August 18, 2014 • 47 mins
Women are far likelier to suffer from insomnia than men, but why? Cristen and Caroline put the science to rest on the biological and psychological female factors that lead to sleepless nights.
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Speaker 1 (00:03):
Welcome to stuff mom never told you. From how Supports
dot com. Hello, and 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
(00:25):
coming into this topic 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,
(00:48):
whether it's 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 in some is created. Well, Caroline,
I you're really a method podcaster. See what I can do,
what I can summersing yourself in the topic, And I'm
(01:09):
sure that there are so many listeners who can relate
to that very cycle of insomnia. The 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
(01:30):
of people experience. Certainly here in the US, a lot
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,
(01:51):
as reported on in the New York Times, we spend
twenty billion dollars a year on sleep aids of different
source is 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
(02:11):
depri and I don't mean you like you Kristin Conger,
Like when Kristin Conger comes to work sleep deprived, but
when the 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,
(02:32):
because your brain is just shutting down. Um, and The
thing is, 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,
(02:53):
Like doctors still aren't entirely sure what causes insomnia. We
know what 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,
(03:17):
and it leads to some some awful things during your
day that you have 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
(03:38):
is a sleep disorder characterized by difficulty falling and or
staying asleep. Yeah, 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, well, I
(04:00):
have a beaple to sleep again. Well, would you characterize
here insomnia then as the acute insomnia or chronic insomnia? Well,
I would say that bout 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,
(04:21):
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, that acute insomnia, I'm pretty
sure it was primary insomnia versus secondaries to primaries, like
just regular run of the mill can't sleep because you're
feeling crazy, versus secondary which is actually sleep problems caused
(04:44):
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 me late man, it is a
kool aid man of insomnia sleep disorders, and 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,
that's really cool, friend of mine insomnia, Ye, have fun
(05:06):
with both of us. Then the secondary Oh man, what
a great medical doctor I would well in 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,
(05:30):
it's also how we react to stress, which can exacerbate insomnia. Yeah,
if you're not dealing with your stress, 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
(05:50):
reduction techniques. We're all guilty of a glass of pino
griggia now and again, and that can actually contribute to
your stress induced insomnia. And they are also a number
of medical conditions such as issues with chronic pain, breathing difficulties,
or needing to urinate frequently that can provoke insomnia because
(06:10):
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, certain medications, and
things like caffeine, which is an obvious one, nicotine, 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
(06:32):
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, we're off,
and now I'm not sleeping well at all. Yeah. Or
you might sleep through the night, but it's not 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
(06:55):
to alcohol. Speaking of alcohol, is your good old handy
dandy period. It's so andy and andy both. So during
your period, your progesterone, your hormone progesterone is highest around
ovulation and during your luteal or post ovulation phase, and
this hormonal cocktail can actually exacerbate the effects of alcohol.
(07:17):
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
culprit hey hormones. I just picture like a giant crowd
of hormones all waving like penances. They're like at a
football game like that. We're not gonna let you sleep.
(07:38):
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 that it's a host of not so fun things
like lower job or school performance, slow reaction times while driving,
(08:00):
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
might contribute to more insomnia. Yeah, it is, it's all.
Insomnia is part of just a terrible cycle of awful things.
(08:21):
Because I mean, the more you get it, the worst
things get. Things like high blood pressure, it aggravates weking,
and obesity, heart disease, all this terrible stuff. But at work,
you know, Kristen mentioned it contributes to lower job in
school performance as one would expect if you're like totally
tired and not firing on all cylinders. There was a
study in two thousand and six from the Journal of Management,
(08:43):
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.
But that that is actually worse. These effects are actually
worse for women. Yeah, that finding in the study that
(09:04):
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
after not getting enough sleep. But I guess that's a
(09:26):
little bit different because it'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
believe that they're suffering from more from insomnia, but that they,
(09:50):
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,
it slows down that recovery period. If you're doing all
this housework, then you have less time to rest and
(10:12):
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
medical or psychiatric problems in lady sleepers. Right. Yeah, because
(10:36):
women are about twice as likely as men to suffer
from major depression during their lives, and it's nearly always
accompanied by difficulty 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
messes up your sleep because you basically wake up gasping
(10:57):
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 apnia as men are,
but once they get past menopause they catch up to men,
(11:18):
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, but kind of
programmed to think that it happens more frequently in men
(11:40):
than in women, they might overlook the signs of sleep
apniaan 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, now that we've talked about
a lot of sort of external factors that interact with
(12:03):
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, and we'll talk more
(12:24):
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 History by Elena Summers Bremner,
(12:46):
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 was why women need more sleep.
