bit of a side note if perhaps
another solution is to multitask less, because research also finds

(19:25):
that multitasking is not exactly better tasking, right, Yeah, exactly.
I know. Well, it's hard to resist multitasking though sometimes Caroline, Well, sure,
unless like, and I'm good at it to an extent.
I'm good at multitasking to an extent, But then my
like undiagnosed adult a d D kicks in and I'll

(19:45):
just I'll start something over here, and then I'll move
over here and do something else, and then by then
my cortex is just like we don't even know what's
going on? Go to sleep? And then he just just
face plant on your cubicle. Yes, if you ever walked
by me and I'm just like face down the cubicle
with the space bargain owing forever, just leave me, well,
I certainly wouldn't want to wake you up, Caroline, because

(20:05):
according to research out of Duke University, women are grumpier
when it comes to losing sleep. They actually used the
words hostile and angry specifically in the morning, and anecdotally,
I've gotten better at being a morning person, but it
took years of training. I know that in high school

(20:28):
when my mother would wake me up, they would there
would be like an hour long window before I was
even approachable. Yeah, no, I I totally get it. I
am not a nice person when I'm like super tired
and I've just woken up, especially if I haven't slept well.
I have been known to throw the covers back and

(20:50):
yell I'm not sleeping, and you know, go storm ountain
try to sleep on the couch. Yeah, I'm not social
for the first bit of the morning, but I think
I'm not as not as hostile and angry as I
used to be. Um, but we might not just be
just old grumpy gusses for no good reason, because according

(21:15):
to these same Deuke University researchers, women actually suffer more
mentally and physically if we don't get enough sleep, which
then puts us at a higher risk for heart disease, depression,
and psychological disorders. And also podcasters referring to you as
a grumpy gus apparently but yeah, it's it's scary, and

(21:35):
and you're like, well, I mean, surely, like there's nothing
so bad about this. But in addition to all of
these things that insomnia puts us at risk for, we
as women end up with higher inflammation markers, and basically
this indicates to a doctor that you are developing health
problems and their linked to pain. So well established women

(21:58):
need more sleep. Even though we might be laying in
the bed more, we aren't necessarily getting it. What is
going on because statistically, women are fifty percent likelier to
suffer from insomnia, and according to a survey from the
National Sleep Foundation that came out in two thousand and seven,
single working women have it worse, which I was surprised

(22:22):
to see because I would have assumed it would have
been working moms. I would have thought so too, But
it turns out that single working women are probably we're
probably bringing it on ourselves because we're like staying out
late doing that thing. Yeah exactly, and we're saying about it.
We're just constantly throwing our hats up in the air,
like Mary Tyler Moore, just like going in overdrive. Um,

(22:45):
married working moms get about the same amount of not
enough sleep as single working women do. And you know,
stay at home moms, you guys don't have it much better.
Three quarters of these women experience symptoms of insomnia. And
why is that? Because we all have a lovely cocktail

(23:07):
of hormones in our bodies that are really the primary
culprit of all of this insomnia. It seemed like all
of the studies that we read regarding gender differences in
sleep patterns and insomnia from adolescence through old age, it
is constantly menstruation, menopause, pregnancy, and hormones that are the

(23:34):
common thread. Yeah, that's right. Amy Wolfson, who's the author
of the Woman's Book of Sleep, a Complete Resource Guide,
said that more than seventy of women complain about sleep
problems during menstruation when hormone levels are at their lowest.
So imagine that stadium full of pen and waving hormones,
just like clearing out of the stadium, and suddenly you

(23:54):
can't sleep. Yeah. Um, if you're listening to this and
you're like, huh, you know what I seem to not
be able to sleep when I'm experiencing p MS, Well,
it's probably because pre menstrual insomnia and pre menstrual hypersomnia
are just two of the menstrual related sleep disorders that

(24:15):
are among those eight known sleep disorders. So there is
a very strong link between our menstrual cycles and how
well we sleep. Yeah. In fact, research even says that
menstruating women report bloating that is significant enough to disturb
their sleep at least two or three days during each
menstrual cycle. And I am interested in hearing from people

(24:39):
who may have experienced this because while I do certainly
bloat every month, I mean, that's no big deal. I've
never actually experienced it so badly that it's interfered with
my sleep. So what's happening on a hormonal level is
that during the luteal phase, which is after ovulation, our
levels of proges their own rises and actually chills out

