MILLIONS OF US ARE LIVING in a near-constant state of stress. Women in particular strain to accept this as an inevitable consequence of our modern, fast-paced lives and the roles we’ve taken on as partners, mothers, and caregivers. Welcoming these multiple roles and their expectations has placed many of us between a rock and a hard place.
Today, underacknowledged Wonder Woman expectations paired with misleading misinformation about how to manage our health and hormones have led to a full-blown crisis. Confronted with a clashing array of crash diets and boot camps, sleeping pills, antidepressants, and plastic surgery, women often turn to supposed health solutions that are not, in actuality, healthy at all. Unable to imagine how our situation might improve, we bend over backward trying to improve ourselves instead. Many women overwork themselves to that end while still feeling unappreciated both at their jobs and at home. Others struggle to keep balance within an equation that possesses none. Eventually, something gives and the physical symptoms of these accumulated stressors can get the best of us.
It is no wonder that women are suffering considerably higher levels of stress than men. Official figures report that the discrepancy occurs primarily in women ages twenty-five to fifty-four, and peaks between thirty-five and forty-four, when many of us are juggling career ladders and the brunt of familial responsibilities simultaneously. Since the latter often includes caring for children and elderly parents at the same time, many women are shouldering what could be considered a minimum of two full-time jobs at once, often without recognition of the fact, and without extra support. As bad timing would have it, all of this coincides with hormonal shifts that require women to take more care of themselves rather than less. Instead, with work and family obligations at an all-time high, we are left with absolutely no time for self-care.
When our systems are taxed beyond their means for years if not decades at a time, there is a toll, emotionally, psychologically, and physically. We may find ourselves short-tempered, jumpy, and frazzled, losing our patience, stamina, and calm. Sometimes we feel empty or depressed, or find that we can’t think straight. Feeling worn down and worn out can often lead to a sluggish mental state, in which we end up losing our keys, spacing on a colleague’s name, or wrestling with that word on the tip of our tongue. So many of us soldier on blindly, feeling there is no other choice. Perhaps we think if only these outside stressors would subside, our internal stress could do the same. The trouble is, stress can lead to serious medical problems, so it’s best not to ignore it, no matter how noble the cause.
Perhaps more than any other health risk, stress is the silent killer our society has yet to acknowledge fully. Those of us in the health field already recognize it as a major contributing factor in all leading causes of death, including heart disease, cancer, lung disease, and Alzheimer’s. Especially for women, research shows that prolonged periods of stress, and the subsequent surge in cortisol levels, decreases overall cell function while sending our hormonal levels plummeting, which can accelerate neuronal aging and aggravate the symptoms of menopause. It is perhaps our tendency to take care of others, even when under stress, that puts women at higher risk of suffering from “caregiver burden.” From a medical perspective, there is evidence that women’s brains are more vulnerable to long-term stress than men’s. For example, a recent study of more than 2,000 middle-aged people showed that if you lead a high-stress life, you could experience memory loss and brain shrinkage before you even turn fifty. According to these studies, the adverse effects of high stress and high cortisol are harsher in the female brain than in the male’s.
A main reason stress has such a powerful impact on well-being is because it is activated in the brain. Let’s examine how this process works, why stress affects us the way it does, and how to get rid of it! We will discuss scientifically validated strategies proven to work for women for keeping stress in check while at the same time improving restful sleep. Reducing stress in our everyday life is vital for maintaining our overall health, as it can improve mood, boost immune function, and promote longevity.
Unlike the symptoms that occur once stress becomes chronic, the initial response is an innocent one, an expression of the brain’s natural instinct to protect us. Our stress response has been exquisitely honed over millions of years as a protective mechanism, beginning with our ancestors having to deal with their fair share of threats, like saber-toothed tigers and famines. Today, the tigers have been replaced by an onslaught of “mental monsters” instead. Where there were once moments of quiet in our lives, we are now daily plagued by the modern “convenience” of making ourselves accessible 24/7—whether it be to view and review the global live-streamed headlines of the day, or the day and night notifications we receive via email, messaging, phone alerts, alarms, and nonstop social media prompts. We are virtually bombarded by incessant interruptions that require our reaction, many of them urgent, most at least pressing. Anxiety mounts as we navigate headlines reflecting a challenging sociopolitical territory often charged with violence, looming health crises, and climate disasters.