(13:07):
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, and essentially he would lock
(13:33):
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 in this room and just rest. Yeah, I know,
and rest care sounds so nice. I would love to
(13:54):
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
complain or do we actually have something to complain about?
Turns out that women spend fifteen more minutes in bed
(14:16):
than men do, but we sleep eleven minutes less. Yeah. Uh.
And when it comes to napping, guys, at least, agreeing
to research from the Pew Center, you take more napst
percent of men reported napping versus of women. So not
a major difference there. But when it comes to who
(14:39):
needs more sleep, doctors say women be needing some sleep
because of our hysterical uteruses. No, Caroline, No, it's actually,
at least, agreeing to professor Jim Horne, who's director of
the Sleep Research Center at Lowborough University in England, it
(15:00):
has to do with our tendency to multitask. Yeah, women
do multitask more than men do. That's on any blog
you'll find up there that will tell you that. But
apparently women need twenty minutes extra deep sleep in order
to rest our core text. The core text during the
(15:20):
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
(15:42):
that multitasking is not exactly better tasking, right, yeah, exactly.
I know. Well it's hard to resist multitasking that sometimes, Caroly, 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 undie noosed adult a d D kicks in and
I'll just I'll start something over here, and then I'll
(16:04):
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. So if you ever
walked by me and I'm just like face down the
cubicle with the space bar going forever, just leave me. Well,
I certainly wouldn't want to wake you up, Caroline, because
according to research out of Duke University, women are grumpier
(16:28):
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
when my mother would wake me up, they would there
(16:49):
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 and 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
yell I'm not sleeping, and you know, go storm mountain,
(17:12):
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
(17:32):
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 guss apparently, but yeah, it's it's scary and
(17:53):
and you're like, well, I mean, surely, like there's nothing
so bad about this. But in addition to all these
things that in ssomnia 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
(18:15):
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 seven,
single working women have it worse, which I was surprised
(18:39):
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
lay doing a 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 and overdrive. Um,
(19:02):
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
(19:24):
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 adolescents through old age, it
is constantly menstruation, menopause, pregnancy, and hormones that are the
(19:52):
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
(20:12):
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
(20:32):
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
(20:56):
who may have experienced this because while I do certainly
out 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 progesterone rises and actually chills out our sleep
(21:21):
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, you have energy
(21:44):
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 and progesterones? Like, hey, friends, here a
few nights over risk. Progesterone comes along, sprinkling fairy dust
(22:08):
on your eyes, and then estrogen bust into the bedroom.
Is like, oh yeah, well, so so does birth control?
I mean, do different types of birth control then affect insomnia?
We did not look into that, Caroline. But I just want,
I mean I want it. Must it must? I I
feel like And this could be mental, this could be
a total coincidence. But when I switched from the pill
(22:29):
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 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 pously because progesterone and estrogen are so commonly linked
to it. Yeah, well so, But speaking of not being
(22:53):
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 grouping of hormones that produce
significant physiological changes. Yeah, and apparently during the third trimester,
(23:18):
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 again wake you up. So
that sounds more like like a secondary insomnia that it's
caused by not a not a health problem, but a
(23:40):
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 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
(24:03):
during this time you get things like a diminished production
of estrogen and particularly progesterone that affects your sleep. Yeah,
and in fact does not get better when it comes
to insomnia as 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
(24:25):
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 the sleep apnea. And I mean, man, your
body is just throwing you 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
(24:47):
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 six looking at gender difference
is in insomnia among adolescents, and it found that when
girls started getting their periods, they became two and a
(25:10):
half times likelier than boys to have insomnia. So yet again,
we have hormones and specifically progesterone, estrogen, et cetera being
strongly related to 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
(25:32):
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 also emerges during puberty that we
talked about before on the podcast is how among girls
rates of depression and anxiety also increased. So one thing
(25:54):
that these researchers looked at was whether or not it