(25:03):
our sleep. Patterns a little bit. Progesterone is more strongly
related with good sleep, So hooray progesterone. But then a
few days before your period starts, when both progesterone and
estrogen levels drop, you have a spike in insomnia. And
then during the follicular phase, which is menstruation to ovulation,

(25:25):
you have energy supplementing estrogen building up until ovulation, which
is also when you see levels in insomnia rise. So
we have like a brief window during our menstrual cycles.
What is that right after ovulation when progesterone is like, hey, friends,

(25:46):
here are a few nights over risk. Progesterone comes along,
sprinkling fairy dust on your eyes, and then es estrogen
bust into the bedroom is like, oh yeah, well, so
so does birth control? I mean, do different types of
birth control then effect insomnia. We did not look into that, Caroline,
But I just want, I mean, I wonder it must
it must I feel like and this could be mental,

(26:08):
this could be a total coincidence. But when I switched
from the pill to an I U D, I feel
like I experience more intense insomnia. I'm on a hormonal
iu D, so I I don't know maybe, so maybe
someone out there can tell us. I would only imagine
that if you are on some kind of hormonal birth
control that it must influence your sleep because progesterone and

(26:30):
estrogen are so commonly linked to it. Yeah, well so,
But speaking of not being on birth control, during pregnancy,
especially in women's third trimester and after childbirth, women experience
these profound fluctuations in their steroid related hormones and those
hormones that are involved in the whole hypothalamic pituitary adrenal

(26:52):
grouping of hormones that produce significant physiological changes. Yeah, and
apparently during the third crimemester, not only are you having
some hormonal fluctuations that contribute to insomnia, but it's also
the fact that your belly is so large and you
have to go to the bathroom more often that will

(27:13):
again wake you up. Yea, So that sounds more like
like a secondary insomnia that it's caused by not a
not a health problem, but a body issue. A baby.
It's caused by a growing baby. Oh that's what it is,
all right. Well, so, once you've crested that hill and
you're coasting into menopause, of course your sleep is also

(27:36):
going to be disrupted then, because why wouldn't it be
because menopausal women experienced wonderful things like hot flashes and
night sweats. And this is during this time you get
things like a diminished production of estrogen and particularly pro
just aone that affects your sleep. Yeah, it in fact
does not get better when it comes to insomnia as

(27:59):
we age. Right, And like we mentioned earlier with the
sleep apnea stuff, menopause is when women really catch up
to men in terms of experiencing that really bad health
issue that doctor. You should definitely go to a doctor
and get checked out. But yeah, so you're experiencing night
sweats and hot flashes and you probably are developing sleep apnea.
And I mean, man, your body is just throwing you

(28:20):
for a loop. Thanks a lot, body, And well, speaking
of a time when your body kind of throws you
for a loop. If you're wondering when this gender gap
in insomnia really starts to widen, it is during puberty.
This is from study in pediatrics that came out in
two thousand and six looking at gender differences in insomnia

(28:43):
among adolescents, and it found that when girls started getting
their periods, they became two and a half times likelier
than boys to have insomnia. So yet again we have
hormones and specifically progesterin, estrogen, etcetera, being strongly related to

(29:06):
our sleep or lack thereof. Yeah, so leading up to puberty,
there's really no huge significant gap between boys and girls
in terms of having insomnia, but that onset of a
girl's period is associated with a two point seven fivefold
increased risk for insomnia. Now, one other gender gap that

(29:26):
also emerges during puberty that we've talked about before on
the podcast is how among girls rates of depression and
anxiety also increased. So one thing that these researchers looked
at was whether or not it was puberty related onset
of depression that might have been fostering cycles of insomnia,

(29:48):
and it and another study that we looked at examining
adult female insomniacs both concluded that it is not specifically
the depress shan and anxiety that are to blame for
these higher rates of insomnia. Again, it always goes back
to those hormonal factors. So all of us to say,

(30:12):
the research that we found states that it is not
depression and other kinds of psychiatric issues that are causing insomnia.
They're sort of they're interrelated, but they aren't codependent. Yeah,
one doesn't necessarily have to depend on the other one happen. Yeah, Well,

(30:33):
I mean, we were just talking about menopause. So if
we're if we're looking, if we're continuing to look at
age groups and insomnia. Uh. The American Journal of Geriatric
Psychiatry INN looked at about three thousand each of men
and women sixty five and older, and they performed a
meta analysis and found that elderly women were at the

(30:53):
highest risk of insomnia. So, like christ and said, it
just darnwell never gets better. They out that more than
sevent men and women reported at least one symptom of insomnia,
with difficulty maintaining sleep being the main one. So they
looked at things like difficulty falling asleep versus difficulty maintaining sleep,
and so they found that women were frequently reported two

(31:16):
or three insomnia symptoms, whereas men more often reported just one.
But some of the protective factors against insomnia that these
researchers highlighted for women in this study at least included
a Mediterranean diet so guzzle that olive oil, drink it up,
um also caffeine and alcohol. What, Yeah, I don't. Yeah.