Although none of this includes a saber-toothed tiger, our bodies respond as if it does: with hypertension, strokes, ulcers, heart attacks, and hormonal crashes. Evolutionarily, our stress response was intended to warn us of immediate danger, and as such was a response or state that we would discharge as soon as we had physically confronted that danger. But the chronic stress we experience today is often experienced while commuting, working at a desk, texting in bed, or otherwise inside our heads. As we “sit with it,” its repercussions can ravage our physical, emotional, and cognitive health.
The way men and women respond to stress can be somewhat different. You are probably familiar with the term “fight-or-flight,” referring to a primordial hormonal response to either attack or flee oncoming potential danger. As discussed, given that the preponderance of medical research is based solely on males, this was the case for fight-or-flight as well. Until 1995, women constituted as little as 17 percent of participants in studies focused on the behavioral and psychological effects of stress. But there’s a new theory in town that focuses on a “female” response to stress.
As scientists finally turned their attention to stress-related differences between the genders, it soon became clear that, while both sexes shared the capacity for fight-or-flight, females seemed to show an alternate reaction. Women often proved more cerebral rather than physical in their stress response to danger. This uniquely female response to stress is called “tend-and-befriend.”
This response likely evolved ages ago, when our ancestors lived in hunter-gatherer communities. Back then, it was normal for men to go hunting (and deal with those tigers) and for women to stay behind, harvesting and taking care of the family. Given that fighting or fleeing is not so easy when you are pregnant, nursing, or caring for your children, females developed their own brand of responding to danger when it arrived. In such moments, they became even more protective of their children (tending to them) while banding together with other women (befriending) to increase everyone’s likelihood of survival. This teamwork also benefited them day to day, not only guaranteeing extra protection and support in raising their offspring, but also providing a more efficient way to gather and share resources such as food. Still today, this primal impulse to form tight, stable alliances may very well be behind our current tendencies to seek out friends to talk, vent, and share our stories.
This difference is due in part to our hormones. Three hormones in particular play a crucial role in the stress response: cortisol, adrenaline, and the “love hormone,” oxytocin. When stress strikes, cortisol and adrenaline raise your blood pressure and sugar levels, which might prompt you to land a punch . . . or turn tail and run. That happens in both men and women. However, in women, as cortisol and adrenaline flood the bloodstream, the brain steps in with a shot of oxytocin. Oxytocin is a hormone that promotes nurturing, loving emotions. Scientists suspect that the additional release of oxytocin may be behind women’s impulse to “tend” to their loved ones and “befriend,” finding comfort in their peers.
Brain imaging studies further confirm this theory by showing that men and women tend to activate different parts of their brains when faced with stress. Women tend to have particularly strong activity throughout the limbic system, the part of the brain primarily involved in emotions, while men tend to activate their frontal cortex, the area in charge of reason. Women under stress also show increased “functional connectivity,” a phenomenon by which different areas of the brain become simultaneously activated and work together. The very same areas of a man’s brain show the opposite effect, a disengagement between these regions. In other words, when women are stressed, both social and emotional areas of the brain go on alert, perhaps reflecting the tendency to reach out and connect, while men may be more likely to withdraw.
There are over 65 million people in America alone serving as caregivers for their ill or disabled relatives. Women account for over 60 percent of these caregivers. (Who among us, I wonder, is not being taken into account in this percentage?) The rates are even higher for Hispanic and African American women. There is a steep physiological-emotional strain that accumulates with caregiving, now acknowledged as the “caregiver burden.”