was puberty related on set of depression that might have
been fostering cycles of insomnia, and it and another study
that we looked at examining adult female insomniacs, both concluded
(26:14):
that it is not specifically the depression 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, the research that we found states
that it is not depression and other kinds of psychiatric
(26:38):
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, 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 in
(27:01):
eleven 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 highest
risk of insomnia. So, like christ and said, it just
darnwell never gets better. They found that more than seventy
of men and women reported at least one symptom of insomnia,
(27:22):
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 more frequently reported two
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
(27:46):
a Mediterranean diet, so guzzled that olive oil, drink it
up um, also caffeine and alcohol. What, yeah, I don't. Yeah,
I wondered about that, because that is something that is
pre against I know in every other well, I mean,
I guess, I guess in moderation, but I don't, I
(28:06):
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 don't have my coffee and
wine if I want it. But yeah. They also cited
hormonal replacement therapy as another protective factor, which they also
(28:26):
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 was the one thing that I didn't find
in our research was like, Okay, well, scientists seem to
(28:48):
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 basically just like, well, here here's the information. Uh,
take a lunasta. I don't know. Um. There was also, though,
(29:10):
there was another study looking at the intersection of gender
and economics when it comes to sleep, and there was
this is coming out of the Centers for Disease Control
and Prevention in two thousand twelve, and it found a
pretty strong correlation between income and quality of sleep. Yeah.
(29:30):
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.
But at every family income level, women were still more
likely to have trouble sleeping. But we did glean one
(29:53):
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
and in the premise for it was researchers being like, Okay,
all right, we hear all the time about how women
are you know, I have a harder time with insomnia,
(30:15):
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 seven studies. Yes, women actually do have
legitimately a worse time with insomnia except in Japan. Yeah,
(30:38):
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 Japanese society's sociodemographic and psychological characteristics.
But see, that's curious to me because when it comes
(30:59):
to you, 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 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
(31:22):
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. 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
(31:43):
broad Carolyn, I think we've figured it out down with
feministinism ruining everyone's sleep. Please don't write me letters. You know,
I don't believe that I'm writing you a letter right now, Caroline.
I'm multitasking. God, You're cortex is going to need so
much rest tonight. I know, but I am curious. Then
(32:04):
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, 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
(32:26):
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,
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
(32:47):
cold air bath. A cold air bath. He sitting naked
in his armchair reading. I'm picturing it. I'm picturing it too.
It was refreshing. Well, I don't have to be awfully chili. Yeah, Well,
we now need to talk about treatments for insomnia. Perhaps
the cold air bathel do you um when it comes
(33:08):
to acute insomnia, those brief windows of sleepless nights that
might happen. Treatment just might not be required, it'll probably
go away 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,
(33:31):
a couple of years ago, I was like not sleeping
at all, I was really stressed out, and my doctor
prescribed me ambient, when really I probably should have been
going to a therapist in 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,
(33:52):
they're all sorts of behavioral therapies developed for helping sleep
and caring insomnia, as such as relaxation exercises, something called
sleep restriction therapy, which is on the more extreme end
of these behavioral therapies where if you say I can't
(34:12):
ever fall asleep until like four in the morning, then
according to sleep restriction therapy, 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 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,
(34:35):
not four in the morning, not that extreme, but I
found myself, like, I think, 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
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
(34:57):
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
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
(35:19):
nights and not sleeping well, I knew that if I did,
I would just lie there and sweat, right, just sweat
the bed. I swept the bed um. But also, like
you know, we we've mentioned um sleep at me a
lot in this podcast episode. You might want to look
into going to a sleep clinic and getting a sea
Pat machine. I have a friend who got a sea
(35:39):
Pat machine and he sleeps like a baby. Now, my
mother was prescribed a sea Pat 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 to have sleep at me and you don't want
to have to use a sea Pat machine, but it
can be life changing for people who use it. It
involved um putting like a mask over your mouth the nose,
(36:00):
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 but a lot
of people do take in the bedroom is sleeping pills. Sleep.
