A Review of "Why We Sleep" for Women's Mental Health
Sleep! So important, yet for women especially, it can be quite evasive. I enjoyed reading Matthew Walker’s book “Why We Sleep: Unlocking the Power of Sleep and Dreams,” as it had so many insights that I found helpful for my own life. I’m writing this to share some of the key points, so other women can benefit!
When life gets busy, you might be tempted to simply “sleep less, do more”. There is now compelling research to support that a different approach will likely be more effective. Sleep plays an incredibly important role in regulating not just our body’s physical health, but also our emotional and mental health and wellbeing. Here are a few of the ways the sleep contributes to our ability, especially as women, to function optimally:
Emotional Regulation and Processing
Sleep has a direct impact on our brain functioning and how our brain is able to respond or react to emotional stimuli. I think we can all relate to having an experience where we didn’t get enough sleep and then reacted to a loved one more strongly than we would think necessary on a day that we’ve had solid sleep. Our amygdala is the part of our brain responsible for processing strong emotions such as fear and anxiety. When we get enough sleep, our amygdala is better regulated and more resilient against emotional stimuli that might trigger it. If, conversely, we skip out on sleep, our pre-frontal cortex is impaired, which can lead to more impulsive and emotionally charged reactions. Combined, when sleep deprived, we’re more likely to have moments where we react and later say “why did I do that?”
Walker also outlines research on how sleep plays a substantial role in regulating the stress hormone cortisol. In the cases of chronic sleep deprivation, our cortisol levels can elevate and stay elevated, which leads to a more steady increase in stress and emotional reactivity. Too much cortisol in the body for too long can have other detrimental effects to our overall health, meaning we might have additional layers of emotional reactivity from also being physically sick or uncomfortable in our bodies.
Hormones and Menstrual Health
On the topic of hormones, women can really capitalize on proper sleep for hormone and menstrual regulation. Sleep plays an important role in regulating hormones like estrogen and progesterone. When we get enough sleep, our hormones have more of an opportunity to stay regulated, which means our body’s healthy processes around menstruation, fertility, and overall reproductive health can stay strumming along. But even if you’re not trying to engage your reproductive system in starting a new life, having your hormones in balance can be really helpful for your own sense of emotional stability. We see how hormone and menstrual cycle dysregulation can cause emotional ruckus in anyone struggling with Premenstrual Dysphoria Disorder or PMDD. Those with PMDD can experience mood swings, irritability, and sadness that substantially impact their functioning and experience of the day-to-day in the weeks prior to menstruation. Getting enough sleep is always a good investment in your hormone regulation piggy bank.
Maintaining a Positive Outlook on Life
When we sleep, our brains are busy consolidating memories from the day and processing information that we took in during waking hours. Have you ever gone through something stressful and noticed how sometimes just one night of sleep can leave you feeling better the next morning? Like sleep can sort of the take “edge” off when recalling something from yesterday that felt *so embarrassing*. REM sleep, and dreaming that occurs during this phase, especially plays an important role in processing and consolidating emotional memories.
Sleep also helps with our problem solving abilities. When we are able to solve our day to day problems, no matter now big or small, we feel better! Every time we solve a problem, we get a little surge of good feeling chemicals in our brain. So if sleep helps us solve our problems, we’re able to move through the day with a greater sense of accomplishment. Sleep also promotes synaptic plasticity, which refers to the neural pathways ability to adapt and change. This is one of the specific routes in the brain that leads to learning, adapting, and problem solving.
Key Take-Aways to Get Better Sleep
Know your Chronotype
Walker describes how research has found and been able to categorize three main chronotypes that we fall into as humans. The concept of chronotypes refers to individual differences in people's biological predispositions for being more alert and active at specific times of the day. When we are able to respect our biological predispositions, we can capitalize on being awake when it naturally feels better to do so, and sleeping when our body is more inclined to sleep.