Research indicates that caregiver burden can severely tax caregivers’ health, while simultaneously compromising their immune response to stress, limiting their ability to cope and heal. At the same time, this type of stress is known to exacerbate existing chronic health conditions, which is quite a problem given that, due to the demands on their time, caregivers are less likely to engage in preventative health behaviors than non-caregivers, such as sleeping and eating properly, exercising, or resting when necessary. As a result, they are not only managing higher levels of stress but do so at a health deficit in comparison with the rest of the nation, sometimes resulting in an increased risk for heart disease, stroke, depression, and even premature mortality. To make matters worse, caregivers tend to have a higher risk of developing Alzheimer’s themselves. We surmise that this is most likely due to the multi-stressors inherent in this commitment, paired with the lack of caregiving to the caregivers themselves.
In keeping with the fact that the effects of shouldering stress have a more severe impact on a woman’s health than a man’s, according to the National Alliance for Caregiving, female caregivers experience a twofold higher level of this burden than male caregivers. This fact might have to do with more than our biology, however. For example, unlike sons, the daughters of Alzheimer’s patients tend to provide more routine assistance (such as changing diapers, cooking, and cleaning), while simultaneously experiencing more guilt for not managing more. Also, female caregivers are less likely to receive support from their spouses, and are instead more likely to quit their jobs to care for their parents. In contrast, male caregivers are more likely to ask for help from other family members, most often their sisters or wives.
In other words, it is not only the sheer number of women acting as caregivers that is of concern but also the fact that they tend to offer fuller assistance, to do so alone, and to even surrender jobs in the process. Nearly 19 percent of all female Alzheimer’s caregivers end up quitting work to manage their caregiving commitment or end up losing their jobs because of these duties—either event ending in financial crisis and an additional emotional toll.
An ironic timing also rounds out this picture, since typically it is middle-aged women who become the primary caregivers for their parents or loved ones. These women are often approaching menopause or are already dealing with it amid these competing pressures, and are therefore managing stress, inside and out, and on all fronts. Their bodies are paying the price.
My goal in writing this book is not only to acknowledge what women are going through but to provide relief and solutions. Stress-management strategies are the vital first line of defense against stress for all women. While it’s perfectly natural to experience stress from time to time, it shouldn’t be a daily visitor in your life. It is paramount that each one of us assesses how to minimize stress in our lives. It is then nothing short of vital to deploy whatever strategies are necessary to make a change, because the simple truth is, you can’t pour from an empty cup. You can’t help others unless you help yourself too. Personally, I repeat this to myself many times a day: I must make time for myself to de-stress and recharge. If you too recognize this need in your life, I’ve outlined simple steps that you can begin taking today. While I cannot promise instantaneous bliss, these tools will help you manage your stress more effectively so that you can take care of yourself more genuinely. Doing this is a proven way to add years to your life, and much happier ones at that.
We may not have much control over many of the sources of stress in our lives, but we do control how we respond to stress. Three key lifestyle factors are crucial in this respect: diet, exercise, and relaxation. If you eat the balanced diet detailed in chapter 10, while strategically supplementing with the vitamins and herbs proven to reduce anxiety and boost energy in chapter 11, and engage in consistent physical activities as described in chapter 12, you’re already on your way. Now as for relaxation, which is something as fundamental to your well-being as food, water, and physical activity, there are many ways to go about it, depending on what your stressors are.
Many women under stress tend to withdraw and cut back on their social life. If research is any indication, we should be doing the opposite, spending time with family and friends on a regular basis. On top of helping women de-stress, having a sense of purpose and social connection has been associated with a longer life span and a reduced risk of dementia. “Social connection” doesn’t mean how many followers you have on Facebook, though those networks can be wonderful, too—it means real personal relationships with people who show up when you need them. Several studies agree that even if your social ties are not very extended, having a family you love is enough to protect your brain, provided you connect with them happily and as often as possible.