The market for sleeping pills has I don't want to
say exploded because that's the sensational term, but it's kind
(36:22):
of exploded. Yeah, 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
all the way back, but in nine you have del Maine,
which was the first benzo diazepine explicitly approved by the
f d A as a sleeping pill. Fast forward all
(36:45):
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 billion times worldwide. Now,
the number of pizzas that have been sleep eaten on
a still unknown, and according to data from the CDC
(37:09):
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. But the trouble with
these sleeping pills is that they might not actually be
(37:29):
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 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
(37:51):
of well, what kind of sleep are you actually getting
when you pop an ambient or ALMST or something like that,
because you might not be getting as deep of asleep
as you would otherwise. Right, Well, the whole thing with
ambient and I am someone who takes Ambien 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
(38:13):
low dose like I do, because that's more of the
placebo effect, let's be honest. But the thing with Ambien
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 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
today is going to be awful. With Ambien, you forget
(38:34):
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 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
(38:55):
were talking about drug reps who were working on medication
that would be more like keep you more consistently asleep
throughout the nights, so not just be that sudden, sudden
onset of sleep and then you sort of toss and
turning 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
(39:17):
there's a whole factor of lifestyle issues related to how
we sleep. I mean, clearly when it comes to sleep
on the hormonal level and insomnia and all of that. Um,
I 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
(39:41):
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, only use your bed for sleep, or sex, etcetera, etcetera. Right,
and there's some good behavioral suggest sense that I hadn't
really thought about. I mean, this seems like it's common
(40:03):
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 early morning walk with a friend as because
you're combining 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.
(40:28):
I socialized with NPR in the morning. I do too,
sometimes I answer them. But the there was a question, though,
posited in the 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,
(40:50):
Ben Franklin and his cold air baths, of sleeping in
these four hour blocks and then waking up in the night,
doing 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
(41:11):
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 out in the world and work and and behave
yourself and 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
(41:31):
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 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 bed. If we can just
(41:53):
go back to the dark ages. But one thing that
hasn't changed though through all of this is the menstruals. Like, yeah,
it seems like 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
(42:14):
insomnia more than men because of our periods. Yeah, all
those hormones fled out of the stadium being like peace out,
see you later, See you went back when you can
sleep again. I 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
(42:38):
we want to hear from you. What's been your experience
with insomnia and have you successfully overcome it and how
did you do that to let us know so we
can share your insights with everybody else. Moms 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 message is
(43:00):
to share with you right now. Well, I've got a
Facebook message here from Caitlin in response to our Explorer
series episode on Seafaring Women, and she writes, Ladies, I
am a marine scientist and literally whoped for joy when
(43:20):
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 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
(43:40):
sitting on deck sipping mohitos while waiting my turn to
play 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 day and age, ship life
can be challenging. No phone service, intimate internet, absolutely no Netflix.
It's enough to send even the most adventurous person crazy
(44:03):
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 we were forced to look
at each other in the eye and communicate without the
assistance of emails, text and Facebook messages. Also, there's something
absolutely breathtaking about looking around you in all directions and
(44:25):
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'm privy to something that not
many people have the opportunity to see, the deep sea.
I've traveled a couple thousand feet deep in a submersible
to a site that was little explored, and I can't
(44:46):
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 Rachel Carson and Sylvia Earle her Deep
Us 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
(45:07):
to her, and she is amazing. As just a few
resources if you're interested, I did outreach for a deep
sea research cruise, so you guys can read about life
at sea at Acid Horizon dot 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
(45:28):
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, who was a woman
after my own heart. She wrote us to share a
story about her family history, particularly one woman named Penelope Um.
(45:49):
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 and
Prince Stout as a child, but recently found a family
history book that went into much more detail. Around sixte
Penelope and her first husband set sail from Holland for
(46:09):
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 and hid in
the hollow of a tree until another group of Native
Americans founder. She lived in the natives village and was
(46:29):
nursed back to health by them. Sometime later, she married
Richard Stout and they moved to New Jersey in sixteen
sixty five, However, partship 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 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.
(46:49):
As we can tell from her previous experiences, Penelope was
not one to give up. Despite having one bum arm,
she took her ten children in a canoe to safety
without shared. When I learned the story of Penelope, I
felt honored to be distantly related to her. She was
an explorer in her own right, living in a new
land at a time when women were not allowed to
(47:10):
be strong willed. I sincerely hope I inherited some of
those traits, along with her good genes that 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 who share their stories
with us. Mom Stuff at how stuff works dot com
is our email address and for links to all of
our social media as well as all of our blog post,
(47:31):
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 because at how stuff works.
