A seismic shift: he snores, she walks
By Adele Horin
The bedroom has become a battleground as increasing numbers of couples fight over the right to a good night's sleep, research shows.
Desperation is forcing many middle-aged and older people to desert the marital bed for the spare room or the sofa, overcoming deep cultural
taboos and their own reluctance.
"The reality of sleep in later life can be more a bed of thorns than a bed of roses," said Sara Arber, professor of sociology at the
University of Surrey, who will deliver her findings in Sydney next week.
It is middle-aged women who seem most sleep-deprived, due not only to menopausal hot flushes, or their partners' habits, but to the worries
that attend their multiple roles as worker and carer. Even in bed, women worry about teenage children out late, their own jobs, elderly parents,
and about disturbing their husband's sleep should they take action to improve their own, such as getting up or reading.
Professor Arber's research, with a British-based Australian academic, Dr Jenny Hislop, is based on a study of 60 women aged 40 to 59, and 62
women over 60; as well as interviews with couples. It reveals couples engaged in a power struggle for the right to sleep, faced with a partner's
snoring, grunting, restlessness, gasping for breath and leg twitching.
Mostly, women lost out, accepting that poor sleep was just part of "a woman's lot in life".
"The reality of mid-life women's sleep is predominantly one of disruption ... difficulty falling asleep, intermittent waking during the night,
lying awake unable to go back to sleep, and/or waking early," Professor Arber said. "A good night's sleep, meaning a night free of disturbances,
and waking up feeling refreshed, is rare."
She added: "Women either consciously or subconsciously subjugate their own need and place themselves at a distinct disadvantage in terms of
access to sleep."
But increasingly middle-aged women with important jobs have started to take themselves off to the spare bedroom or the couch.
"It's the more powerful women who will sleep separately. For people under 40, and for more traditional couples, except where there's extreme
ill health, it is totally unacceptable, no matter how bad your sleep is. Men hate it."
The double bed is highly symbolic, and the decision to move out, permanently or intermittently, can be interpreted by a partner, children and
friends as the death knell of the relationship.
"He says we may as well get a divorce then," said a 70-year-old woman, describing her husband's reaction to the suggestion of separate beds.
But other women were at pains to explain separate beds did not mean the end of a sex life. They questioned the tradition of one bed for the dual
purpose of sex and sleep.
As for snoring, it seemed virtually all men from their mid-40s on snored, according to their partners. Women were annoyed and disturbed by the
snoring but accepted this was what men did. A smaller proportion of women snored and they were the butt of vitriolic comments from their
husbands. "The women were embarrassed; it's a very unfeminine thing to do," Professor Arber said.
As well, men had a different attitude to sleep. They considered it "wimpish" to need too much, while women believed it important to get their
beauty sleep.
Professor Arber said people must accept sleep will get worse as they age, and that eight hours of unbroken sleep is enjoyed mainly by people
in their 20s.
Currently resident at the Australian National University, she will address a seminar at the Social Policy Research Centre at the University of
NSW on Tuesday.
Alexandra Smith writes: Ken Barker and his partner Sarah-Jane Bright are not the typical Australian couple between the sheets. He
sleeps so heavily he has no idea whether she snores - but would not care if she did.
Ms Bright, on the other hand, gives him just one chance. The 23-year-old university administration assistant says if she hears the slightest
hint of a snore she is quick to give him a nudge, or even an elbow if that is what it takes.
Nude and snoring!
1:01p.m. 10 March 2008
The Daily.com
Almost four in 10 Australian men like to sleep in the nude while women aren't getting enough sleep because
their blokes are snoring.
“We conducted an audit of sleeping patterns and found out that whilst men and women have the same amount of
sleep per night, it’s women who are tired and cranky the next day,” said Fantastic Furniture marketing manager, Philip
Kahana.
The survey revealed that the majority of respondents (67.5 per cent) said they had an average of 6-8 hours
sleep, yet more than half of the women (50.7 per cent) said they felt tired in the daytime and wished they’d had more
sleep.
Further investigation revealed that almost half (48.8 per cent) of the men in the study snored compared to
just 29.1 per cent of women.
“No wonder women are tired in the daytime if their partner is keeping them awake snoring all night!” said
Mr Kahana.
One female respondent said that her partner had kept her awake with his snoring for years, leaving her
irritable and short tempered in the day. “In the end the choice was either to get a divorce or sleep in separate rooms,” she
said.