(31:39):
I wondered about that because that is something that is
preached against in every other I mean, I guess, I
guess in moderation, but I don't. I don't know. I mean,
I don't know. Maybe these women were really enjoying a
Mediterranean diet that included a lot of red wine. Well,
and you know what, when I'm post menopausal, I will
I my coffee and wine if I want it. I

(32:03):
earned it. But yeah. They also cited hormonal replacement therapy
as another protective factor, which they also noted was a
bit of a controversial suggestion because not everybody is a
fan of hormone replacement therapy. But it makes sense because
of yet again, those hormonal connections to insomnia. Because this

(32:25):
was the one thing that I didn't find in our
research was like, okay, well, scientists seem to know that
our menstrual cycles have a large influence on insomnia. So
is there any any kind of treatment for that, any
kind of way to Nope, I saw nothing. It was

(32:45):
basically just like, well, here here's the information. Uh take
a lunasta. I don't know. Um. There was also, though
there was another study looking at the intersection of gender
and economics when it comes to sleep, and there was
This was coming out of the Centers for Disease Control
and Prevention in two thousand twelve, and it found a

(33:06):
pretty strong correlation between income and quality of sleep. Yeah.
The study basically found that as family income increases, trouble
sleeping decreases. And that makes sense. I mean, they found
that more the more people who were below the poverty
line experienced more insomnia banded people who were away above it.

(33:28):
But at every family income level, women were still more
likely to have trouble sleeping. But we did glean one
geographical outlier when it comes to the gender gap in insomnia,
and this was coming from a meta analysis in the
journal Sleep in two thousand and six. Um. When the

(33:49):
in the premise for it was researchers being like, Okay,
all right, we hear all the time about how women are,
you know, have a harder time with insomnia, But is
that really true? Is just just sort of a methodological trick?
Are women just more likely to seek treatment for it?
Is it because women are more depressed? Well, first of all,
they concluded that okay, actually yes, they looked at twenty

(34:12):
seven studies. Yes, women actually do have legitimately a worse
time with insomnia, except in Japan. Yeah, this is so interesting.
The study authors think that the lack of gender differences
in insomnia, the fact that it's pretty much even Stephen,
is based on the fact that there's less variation in

(34:33):
Japanese society's sociodemographic and psychological characteristics. But see, that's curious
to me because when it comes to at least gender
roles in Japan, from what I've read and also heard
from people living in Japan, um, it's less progressive. It's

(34:54):
more their generals are more traditional than they would be
in the West. Well, I think, I mean, in my brain,
not having like gone into this very deeply, that kind
of actually makes sense because if people are very set
in their roles and they're comfortable with their roles, and
nobody's trying to, like, you know, cause a revolution or anything,

(35:15):
I don't know, like a feminist revolution or anything. Um,
maybe people are just sleeping better if if things are
very set in your society. And I'm, of course I'm
painting this all with a very broad Well, Carolyn, I
think we've figured it out down with feministinism is ruining
everyone's sleep. Please don't write me letters. You know, I

(35:36):
don't believe that I'm writing you a letter right now, Carolin,
I'm multitasking. God, your cortex is going to need so
much rest tonight. But I am curious then if there
are any listeners in Japan who can give us some insights,
please let us know, because this was even something that
the researchers couldn't explain in the study. They were like,

(35:58):
there's something about Japan, and they even broaden it to
just East Asia in general. So I wonder what it
is about sleep patterns there, because if you look at
the history of sleep, like in the West, the way
that we sleep has changed since the Industrial Revolution, where
we actually used to not just sleep in closer quarters,

(36:19):
but we also slept in shifts. For instance, like Ben
Franklin would get up and go on these like night
walks in the middle. You know. You know what Ben
Franklin would do. He would get up and take a
cold air bath, a cold air bath, sitting naked in
his armchair reading. I'm picturing it. I'm picturing it too.
I bet it was refreshing. Well, I don't have to