And if you’re more of an introvert and need solitude to recharge—do your very best to book in some unstructured time for yourself. By “unstructured” I mean that you’re not on a schedule, you’re not checking your calendar, and you’re not wondering how somebody else is doing. Just use the time to do whatever comes to your mind.
Regularly “unplugging” is particularly important when your stress is work or relationship-based. Studies indicate that deliberately detaching from work-related communication during non-work time is positively associated with employee recovery and health. Moreover, research has now proved that time spent on cell phones, tablets, and computers does minimize our ability to sleep. Whether you’re surfing the Web, playing a video game, or using your phone to knock out a few emails, you’re inadvertently preventing yourself from a restful night. The blue light that screens emit restrains the body’s production of melatonin, the hormone that controls your sleep-wake cycle, or circadian rhythm. Reduced melatonin makes it harder to fall and stay asleep, while also increasing cortisol levels. Cortisol is great at waking you up and keeping you up while messing with your hormonal balance, too.
To make sure technology isn’t making you even more stressed out, give yourself at least thirty minutes of screen-free transition time before hitting the hay. A small ritual like putting your cell phone to charge in another room at night or switching it to airplane mode can cue immediate relief. Even better, consider periodic breaks from electronics and social media, designating an e-free weekend or a twelve-to-twenty-four-hour detox. Start a challenge with family and friends and enjoy the results!
There is an emerging body of science indicating that natural settings hold restorative powers for the mind and the body. Those of us who are city dwellers spend far less time in nature than is good for us. Lack of outdoor time is linked to higher levels of stress, depression, and anxiety. So it’s safe to say that we would all benefit from bringing a little more nature into our lives. Make a point of enjoying a day at the beach, going for a hike, or doing something as simple as taking a stroll in the park, phone-free. You could also get creative and bring the outside, in, introducing plants, flowers, and water elements to your office or home.
Even those people who do shut down their phones and venture outside regularly can suffer from persistent stress. Then it’s time to reach for mind-body techniques like meditation, mindfulness training, or yoga. While rigorous research in this field has only just begun, the available evidence indicates that relaxation techniques perform target-reduction on the harmful consequences stress has on the brain. At the same time, they promote hormonal balance. This is especially important for women who suffer from hot flashes but have limited pharmaceutical options, such as cancer patients and women with a history of heart disease, liver disease, or endometriosis. Additionally, mind-body techniques can be helpful to women choosing to navigate menopause naturally, without any help from medications.
These time-tested relaxation techniques might also give caregivers an opportunity to take a breather while calming their loved ones. Since anxiety and panic attacks often afflict patients with dementia, especially in the early stages of the disease when they first come to grips with declining cognitive capabilities, sharing a mindfulness practice with whoever is in your care gives you both a moment’s peace amid an otherwise stressful day. And let’s not forget the positive effect that deep breathing and mindfulness can have on both parents and children, especially when started at a young age. For instance, we always encourage our four-year-old daughter to take three deep belly breaths if she is feeling upset or overwhelmed, and encourage open discussion about how she is feeling and her emotions. This simple practice really made an enormous difference during the so-called terrible threes.
For millennia, cultures worldwide have used meditation as a way to cultivate physical, mental, and spiritual well-being. We have since begun to study how these practices also protect the brain from stress overload. Emerging research suggests that meditation not only reduces stress and anxiety but also has a positive influence on neuroplasticity. This refers to the brain’s ability to adapt and change, thereby restoring and repairing itself. Breathing techniques, in particular, have been associated with reducing the brain shrinkage that can happen over time and reversing gene expression responsible for stress-induced symptoms. Practicing slow, deep breaths lowers a racing heart, melting stress into calm, while also pulling back on the reins of the inflammation that would have ensued otherwise.
There are many different forms of meditation available to try. For those of you with ants in your pants, there is even something called a “walking meditation,” or a “doing the dishes” meditation, so keep an open mind as you find the practice that suits you best. Each of the alternatives below can be effective at reducing stress while subsequently improving multiple aspects of your health at the same time.