Dot Com
Welcome to stuff mom never told you. From how Supports
dot com. Hello, and 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
(00:25):
coming into this topic 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,
(00:48):
whether it's 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 in some is created. Well, Caroline,
I you're really a method podcaster. See what I can do,
what I can summersing yourself in the topic, And I'm
(01:09):
sure that there are so many listeners who can relate
to that very cycle of insomnia. The 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
(01:30):
of people experience. Certainly here in the US, a lot
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,
(01:51):
as reported on in the New York Times, we spend
twenty billion dollars a year on sleep aids of different
source is 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
(02:11):
depri and I don't mean you like you Kristin Conger,
Like when Kristin Conger comes to work sleep deprived, but
when the 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,
(02:32):
because your brain is just shutting down. Um, and The
thing is, 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,
(02:53):
Like doctors still aren't entirely sure what causes insomnia. We
know what 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,
(03:17):
and it leads to some some awful things during your
day that you have 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
(03:38):
is a sleep disorder characterized by difficulty falling and or
staying asleep. Yeah, 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, well, I
(04:00):
have a beaple to sleep again. Well, would you characterize
here insomnia then as the acute insomnia or chronic insomnia? Well,
I would say that bout 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,
(04:21):
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, that acute insomnia, I'm pretty
sure it was primary insomnia versus secondaries to primaries, like
just regular run of the mill can't sleep because you're
feeling crazy, versus secondary which is actually sleep problems caused
(04:44):
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 me late man, it is a
kool aid man of insomnia sleep disorders, and 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,
that's really cool, friend of mine insomnia, Ye, have fun
(05:06):
with both of us. Then the secondary Oh man, what
a great medical doctor I would well in 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,
(05:30):
it's also how we react to stress, which can exacerbate insomnia. Yeah,
if you're not dealing with your stress, 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
(05:50):
reduction techniques. We're all guilty of a glass of pino
griggia now and again, and that can actually contribute to
your stress induced insomnia. And they are also a number
of medical conditions such as issues with chronic pain, breathing difficulties,
or needing to urinate frequently that can provoke insomnia because
(06:10):
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, certain medications, and
things like caffeine, which is an obvious one, nicotine, 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
(06:32):
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, we're off,
and now I'm not sleeping well at all. Yeah. Or
you might sleep through the night, but it's not 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
(06:55):
to alcohol. Speaking of alcohol, is your good old handy
dandy period. It's so andy and andy both. So during
your period, your progesterone, your hormone progesterone is highest around
ovulation and during your luteal or post ovulation phase, and
this hormonal cocktail can actually exacerbate the effects of alcohol.
(07:17):
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
culprit hey hormones. I just picture like a giant crowd
of hormones all waving like penances. They're like at a
football game like that. We're not gonna let you sleep.
(07:38):
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 that it's a host of not so fun things
like lower job or school performance, slow reaction times while driving,
(08:00):
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
might contribute to more insomnia. Yeah, it is, it's all.
Insomnia is part of just a terrible cycle of awful things.
(08:21):
Because I mean, the more you get it, the worst
things get. Things like high blood pressure, it aggravates weking,
and obesity, heart disease, all this terrible stuff. But at work,
you know, Kristen mentioned it contributes to lower job in
school performance as one would expect if you're like totally
tired and not firing on all cylinders. There was a
study in two thousand and six from the Journal of Management,
(08:43):
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.
But that that is actually worse. These effects are actually
worse for women. Yeah, that finding in the study that
(09:04):
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
after not getting enough sleep. But I guess that's a
(09:26):
little bit different because it'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
believe that they're suffering from more from insomnia, but that they,
(09:50):
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,
it slows down that recovery period. If you're doing all
this housework, then you have less time to rest and
(10:12):
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
medical or psychiatric problems in lady sleepers. Right. Yeah, because
(10:36):
women are about twice as likely as men to suffer
from major depression during their lives, and it's nearly always
accompanied by difficulty 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
messes up your sleep because you basically wake up gasping
(10:57):
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 apnia as men are,
but once they get past menopause they catch up to men,
(11:18):
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, but kind of
programmed to think that it happens more frequently in men
(11:40):
than in women, they might overlook the signs of sleep
apniaan 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, now that we've talked about
a lot of sort of external factors that interact with
(12:03):
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, and we'll talk more
(12:24):
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 History by Elena Summers Bremner,
(12:46):
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 was why women need more sleep.