Recent research has shown that snorers can reach decibel levels similar to those produced by a jet aircraft
at low altitude when measured in the bedroom.
“Snoring is not only disruptive to family life, it causes other family members to lose sleep and can lead
to social isolation, especially from spouses,” say researchers at Monash University.
When women finally do settle down to sleep, the survey found they are more likely to sleep talk than their
partner (26.5 per cent) and grind their teeth (12.4 per cent).
According to Government health statistics, teeth grinding can be a physical expression of mental
stress.
“Women may be grinding their teeth as a stress response to their male partner’s snoring,” suggested Philip
Kahana.
The differing nocturnal habits of men and women don’t end there – when it comes to choosing a mattress, the
majority of women (55.2 per cent) said they preferred a soft mattress compared to 44 per cent of men, with most men (49.5 per
cent) preferring a hard one.
But Aussie men are not as conservative between the sheets as we might think with 38.2 per cent of men
choosing to sleep in the nude, compared to 19.8 per cent of women.
Most women are opting for modesty by wearing a night dress or underwear to bed. Not unexpectedly, newly
weds are more likely to sleep naked than those married for ten years or more.
“I sleep better in the nude because I feel more relaxed and cooler in bed,” said one male
respondent.
At the end of the day, both men and women like to sleep on a regular side of the bed and snuggle down
together with 63.2 per cent going to bed at the same time as their partners.
Poor sleep more dangerous for women
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| Women's Health News |
| Published: Tuesday, 11-Mar-2008 |
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Researchers at Duke University Medical Center say they may have figured out why poor sleep
does more harm to cardiovascular health in women than in men.
Their study, appearing online in the journal Brain, Behavior and Immunity, found that poor
sleep is associated with greater psychological distress and higher levels of biomarkers associated with elevated
risk of heart disease and type 2 diabetes. They also found that these associations are significantly stronger in
women than in men.
"This is the first empirical evidence that supports what we have observed about the role of
gender and its effects upon sleep and health," says Edward Suarez, an associate professor in the department of
psychiatry and behavioral sciences at Duke and the lead author of the study. "The study suggests that poor sleep
- measured by the total amount of sleep, the degree of awakening during the night, and most importantly, how long
it takes to get to sleep - may have more serious health consequences for women than for men."
Suarez says that while women are twice as likely as men to report problems with sleep, most
sleep studies in the past have focused on men, a phenomenon that has been slowly changing in recent
years.
Researchers studied 210 apparently healthy, middle-aged men and women without any history of
sleep disorders. None smoked or took any medications on a daily basis and investigators excluded any women who
were on hormone therapy, which has been shown in some studies to alter sleep patterns in some women.
Using a standardized sleep quality questionnaire, participants rated various dimensions of
their sleep during the previous month. Additional measures assessed the extent of any depression, anger,
hostility and perceived social support from friends and family.
Blood samples taken from the volunteers were measured for levels of biomarkers associated with
increased risk of heart disease and diabetes, including insulin and glucose levels, fibrinogen (a clotting
factor) and two inflammatory proteins, interleukin-6 and C-reactive protein.
The researchers found that about 40 percent of the men and the women were classified as poor
sleepers, defined as having frequent problems falling asleep, taking 30 or more minutes to fall asleep or
awakening frequently during the night. But while their sleep quality ratings were similar, men and women had
dramatically different risk profiles.
"We found that for women, poor sleep is strongly associated with high levels of psychological
distress, and greater feelings of hostility, depression and anger. In contrast, these feelings were not
associated with the same degree of sleep disruption in men," says Suarez.
Women who reported higher degree of sleep disruption also had higher levels of all the
biomarkers tested. For women, poor sleep was associated with higher levels of C-reactive protein and
interleukin-6, measures of inflammation that have been associated with increased risk of heart disease, and
higher levels of insulin. The results were so dramatic that of those women considered poor sleepers, 33 per cent
had C-reactive protein levels associated with high risk of heart disease, says Suarez.
"Interestingly, it appears that it's not so much the overall poor sleep quality that was
associated with greater risk, but rather the length of time it takes a person to fall asleep that takes the
highest toll," says Suarez. "Women who reported taking a half an hour or more to fall asleep showed the worst
risk profile."
The study was supported by a grant from the National Institutes of Health.