Morning Larks (Early Chronotypes): Individuals with a morning chronotype, often referred to as "morning larks," tend to feel most alert and productive in the early hours of the day. They naturally wake up early and may experience a decline in alertness and energy levels as the day progresses.
Night Owls (Late Chronotypes): On the opposite end of the spectrum are individuals with an evening chronotype, commonly known as "night owls." Night owls feel most awake and alert during the later hours of the day and evening. They may find it challenging to wake up early and often experience a surge in energy later in the day.
Intermediate Chronotypes: Between the extreme morning and evening chronotypes, there are individuals who fall into the category of intermediate chronotypes. These individuals have a more balanced distribution of alertness throughout the day and may not strongly favor either morning or evening activities.
Knowing our chronotype can empower us to make choices that respect these deep seated biological mechanisms. This can, of course, be challenging to do in today’s modern life. Traditional work schedules are not always conducive to our chronotypes, probably most notably the night owl. Wherever you do have control of your schedule, and when you work or perform other activities that benefit from your most alert and engaged states, try to incorporate your needs based on knowledge of your chronotype.
Postpartum Sleep Challenges
As a mom of two, I know personally how hard it is to get the sleep that you need after giving birth to a new baby. Postpartum is an incredibly challenging time, often requiring specialized therapy for new mothers; ensuring the birthing person gets enough sleep becomes a huge priority and can make every part of this period feel a bit easier. Sometimes people say “sleep when the baby sleeps,” which in my experience was way easier said than done. I personally needed to know that my baby was in the care of someone else, sleeping or not, in order to take a nap during the day.
I highly recommend thinking about what your chronotype is - and what your optimal sleep needs are - prior to giving birth. I’m a night owl, so I can stay up late with a baby, but I need to know that I can sleep in the next morning. I arranged for help with the baby starting at 7a, so if I was up for long stretches in the night, I could at least know that at 7a I could go back to bed and sleep for a few hours.
If you’re a morning lark, it might be helpful to move your bedtime up to whenever the baby starts their nighttime sleep (when this becomes distinguishable from daytime sleep). You might miss out on some time with a partner, or other adult social interaction, but the benefits of getting sleep will make whatever you’re missing worth it. And remember, this is just a temporary adaptation during early postpartum.
My other recommendation is to consider hiring a night nurse, if only for one night/week for the first few weeks postpartum. Being able to sleep in a continuous cycle, or a few continuous longer cycles in one night will be deeply restorative. It might feel like a luxury, but trust me, it’ll be a great investment in your overall mental and physical health and ability to function in those early weeks.
Cognitive Behavioral Therapy for Insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I), has been found to be hugely helpful for sleep challenges. Walker describes how CBT-I is often more effective than any kind of sleeping pill or medication on the market - and certainly with less potential for side effects. I highly recommend exploring CBT-I, either with a therapist, or by the use of an app created specifically with CBT-I as a foundation.
Here are some of the apps on the market right now to check out that have CBT-I as a base:
CBT-i Coach - Developed by the VA for Veterans. Free. Designed to be used when you’re also seeing a therapist or other provider to work on your sleep.
Insomnia Coach - Also developed by the VA. Free. Designed to be easily used on it’s own without the assistance of a therapist or provider.
Sleep Reset: CBT-I - This appears to be a powerful program grounded in sleep research. It is an 8 week paid program.
Restful CBT-i Insomnia Diary - A popular app that can be used with or without therapy. Annual subscription.
This is just the beginning
In summary, sleep is crucial for optimal emotional and mental well-being for women. Prioritizing your sleep needs, and ensuring you get adequate sleep for you, can make your waking hours so much more enjoyable. Of course this article and book review was not able to touch on all of the complexity of factors that can impact sleep. I encourage you to use this as a starting place to explore how you might first prioritize your sleep, and then take specific steps to improve it. Our therapists are here to help you explore any complexities in your sleep, and things that might be interfering with optimal sleep that are beyond what is covered here. Sometimes we have to be feeling better emotionally and mentally first before we can get the sleep we need! Contact us if you’re ready to start that journey.