Transcendental Meditation (TM) has become a popular choice. You sit for a set number of minutes twice a day while reciting a personalized mantra. This mantra is given to you by a teacher and isn’t meant to be shared with anyone. Those who practice TM report settling into a state of deep relaxation, often leading to a feeling of inner calm or peace. In clinical studies, TM was indeed shown to lower blood pressure as well as the risk of heart disease. In one example, a randomized controlled trial of 201 men and women with coronary heart disease showed a 48 percent reduction in their risk for mortality and a 24 percent reduction in the risk of heart attacks and strokes after just a few years of regularly practicing TM. If you’re interested in learning more, the David Lynch Foundation is a great place to start: www.davidlynchfoundation.org.
Mindfulness meditation, a Buddhist-based breathing practice that has been studied quite extensively, involves focusing on what’s around you on a moment-to-moment basis. Mindfulness-Based Stress Reduction (MBSR), a technique that focuses on the breath for up to forty minutes at a time, was found to be beneficial to lowering stress in Alzheimer’s patients and their caregivers. Additionally, MBSR seems to help relieve the symptoms of menopause. In a randomized trial of 110 late perimenopausal and early post-menopausal women, there was a 15 percent reduction of hot flashes and night sweats in the group that received MBSR as compared with a group that did not. The MBSR group also showed durable improvement in quality of life and sleep, along with lower anxiety and perceived stress.
Another great option is Kirtan Kriya (KK), a singing meditation that comes from the Kundalini yoga tradition. KK prescribes practicing the specific sounds “Saa Taa Naa Maa” accompanied by mudras, elegant finger positions, for just twelve minutes a day. This short but sweet practice has been shown to reduce inflammation while improving memory, sleep, and overall well-being in people with average cognition as well as in patients with mild cognitive impairment. In one study, participants experienced improved mental clarity and up to a 50 percent increase in memory skills within eight weeks.
Currently, KK is the only meditation that’s been specifically tested in patients with a dementia diagnosis. Moreover, KK has the added benefit of having been explicitly tested on women. A pilot study by the Alzheimer’s Research & Prevention Foundation (ARPF) investigated the cognitive impact of KK on 161 women at risk for Alzheimer’s, including some experiencing forgetfulness, some with a diagnosis of mild cognitive impairment, and others under pressure due to their caregiving roles. After two to four months of training, those who practiced every day showed increased blood flow to several parts of the brain, as well as improvement in their overall cognitive function. Wouldn’t it be wonderful if a better memory was ours merely by singing for twelve minutes each morning?
If you are new to meditation, I would recommend starting with KK. It’s easy and free. Just follow the guidelines in table 16—and check out the ARPF website for additional information: alzheimersprevention.org/research/12-minute-memory-exercise. You can also practice KK to music, if that helps. Several playlists are available on Spotify, YouTube, and other channels. If you do it on your own, I suggest using an app like Insight Timer, which lets you set intervals with gentle sounds that indicate it’s time to transition your chanting.
TABLE 16. HOW TO PRACTICE KIRTAN KRIYA
Courtesy of the ARPF
Sit in Easy Pose on the floor or on a chair or couch. Easy Pose is a simple cross-legged position. But if you’re new to yoga, sit however is most comfortable for you.
Keep the back of your neck straight and your chin slightly down. You almost feel like the top of your head is being pulled up by a cord. Sit up straight and allow your body to be in alignment.
Rest your hands on your knees with your palms facing upward.
While chanting the sounds saa taa naa maa, touch your thumb to your index finger (saying Saa), thumb to middle finger (saying Taa), thumb to the ring finger (saying Naa), and thumb to the pinkie finger (saying Maa).
For a 12-minute practice, here is the sequence:
Chant out loud for 2 minutes.
Chant in a whisper for 2 minutes.
Chant in silence for 4 minutes.