Suarez says he's planning further studies to understand the complex relationship between health
risk and poor sleep in men and women. He believes that the gender differences may be due, in part, to variation
in the activity of a number of naturally occurring substances in the body, such as tryptophan, an amino acid;
serotonin, a neurotransmitter; and melatonin, a neurohormone. "All of these substances are known to affect mood,
sleep, onset of sleep, inflammation and insulin resistance," he says.
"Good sleep is related to good health. More research needs to be done to define gender-linked
responses to poor sleep, including the role that sex hormones play over a lifetime and how sleep needs and
responses change from childhood to maturity," says Suarez.
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Bad sleep bad for women's hearts
From correspondents in New York
March 18, 2008 12:53pm
EVIDENCE continues to mount that sleep problems can affect heart health, with worse consequences for
women, and a new study could help explain why.
Women who reported poor sleep quality and had difficulty falling asleep had more psychosocial distress than
their peers who slept well.
They also had higher blood levels of substances linked to type 2 diabetes, heart disease and other health
problems, Edward Suarez of the Duke University Medical Centre in Durham, North Carolina, found.
But for men, there was no link between how well they slept and their mental or physical health.
To date, most studies investigating sleep and heart disease have included people with serious sleep
disorders, such as sleep apnea, the US researcher points out. In the current study, Dr Suarez had 210 healthy men and women
without clinically diagnosed sleep disorders fill out a questionnaire evaluating sleep quality.
Among women, Dr Suarez found, poor sleep quality, having difficulty falling asleep on more than two nights
a week and taking longer than half an hour to fall asleep were tied to higher levels of fasting insulin - a sign of increased
type 2 diabetes risk - as well as higher levels of markers of inflammation and of fibrinogen, a clotting factor that has been
tied to stroke.
Women who slept poorly also reported more symptoms of depression, hostility and anger.
"Interestingly, it appears that it's not so much the overall poor sleep quality that was associated with
greater risk, but rather the length of time it takes a person to fall asleep that takes the highest toll," Dr Suarez
noted in a Duke University press release.
"Women who reported taking a half an hour or more to fall asleep showed the worst risk profile."
Gender differences in the function of the brain chemical serotonin, the hormone melatonin, or the amino
acid tryptophan could help explain the findings, Dr Suarez said, given that all three chemicals are involved in both mood and
cardiovascular health.
"Improvements in sleep as a means of reducing risk for cardiovascular disease may prove particularly
important in women," he concludes.
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Snoring a warning sign for more women
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Sleep apnoea puts expectant mothers at risk of hypertension
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Snoring will no longer be seen as an old man's problem, with new research showing that more women than previously thought suffer from the
life-threatening disorder known as sleep apnoea which is characterised by prolific snoring.
In a development which shifts traditional attention on snoring away from middle aged men and towards women and children, Australian sleep
expert Dr Peter Cistulli told the World Congress on Sleep Apnoea in
Sydney this week that many women either don't know they suffer from the disease or chose to ignore it because it is embarrassing. Sleep
apnoea is thought to affect four per cent of middle-aged men and two per cent of middle-aged women. Half of all people who snore are believed
to suffer from the condition.
Sleep apnoea is a disorder which can stop breathing up to 300 times a night. The main symptoms is snoring, and the disease has been linked
with car accidents, heart disease, stroke and hypertension. The frequent interruptions to sleep often cause early morning headaches and
excessive daytime sleepiness.
Dr Cistulli who is Director of the Sleep Disorders Centre at Sydney's St George
Hospital said sleep apnoea was much more common in women than researchers appreciated.
"Ten years ago we thought that ten time as many men as women were sufferers. Now we know the ratio is more like two to one. But the clinics
are still dominated by men, which means women aren't presenting with the problem, or only presenting late in life.
Many women don't come forward for treatment because they have more stamina than men, Dr Cistulli said. They ignore the symptoms and tend to
focus more on their husband's health. He said it was possible women were not aware they suffered because their partners were too polite to
tell them they snored. "Anyone who snores should certainly see their GP for assessment," he said.
Dr Cistulli said new research suggested that removing tonsils during childhood could be the best time to tackle the problem. Dr Cistulli said
children should have a sleep test to see if they were interfering with their own sleep.
He said there is also new evidence that treating pregnant women who suffer from sleep apnoea can help reduce high blood pressure and improve
the outcome of the birth.
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