(13:07):
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, and essentially he would lock
(13:33):
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 in this room and just rest. Yeah, I know,
and rest care sounds so nice. I would love to
(13:54):
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
complain or do we actually have something to complain about?
Turns out that women spend fifteen more minutes in bed
(14:16):
than men do, but we sleep eleven minutes less. Yeah. Uh.
And when it comes to napping, guys, at least, agreeing
to research from the Pew Center, you take more napst
percent of men reported napping versus of women. So not
a major difference there. But when it comes to who
(14:39):
needs more sleep, doctors say women be needing some sleep
because of our hysterical uteruses. No, Caroline, No, it's actually,
at least, agreeing to professor Jim Horne, who's director of
the Sleep Research Center at Lowborough University in England, it
(15:00):
has to do with our tendency to multitask. Yeah, women
do multitask more than men do. That's on any blog
you'll find up there that will tell you that. But
apparently women need twenty minutes extra deep sleep in order
to rest our core text. The core text during the
(15:20):
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
(15:42):
that multitasking is not exactly better tasking, right, yeah, exactly.
I know. Well it's hard to resist multitasking that sometimes, Caroly, 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 undie noosed adult a d D kicks in and
I'll just I'll start something over here, and then I'll
(16:04):
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. So if you ever
walked by me and I'm just like face down the
cubicle with the space bar going forever, just leave me. Well,
I certainly wouldn't want to wake you up, Caroline, because
according to research out of Duke University, women are grumpier
(16:28):
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
when my mother would wake me up, they would there
(16:49):
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 and 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
yell I'm not sleeping, and you know, go storm mountain,
(17:12):
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
(17:32):
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 guss apparently, but yeah, it's it's scary and
(17:53):
and you're like, well, I mean, surely, like there's nothing
so bad about this. But in addition to all these
things that in ssomnia 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
(18:15):
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 seven,
single working women have it worse, which I was surprised
(18:39):
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
lay doing a 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 and overdrive. Um,
(19:02):
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
(19:24):
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 adolescents through old age, it
is constantly menstruation, menopause, pregnancy, and hormones that are the
(19:52):
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
(20:12):
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
(20:32):
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
(20:56):
who may have experienced this because while I do certainly
out 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 progesterone rises and actually chills out our sleep
(21:21):
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, you have energy
(21:44):
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 and progesterones? Like, hey, friends, here a
few nights over risk. Progesterone comes along, sprinkling fairy dust
(22:08):
on your eyes, and then estrogen bust into the bedroom.
Is like, oh yeah, well, so so does birth control?
I mean, do different types of birth control then affect insomnia?
We did not look into that, Caroline. But I just want,
I mean I want it. Must it must? I I
feel like And this could be mental, this could be
a total coincidence. But when I switched from the pill
(22:29):
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 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 pously because progesterone and estrogen are so commonly linked
to it. Yeah, well so, But speaking of not being
(22:53):
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 grouping of hormones that produce
significant physiological changes. Yeah, and apparently during the third trimester,
(23:18):
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 again wake you up. So
that sounds more like like a secondary insomnia that it's
caused by not a not a health problem, but a
(23:40):
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 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
(24:03):
during this time you get things like a diminished production
of estrogen and particularly progesterone that affects your sleep. Yeah,
and in fact does not get better when it comes
to insomnia as 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
(24:25):
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 the sleep apnea. And I mean, man, your
body is just throwing you 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
(24:47):
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 six looking at gender difference
is in insomnia among adolescents, and it found that when
girls started getting their periods, they became two and a
(25:10):
half times likelier than boys to have insomnia. So yet again,
we have hormones and specifically progesterone, estrogen, et cetera being
strongly related to 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
(25:32):
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 also emerges during puberty that we
talked about before on the podcast is how among girls
rates of depression and anxiety also increased. So one thing
(25:54):
that these researchers looked at was whether or not it
was puberty related on set of depression that might have
been fostering cycles of insomnia, and it and another study
that we looked at examining adult female insomniacs, both concluded
(26:14):
that it is not specifically the depression 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, the research that we found states
that it is not depression and other kinds of psychiatric
(26:38):
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, 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 in
(27:01):
eleven 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 highest
risk of insomnia. So, like christ and said, it just
darnwell never gets better. They found that more than seventy
of men and women reported at least one symptom of insomnia,
(27:22):
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 more frequently reported two
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
(27:46):
a Mediterranean diet, so guzzled that olive oil, drink it
up um, also caffeine and alcohol. What, yeah, I don't. Yeah,
I wondered about that, because that is something that is
pre against I know in every other well, I mean,
I guess, I guess in moderation, but I don't, I
(28:06):
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 don't have my coffee and
wine if I want it. But yeah. They also cited
hormonal replacement therapy as another protective factor, which they also
(28:26):
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 was the one thing that I didn't find
in our research was like, Okay, well, scientists seem to
(28:48):
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 basically just like, well, here here's the information. Uh,
take a lunasta. I don't know. Um. There was also, though,
(29:10):
there was another study looking at the intersection of gender
and economics when it comes to sleep, and there was
this is coming out of the Centers for Disease Control
and Prevention in two thousand twelve, and it found a
pretty strong correlation between income and quality of sleep. Yeah.