Chant in a whisper for 2 more minutes.
Chant out loud for 2 more minutes.
Inhale and stretch your arms up. Exhale, lower your arms, and relax for a moment.
Yoga is a mind-body practice originating from ancient Indian philosophies. Various styles of yoga typically combine physical postures and movement, breathing techniques, and meditation or relaxation. While so far there is little evidence that yoga helps fend off full-blown dementia, a randomized clinical trial of Kundalini yoga provided promising evidence of short- and long-term benefits in patients with mild cognitive impairment after just twelve weeks of treatment. Moreover, five separate studies showed that women who practice yoga had reduced symptoms of stress and insomnia. Other encouraging results are in from clinical trials that evaluated the effects of yoga and meditation on breast cancer survivors. A study of 40 breast cancer patients showed that a twelve-week intervention combining traditional hatha yoga with meditation significantly lowered menopausal symptoms in the patients, including those on chemotherapies. After twelve weeks, the patients reported an overall improved quality of life, including fewer hot flashes, fewer urogenital symptoms, as well as less fatigue.
Acupuncture is a pillar of the practice of traditional Chinese medicine (TCM) in which a practitioner stimulates specific points on the body associated with the body’s “meridians,” or energy channels, to treat disease and the pain they produce. The insertion of fine needles into the skin stimulates various systems and organs of the body to reduce ailments and symptoms. Relative to our focus, studies have shown a reduced frequency and severity of hot flashes in post-menopausal women, however less so than that achieved by MHT. Just the same, it poses a med-free alternative to those women seeking one. One of my best friends described acupuncture, when practiced by a highly educated practitioner, as “almost freakin’ magic.”
Restless nights, obsessive thoughts, and counting sheep. Ring any bells?
Well, it’s a fact: women have a harder time sleeping than men do. The National Sleep Foundation’s Women and Sleep Poll found that women have more difficulty not only falling asleep but staying asleep as well. It is no wonder then that they also experience more daytime sleepiness, especially in the years to either side of menopause. Menopausal night sweats persistently wake women up in the middle of the night, making for poor sleep if you’re lucky, and insomnia if you’re not. And let’s not forget the many years of lost sleep taking care of children. A friend just sent me this, which made me smile: “Moms do not sleep. Moms hover in a state of semi-consciousness, waiting for someone to need something.” So true, no matter how young or how old your children are.
That said, chronic sleep disturbance is a big problem. It triggers not only low mood and potentially depression but cognitive troubles as well. Essentially, when we sleep, the brain is processing information and coming up with solutions to complex problems. Anyone who’s experienced sleep difficulties, let alone insomnia, knows how hard it is to function properly after even a few nights of missed sleep. While a good night’s rest is a non-negotiable ingredient for the brain’s memory consolidation and learning, poor sleep makes quick work of degrading these essential abilities. There’s also the way that we process emotional information. The tired brain remembers negative experiences and negative facts, and it forgets the positive ones, which in and of itself can trigger mood swings and depressive feelings.
Basically, lack of sleep is a more serious problem than one might think. With so many people typically suffering from it, we begin to rationalize that it’s “doable”—since, for many of us, it has become the norm. But an emerging body of evidence shows long-term ill effects, many of them fairly grave. Among a long list of heavy hitters, an increased risk of cognitive decline and dementia has made an appearance. Recent studies demonstrate that sleep is the only moment the brain has during an otherwise too-busy day to get to the “housekeeping” essential to relieving itself from harmful toxins. Both too little sleep and fragmented sleep have been linked to the increased accumulation of Alzheimer’s plaques in the brains of otherwise seemingly healthy people, along with poorer cognitive function.