(36:40):
be awfully chili. Yeah, well, well we now need to
talk about treatments for insomnia. Perhaps the cold air bath
will do you. Um, when it comes to acute insomnia,
those brief windows of sleepless nights, it might happen. Treatment
just might not be required. It will probably go away

(37:01):
on its own, Yeah, exactly. For the chronic insomniacs out there, however,
you might want to seek treatment, and that could include
treating underlying causes of insomnia. For instance, Um, a couple
of years ago, I was like not sleeping at all,
I was really stressed out, and my doctor prescribed me ambient,

(37:22):
when really I probably should have been going to a
therapist and dealing with my incredible levels of anxiety, because
once you treat that anxiety, that tends to chip away
at insomnia. Yeah. And speaking of therapy, they're all sorts
of behavioral therapies developed for helping sleep and curing insomnia,
as such as relaxation exercises, something called sleep restriction therapy,

(37:47):
which is on the more extreme end of these behavioral
therapies where if you say, can't ever fall asleep until
like four in the morning, then, according to sleep restriction
therapy P, you would make yourself stay awake, not get
in bed until four in the morning, and make yourself
sleep through the night. And so it would basically be

(38:08):
like training your brain to say, oh, well, I got
in bed and then I fell asleep. Yes, it was
four in the morning, and then you gradually like step
it back and back and back. I've done that, well,
not four in the morning, not that extreme, but I
found myself like I would get really sleepy kind of
early in the night, at like nine o'clock. Um, but
I knew that I was never going to fall asleep
and actually go to bed until around midnight. But it

(38:31):
it fostered so much anxiety, especially on like a Sunday night,
you know, when you know you have to go back
to work the next day or whatever. And so one
Sunday night, instead of getting into bed early like I
had wanted to do and I had tried to do,
I just stayed on the couch and read until about
honestly about eleven eleven thirty and got in bed then
and it was hunky dory. So that was sort of

(38:51):
reverse sleep training, because you were wanting to go to
sleep too early rather than not being able to. Yeah,
like I was sleepy, and I wanted to get in bed,
but I knew that if I did, based on previous
nights of not sleeping, well, I knew that if I did,
I would just lie there and sweat, just sweat the bed.
I should I sweat the bed um. But also, like
you know, we we've mentioned um sleep ap me a

(39:13):
lot in this podcast episode. You might want to look
into going to a sleep clinic and getting a c
PAP machine. I have a friend who got a c
PAT machine and he sleeps like a baby. Now, my
mother was prescribed a CPAP machine, but she refuses to
use it because she's too proud. What does a c
PAP machine look like? It's it's a big, old robot
looking thing. Like you don't want it. You don't want

(39:34):
to have sleep at me, and you don't want to
have to use a c PAP machine. But it can
be life changing for people who use it. It It
involves um putting like a mask over your mouth and nose,
and it's pumping air. Someone else can explain this way
better than I can, But it's it's uh not a
small machine. Well, something that is small that a lot
of people do take in the bedroom is sleeping pills sleep.

(39:58):
The market for sleeping pills has I don't want to
say exploded because that's the sensational term, but it's kind
of explodahiyah. We're taking more sleeping pills than ever before. Yeah.
So if you look back, this is coming from the
New Yorker and article they did on sleeping pills back
in all the way back, but in nineteen seventy you

(40:19):
have del Maine, which was the first benzo diazepine explicitly
approved by the f d A as a sleeping pill.
Fast forward all the way to two thousand six and
prescriptions of sleeping pills hit forty nine million. Ambience Manufacturer
estimated that that pill in particular had been taken twelve

(40:41):
billion times worldwide. Now, the number of pizzas that have
been sleep eaten on ambience still unknown, And according to
data from the CDC as of two thousand thirteen, around
four percent of Americans we're using prescriptions sleep aids and
are used more commonly surprise among women and older adults.