(29:30):
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.
But at every family income level, women were still more
likely to have trouble sleeping. But we did glean one
(29:53):
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
and in the premise for it was researchers being like, Okay,
all right, we hear all the time about how women
are you know, I have a harder time with insomnia,
(30:15):
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 seven studies. Yes, women actually do have
legitimately a worse time with insomnia except in Japan. Yeah,
(30:38):
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 Japanese society's sociodemographic and psychological characteristics.
But see, that's curious to me because when it comes
(30:59):
to you, 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 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
(31:22):
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. 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
(31:43):
broad Carolyn, I think we've figured it out down with
feministinism ruining everyone's sleep. Please don't write me letters. You know,
I don't believe that I'm writing you a letter right now, Caroline.
I'm multitasking. God, You're cortex is going to need so
much rest tonight. I know, but I am curious. Then
(32:04):
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, 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
(32:26):
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,
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
(32:47):
cold air bath. A cold air bath. He sitting naked
in his armchair reading. I'm picturing it. I'm picturing it too.
It was refreshing. Well, I don't have to be awfully chili. Yeah, Well,
we now need to talk about treatments for insomnia. Perhaps
the cold air bathel do you um when it comes
(33:08):
to acute insomnia, those brief windows of sleepless nights that
might happen. Treatment just might not be required, it'll probably
go away 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,
(33:31):
a couple of years ago, I was like not sleeping
at all, I was really stressed out, and my doctor
prescribed me ambient, when really I probably should have been
going to a therapist in 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,
(33:52):
they're all sorts of behavioral therapies developed for helping sleep
and caring insomnia, as such as relaxation exercises, something called
sleep restriction therapy, which is on the more extreme end
of these behavioral therapies where if you say I can't
(34:12):
ever fall asleep until like four in the morning, then
according to sleep restriction therapy, 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 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,
(34:35):
not four in the morning, not that extreme, but I
found myself, like, I think, 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
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
(34:57):
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
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
(35:19):
nights and not sleeping well, I knew that if I did,
I would just lie there and sweat, right, just sweat
the bed. I swept the bed um. But also, like
you know, we we've mentioned um sleep at me a
lot in this podcast episode. You might want to look
into going to a sleep clinic and getting a sea
Pat machine. I have a friend who got a sea
(35:39):
Pat machine and he sleeps like a baby. Now, my
mother was prescribed a sea Pat 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 to have sleep at me and you don't want
to have to use a sea Pat machine, but it
can be life changing for people who use it. It
involved um putting like a mask over your mouth the nose,
(36:00):
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 but a lot
of people do take in the bedroom is sleeping pills. Sleep.