When you draw back the curtains, sleep is quite the spectacle. Even though any heavy sleeper you’ve observed may seem to be doing nothing more than working on his snore, deep sleep is not as simple as it appears. In actuality, an intricate succession of sleep stages is in the works. Of course, the first stage is managing to fall asleep in the first place! Once we’ve achieved that, we drift through the “light sleep” of the second stage. It’s during this moment that the brain prepares to shut itself down, much like our computers do when put to sleep. During the third and fourth stages, your brain finally enters a deep, “slow wave” sleep. It’s during this stage that the brain gets to tend to its housework, washing away the day’s waste along with harmful toxins such as Alzheimer’s plaques. After a while, this restorative phase is interrupted by the rapid eye movement (REM) stage, cuing dream time. When REM is over, this five-step cycle begins all over again, giving your brain additional chances to heal and repair.
But when you’re not getting enough sleep in the first place, or waking up throughout the night—especially in the middle of precious slow-wave sleep—this vital process is compromised, hobbling your brain’s overall performance, as well as the successful removal of Alzheimer’s plaques. When something regularly obstructs our nightly slow-wave sleep, a substantial buildup of Alzheimer’s plaques can result.
Consequently, sleep hygiene (doing what’s necessary to put a stop to this) is not a maybe—but a must. While studies continue to waffle as to exactly how long we should sleep (perhaps due to the collapsing of a one-size-fits-all approach), for now, shooting for seven to eight hours per night is probably a safe bet for most people, with a minimum of six for those sixty-five or older.
Curiously, the crucial slow-wave sleep stage is typically a bit longer in women than in men. So why aren’t we reaping the benefits? Because we’re generally not getting it! If that weren’t enough, sleep apnea has also become a problem for women over fifty, affecting over half of all post-menopausal women. Typically considered a “male issue,” sleep apnea is a potentially dangerous sleep disorder that interrupts a person’s breathing during sleep, sometimes hundreds of times a night. Additionally, these interruptions in breathing can lead to the brain not getting enough oxygen. So if you snore loudly and feel dull after a full night’s sleep, sleep apnea could be the culprit.
Fortunately, we’ve got some solutions to support our sleepy brains.
For sleep apnea, interventions range from lifestyle changes to CPAP therapy and surgery. If you are concerned you might suffer from it, talk to your doctor or visit the National Sleep Foundation website for more information. For those of you who don’t have sleep apnea and still can’t sleep, you’re up next.
In the United States, doctors tend to hand out sleeping pills like candy at Halloween. I am not a fan of sleeping pills, and neither should you be. These meds are not always the best solution, mainly because they are not as helpful as pharmaceutical companies would have us believe. In fact, the average sleeping pill adds a maximum of forty minutes of sleep to your night while potentially bestowing multiple side effects instead. If you’re tired of staring at your clock, forgo the meds and look to these suggestions before hitting the hay:
Practice a “wind down” time with electronic devices (no texting, TV, streaming, or email) for at least thirty minutes before bed. Once you regularly embrace, rather than resist, this practice, it not only reduces stress but also allows your body to access melatonin to re-acclimate itself to falling and staying asleep.
Consider keeping smartphones, TVs, and electronics in general out of the bedroom. Your bedroom should be a place of sleep.
Make sure your bedroom isn’t too warm. Part of the initiation of sleep is a slight drop in body temperature. If the room is too warm, you can’t lose that body heat, which means it is more difficult to go to sleep.
Minimize light coming into the bedroom. If you don’t want to get up early, the bedroom should be dark.
For many women, ambience is important. If this is you, create a comfortable environment by dimming the lights or lighting a few candles around the room. Putting some calming music on and perhaps burning essential oils like lavender oil can really help one unwind.
The mind and body practices described above should also help you sleep. For example, there are some really nice guided sleep meditations available on iTunes and on the internet (some of my favorites are by Jon Kabat-Zinn).
Aiming to go to bed and wake up at the same time each day promotes regular sleep habits. Your body likes relying on a rhythm when it comes to sleep. Try to reassure it this way.
If you wake up in the middle of the night, don’t panic. Do something relaxing, like a sleep meditation, or listen to calming music to allow your brain to fall back asleep. Do not check your cell phone or watch TV instead.