(41:04):
But the trouble with these sleeping pills is that they
might not actually be improving the quality of sleep that
you get. There was one study that was cited in
The New York Times talking about how and I don't
have the exact figures in front of me, but it
was something along the lines of taking a sleeping pill,

(41:25):
and it helped the people fall asleep less than fifteen
minutes faster than the people who didn't take that. And
then it's the question of, well, what kind of sleep
are you actually getting when you pop an ambient or
a lamask or something like that, because you might not
be getting as deep of asleep as you would otherwise. Right, Well,

(41:47):
the whole thing with ambient, and I am someone who
takes ambient now, and again, it's not so much that
it's knocking you out cold for the whole night, especially
if you're taking a really low dose like I do,
because that's more of the placebo effect. Let's be honest.
The thing with ambient and other pills like it is
that it gives you temporary amnesia. So when you wake
up during the middle of the night, Let's say you

(42:07):
roll over and you can't go back to sleep, and
you're panicked about it, and you wake up the next
day and you're like, God, I just know I slept
terribly and um, so I'm going today is going to
be awful. With ambien, you forget that you ever rolled over,
or you forget that you had that moment of like
waking up and looking out the window or something crazy,
or you know, getting up and eating a pizza. It
just kind of gives you the impression when you wake

(42:27):
up the next day that oh, I slept okay, and
today is going to be great. So it's sort of
some mind trickery going on, total mind trickery. And and
in that New Yorker piece, they were talking about drug
reps who were working on medication that would be more
like keep you more consistently asleep throughout the nights, so

(42:48):
not just be that sudden, sudden onset of sleep and
then you sort of toss and turn you just don't
remember it. They're trying to work on pills that actually
keep you asleep, but there's all these questions of safety
and so we'll see. Well, and then there's the whole
factor of lifestyle issues related to how we sleep. I mean,
clearly when it comes to you know, sleep on the
hormonal level and insomnia and all of that. Um, I

(43:11):
don't think that you know, don't look at your cell
phone an hour before you go to bed is really
going to cut it. But there are so many different
behavioral tips and tricks that are endlessly cycled and recycled
on the internet that I don't think we even need
to go through on the podcast. They're so common, such as,
you know, limit your screen time, make your bedroom cool,

(43:34):
only use your bed for sleep or sex, etcetera, etcetera. Right,
and there's some good behavioral suggestions that I hadn't really
thought about. I mean, this seems like it's common since now,
of course, And it's just exposing yourself to sunlight as
soon as you can to sort of tell your body
and your brain and all those pesky hormones that it's
time to get up. They even suggest getting in an

(43:57):
early morning walk with a friend as because you're combined
social stuff, so you're using your brain to interact with
your friend and then getting sunlight and exercise. And to me,
I just, um, I'd rather be asleep. I socialized with
NPR in the morning. I do too, sometimes I answer them.
But the there was a question, though, posited in the

(44:19):
New York Times article that we've been siding throughout the
podcast as to whether we are now just fighting our
ancestor's way of sleeping, which was you know Ben Franklin
and his cold air baths, of sleeping in these four
hour blocks and then waking up in the night, doing

(44:40):
a few things and going back to sleep. Maybe we are,
you know, forcing ourselves into unnatural sleep patterns. Yeah, I mean,
it's definitely a cultural global idea that you get in
your pjs and you brush your teeth and you go
to sleep for exactly eight hours and then you get
up and you go be a very good citizen al
in the world and work and and behave yourself and

(45:02):
all that good stuff. But yeah, maybe we are just
completely fighting nature, because it's not as if, you know,
these ancestors who were getting up in the middle of
the night, they'd sleep for hours, get up, do whatever,
go back to sleep. It's not like they had it
so so great. You know, we have all these temper
pedic mattresses and these pitch black rooms and don't don't
use any blue light. Oh god. But I mean they

(45:23):
were sleeping, you know, thirty five people to a bed.
They had like mice and who knows what mice and life.
So let's bring back the mice. Let's get the thirty
five people if we can just go back to the
dark ages. But one thing that hasn't changed though through
all of this is the menstrual cycle. It seems like

(45:44):
I wonder if no matter what, if you know, all
other factors controlled for if it's still like regardless, if
women would have still have trouble with insomnia more than
men because of our periods. Yeah, all those hormones fled
down of the stadium being like peace out, see you later,
see you went back when you can sleep again. I

(46:06):
hope this was illuminating, though for not not too illuminating.
They want people to be able to sleep calmly. I
hope this shed a calm dim light for women in
particular who do have trouble sleeping. And we want to
hear from you. What's been your experience with insomnia and
have you successfully overcome it and how did you do