The market for sleeping pills has I don't want to
say exploded because that's the sensational term, but it's kind
(36:22):
of exploded. Yeah, 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
all the way back, but in nine you have del Maine,
which was the first benzo diazepine explicitly approved by the
f d A as a sleeping pill. Fast forward all
(36:45):
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 billion times worldwide. Now,
the number of pizzas that have been sleep eaten on
a still unknown, and according to data from the CDC
(37:09):
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. But the trouble with
these sleeping pills is that they might not actually be
(37:29):
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 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
(37:51):
of well, what kind of sleep are you actually getting
when you pop an ambient or ALMST or something like that,
because you might not be getting as deep of asleep
as you would otherwise. Right, Well, the whole thing with
ambient and I am someone who takes Ambien 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
(38:13):
low dose like I do, because that's more of the
placebo effect, let's be honest. But the thing with Ambien
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 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
today is going to be awful. With Ambien, you forget
(38:34):
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 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
(38:55):
were talking about drug reps who were working on medication
that would be more like keep you more consistently asleep
throughout the nights, so not just be that sudden, sudden
onset of sleep and then you sort of toss and
turning 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
(39:17):
there's a whole factor of lifestyle issues related to how
we sleep. I mean, clearly when it comes to sleep
on the hormonal level and insomnia and all of that. Um,
I 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
(39:41):
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, only use your bed for sleep, or sex, etcetera, etcetera. Right,
and there's some good behavioral suggest sense that I hadn't
really thought about. I mean, this seems like it's common
(40:03):
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 early morning walk with a friend as because
you're combining 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.
(40:28):
I socialized with NPR in the morning. I do too,
sometimes I answer them. But the there was a question, though,
posited in the 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,
(40:50):
Ben Franklin and his cold air baths, of sleeping in
these four hour blocks and then waking up in the night,
doing 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
(41:11):
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 out in the world and work and and behave
yourself and 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
(41:31):
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 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 bed. If we can just
(41:53):
go back to the dark ages. But one thing that
hasn't changed though through all of this is the menstruals. Like, yeah,
it seems like 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
(42:14):
insomnia more than men because of our periods. Yeah, all
those hormones fled out of the stadium being like peace out,
see you later, See you went back when you can
sleep again. I 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
(42:38):
we want to hear from you. What's been your experience
with insomnia and have you successfully overcome it and how
did you do that to let us know so we
can share your insights with everybody else. Moms 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 message is
(43:00):
to share with you right now. Well, I've got a
Facebook message here from Caitlin in response to our Explorer
series episode on Seafaring Women, and she writes, Ladies, I
am a marine scientist and literally whoped for joy when
(43:20):
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 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
(43:40):
sitting on deck sipping mohitos while waiting my turn to
play 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 day and age, ship life
can be challenging. No phone service, intimate internet, absolutely no Netflix.
It's enough to send even the most adventurous person crazy
(44:03):
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 we were forced to look
at each other in the eye and communicate without the
assistance of emails, text and Facebook messages. Also, there's something
absolutely breathtaking about looking around you in all directions and
(44:25):
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'm privy to something that not
many people have the opportunity to see, the deep sea.
I've traveled a couple thousand feet deep in a submersible
to a site that was little explored, and I can't
(44:46):
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 Rachel Carson and Sylvia Earle her Deep
Us 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
(45:07):
to her, and she is amazing. As just a few
resources if you're interested, I did outreach for a deep
sea research cruise, so you guys can read about life
at sea at Acid Horizon dot 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
(45:28):
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, who was a woman
after my own heart. She wrote us to share a
story about her family history, particularly one woman named Penelope Um.
(45:49):
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 and
Prince Stout as a child, but recently found a family
history book that went into much more detail. Around sixte
Penelope and her first husband set sail from Holland for
(46:09):
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 and hid in
the hollow of a tree until another group of Native
Americans founder. She lived in the natives village and was
(46:29):
nursed back to health by them. Sometime later, she married
Richard Stout and they moved to New Jersey in sixteen
sixty five, However, partship 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 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.
(46:49):
As we can tell from her previous experiences, Penelope was
not one to give up. Despite having one bum arm,
she took her ten children in a canoe to safety
without shared. When I learned the story of Penelope, I
felt honored to be distantly related to her. She was
an explorer in her own right, living in a new
land at a time when women were not allowed to
(47:10):
be strong willed. I sincerely hope I inherited some of
those traits, along with her good genes that 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 who share their stories
with us. Mom Stuff at how stuff works dot com
is our email address and for links to all of
our social media as well as all of our blog post,
(47:31):
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
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Samantha McVey
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