If you have to get up in the night, use a soft amber-colored night-light rather than turning on overhead lights.
Some doctors recommend using a wearable sleep tracking device, which can be helpful to become more aware of your sleep patterns and make adjustments accordingly. But once you have a better sense of your typical sleep pattern, take it off. There’s no particular need to have these devices on at night when we’re bombarding ourselves with technology all day as it is.
Low-adrenaline physical activity such as a light tidying up or a non-exerting yoga can relax your brain.
The healthy diet outlined in chapter 10, with the right combination of supplements, is also crucial for recharging and restoring our endlessly active brains. Look into this combo as an alternative to OTC and prescription sleep meds.
Nutritionists know a thing or two about sleep; here’s a little trick. The same foods that help bolster mood also help you sleep. Mood and sleep have an ally in common: the amino acid tryptophan. The brain needs tryptophan to make serotonin (which calms you down) as well as melatonin (which makes you fall asleep). There are two key steps to ensure you’re consuming enough tryptophan to do the trick. First off, make a dinner including foods rich in tryptophan. These include milk, yogurt, fish, shellfish, and chicken. Plant-based foods such as chia, raw cacao, rice, oats, soybeans, prunes, and sesame and pumpkin seeds also score high in tryptophan. Second, eat some select carbohydrates with these tryptophan-rich foods to help increase their absorption. Salmon served with brown rice hits the mark. Or try a dessert of yogurt drizzled with cacao after dinner. (There’s a reason why warm milk and honey has survived the centuries as a bedtime favorite.)
Another trick is to eat foods that contain melatonin, the hormone that makes you sleep. Among these, pistachios are the real star. These flavorful nuts are simply off the charts as the most melatonin-rich food on the planet. Eating a whole handful of pistachios is equivalent to taking a melatonin supplement, which is clearly preferable, as pistachios are also a great source of tryptophan, fiber, and vitamin B6 (and they’re tasty). Wheat, barley, and oats are also high in melatonin, as are grapes, cherries, and strawberries.
Pay attention to your B vitamins, especially B6 and B12. Too little of these vitamins may promote insomnia. You can quickly fix this by eating the right foods (preferably fish, eggs, and milk for B12, and green leafy veggies like spinach and cabbage for B6) and taking B supplements when needed.
For some of us, it’s more about what to avoid instead. Caffeine and alcohol can keep you awake and intrude upon REM sleep. Alcohol may help you fall asleep, but it can also cause you to wake up in the middle of the night. Avoid these beverages after 2:00 p.m. for a while and see what happens.
If you haven’t yet stopped smoking, avoid any smoking or nicotine for at least four hours before bedtime.
Sleep recommendations for women would not be complete without bringing up progesterone. Like estrogen, progesterone bottoms out during menopause. Progesterone has anxiety-reducing effects on the brain, so its waning can lead to sleep difficulties. If this is you, it’s time to boost your progesterone levels. Studies have found that progesterone creams and the supplements described in chapter 11 can prove quite effective.
Beware of OTC sleep aids, especially those with added painkillers. They can tax the liver considerably over time, along with other concerning side effects we will cover in the next chapter. Using sedative medications like benzodiazepines or Benadryl (by far one of the top meds used by women) are not advised either. Discontinuing sedative medications when not clinically indicated also deserves consideration, under your doctor’s supervision.
In the end, every woman experiences sleep and stress differently. But the basic premise of optimizing both is the same: take the time to listen to yourself, search for the root causes of your symptoms, implement gradual changes, and give yourself enough time to receive the results. Be persistent and consistent. Taking this approach can genuinely help you in the long term. Reaching for medications that often do no more than mask your symptoms can give an illusion of better sleep in exchange for any actual improvement. Tweaking your way to a stress-free day and a sound night’s sleep is well worth your time, as is finding ways to relax and de-stress for the long haul. Your present and future well-being rely on it.