(46:30):
that to let us know so we can share your
insights with everybody else. Mom Stuff at how stuff works
dot com is our email address. You can also tweet
us at mom stuff podcast or messages on Facebook. And
we've got a couple of messages to share with you
right now. I've had a Facebook message here from Caitlin

(46:52):
in response to our Explorer series episode on Seafaring Women,
and she writes, Ladies, I am a marine scientists and
literally whooped for joy when I saw your Seafaring Women
podcast title. The timing is especially appropriate as I just
returned from a research expedition at sea. I work in
a deep sea research lab, and part of my job

(47:14):
entails going out to sea to collect samples and study
sites that can exist thousands of meters deep. When I
tell friends and family that I'm heading to see the
general consensus is that I'm sitting on deck sipping mohitos
while waiting my turn to blaze shuffle board. Many folks
have a hard time understanding why in the world I
would even want to be stranded on a ship for
multiple weeks at a time. It's true, even in this

(47:36):
day and age, ship life can be challenging. No phone service,
interimittent Internet, absolutely no Netflix. It's enough to send even
the most adventurous person crazy after a while. I, however,
embrace the isolation for one with no phone to serve
as a distraction. People actually converse at meals. I've developed
long lasting friendships with people I have sailed with because

(47:57):
we were forced to look at each other in the
eye and communicate without the assistance of emails, texts, and
Facebook messages. Also, there's something absolutely breathtaking about looking around
you in all directions and seeing no indication of human life.
Some of the best star gazing I've ever done has
been on a ship, and a huge incentive from the
science perspective is that when I'm at sea, I am

(48:18):
privy to something that not many people have the opportunity
to see, the deep sea. I've traveled a couple of
thousand feet deep in a submersible to a site that
was little explored, and I can't even begin to describe
what it feels like to know that you're seeing something
that no one has ever seen before. It's surreal and
it sounds surreal. She goes on to talk about how

(48:40):
Rachel Carson and Sylvia Earle or Deepness have been long
standing heroines of mine, and when I had the opportunity
to meet Sylvia Earle, it took me thirty minutes to
work up the nerve to talk to her, and she
is amazing. As just a few resources if you're interested,
I did outreach for deep sea research crews so you
guys can read about life see at acid Horizon dot

(49:02):
tumbler dot com. And for those of your listeners who
are interested in exploring the deep sea from the comfort
of their homes, check out nautilus live dot org. They
have a live feed running from their ship and viewers
can watch and listen to the scientists explore the sea floor.
That is so cool, Caitlin, and thank you so much
for writing in. And I have a letter here from Whitney,

(49:23):
who is a woman after my own heart. She wrote
us to share a story about her family history, particularly
one woman named Penelope Um. She says the story is
not exactly related to exploring, but to female perseverance in
the settlement of North America. She says, I had remembered
vague details about Penelope van prince Stout as a child,

(49:45):
but recently found a family history book that went into
much more detail around Penelope and her first husband set
sail from Holland for New Amsterdam. Unfortunately, the ship they
were on somehow sunk just off the coast of Sandy Hook,
but most of the party made it to shore. Once
on land, the party was attacked by Native Americans in
the area, killing Penelope's husband. Penelope suffered major stomach wounds

(50:06):
and hid in the hollow of a tree until another
group of Native Americans founder. She lived in the natives
village and was nursed back to health by them. Sometime later,
she married Richard Stout and they moved to New Jersey
in sixteen sixty five. However, hardship was not over for Penelope.
She had become close to the native tribe that saved
her life, and when they heard of a planned attack

(50:27):
on her settlement, they came to warner her husband, Richard
either didn't believe her warnings about an attack or chose
to stay in fight. As we can tell from her
previous experience, as Penelope was not one to give up.
Despite having one bum arm, she took her ten children
in a canoe to safety without Richard. When I learned
the story of Penelope, I felt honored to be distantly
related to her. She was an explorer in her own right,

(50:49):
living in a new land at a time when women
were not allowed to be strong willed. I sincerely hope
I inherited some of those traits along with her good genes.
As she lived to be a hundred and ten years old, Whitney.
That is so cool. Thank you so much for sharing
your history story, and thanks to everybody to share their
stories with us. Mom stuff at how stuff works dot
com is our email address and for links to all

(51:12):
of our social media as well as all of our
blog post, videos, and podcasts which include our sources so
you can follow along. There's one place to go, and
it's stuff Mom Never Told You dot com. For more
on this and thousands of other topics, is it how
stuff works dot com

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