Scoop’s Views

Stay-at-home-moms most likely to sleep poorly

Washington (March 6) – Sixty percent of American women say they get a good night’s sleep only a few nights per week or less, and 67 percent say they frequently experience a sleep problem. Additionally, 43 percent say that daytime sleepiness interferes with their daily activities, according to a new poll released today by the National Sleep Foundation (NSF). Women’s lack of sleep affects virtually every aspect of their time-pressed lives, leaving them late for work, stressed out, too tired for sex and little time for their friends.

NSF’s 2007 Sleep in America poll sought to look at the sleep patterns of adult women (ages 18-64), as the NSF’s 2005 Sleep in America poll found that women are more likely to experience sleep problems than men. The 2007 poll found that women of all ages are experiencing sleep problems, which change and increase in severity as they move through the different biological stages of their lives. Lifestyle also plays a significant, often negative, role in women’s sleep and daytime alertness.

Working mothers (72 percent) and single working women (68 percent) are more likely to experience symptoms of sleep problems like insomnia. Stay-at-home mothers report a high level of overall sleep problems, with 74 percent saying they are experiencing symptoms of insomnia at least a few nights each week, 59 percent saying they frequently wake up feeling un-refreshed, and nine percent report co-sleeping with a child or infant, which adds to the sleep disturbances they experience each night.

American women are struggling to cope with this lack of sleep. Although women’s lifestyles are compromised due to lack of sleep, they keep going. Eighty percent of women say that when they experience sleepiness during the day they just accept it and keep going. However, in order to keep going, 65 percent are likely to use caffeine beverages, with 37 percent of all women consuming three or more caffeinated beverages per day.

Despite being frequently tired, women are not heading to bed earlier. In the hour prior to going to bed, instead of retiring early, 87 percent say they watch television, 60 percent complete the remainder of their household chores, 37 percent do activities with children, 36 percent do activities with other family, 36 percent are on the Internet, and 21 percent do work related to their job at least a few nights a week.

Poor sleep is associated with poor mood. The majority of women reported being bothered by worrying too much about things (80 percent) and/or being stressed out or anxious (79 percent).

Sleep problems often co-exist with mood disturbances. In fact, more than one-half of the women polled (55 percent) reported that they felt unhappy, sad or depressed in the past month and one-third (36 percent) reported that they recently felt hopeless about the future. The relationship between sleep and mood is bi-directional.

Mood effects can cause poor sleep and poor sleep can put someone at a greater risk for symptoms of depression and anxiety.

“Women of all ages are burning the candle at both ends and as a result they are sleepless and stressed out,” said Richard L. Gelula, NSF’s chief executive officer. “Poor sleep impacts every aspect of a woman’s life, as well as her health. This year, we are asking women to take the steps necessary to make healthy sleep a higher priority in their lives and in the lives of their families.”

Lack of Sleep Disrupts Quality of Life

The Sleep in America poll also finds that a lack of a good night’s sleep is interfering with a woman’s quality of life. Women report that they often choose to put healthy activities last on their priority list as they struggle through their daily lives. When pressed for time, one-half of the women polled responded that sleep (52 percent) and exercise (48 percent) are the first things they sacrifice.

More than one-third of women say they also reduce the amount of time they spend with friends and family (39 percent), stop eating healthy (37 percent), and don’t participate in sexual activity with their partner (33 percent) when they run out of time or are too sleepy in a day.

Work is the last thing that women say they sacrifice when pressed for time; only 20 percent of women responded that they would opt to put work on the back burner when they run out of time or are too sleepy.

About two-thirds (68 percent) of the women polled say they were working during the past month, with almost one-half (46 percent) saying that they worked full-time.

Some working women (eight percent) report that they miss work at least once a month due to sleepiness or a sleep problem.

Two in ten say they were late to work more than once in the past month due to oversleeping (20 percent) or feeling too tired when they woke up (19 percent).

About one-half of women who are working (53 percent) say that their work schedule is flexible and women between the ages of 18 and 24 are significantly more likely than their older counterparts to work non-traditional hours or overnight shifts.

Despite warnings, women are still driving drowsy. More than one-quarter (27 percent) of women polled said they have driven drowsy at least once a month in the past year; 10 percent of those who had driven drowsy did so with a child in the car.

The National Highway Traffic Safety Administration (NHTSA) estimates that up to 100,000 police-reported crashes annually involve drowsiness or fatigue as a principal causal factor.

“Women who spend less than seven hours in bed at night are more likely to doze off during the day, report symptoms of depression, drive drowsy and use coping mechanisms just to make it through their day,” said Kathryn Lee, Ph.D,a member of the NSF poll task force. “Furthermore, women tend to compromise the most important aspects of good health — diet, exercise and sleep — when trying to juggle the day’s ongoing responsibilities.

Foregoing healthy lifestyle habits in favor of more time during the day is not the solution. In fact, it can be detrimental to optimum health and performance.”

Dr. Lee is a Professor of Family Health Care Nursing at the University of California, San Francisco.

Sleep and Health

The NSF Sleep in America poll also found poor health and obesity are linked to an increased frequency of sleep problems. Women who report being in fair or poor health are significantly more likely than those who report being in excellent or very good health to

• Experience any symptom of a sleep disorder at least a few nights per week (66 percent vs. 30 percent)
• Have been told by a doctor that they have a sleep disorder (40 percent vs.10 percent)
• Experience daytime sleepiness at least a few days per week (46 percent vs.12 percent)
• Have missed at least one day of work because of sleepiness or a sleep problem in the past month (26 percent vs. seven percent)
• Use any sleep aid at least a few nights per week (54 percent vs. 19 percent)

Additionally, women with height and weight that would be categorized as obese (BMI greater than or equal to 30) are more likely than those with a BMI classified as overweight or average weight to

• Snore at least a few nights each week (46 percent vs. 33 percent for overweight and 21 percent for average weight)
• Experience daytime sleepiness at least a few days a week (31 percent vs. 22 percent for overweight and 18 percent for average weight)
• Use a prescription sleep aid at least a few nights per week (23 percent vs. 14 percent for overweight and 11 percent for average weight)

“Adopting healthy behaviors such as eating nutritious foods, being physically active, watching your weight, and getting enough sleep are important steps toward living a healthy life,” said Janet Collins, Ph.D., director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC).

Women, Biology and Sleep

The 2007 NSF Sleep in America poll also asked respondents about the quality and quantity of sleep. These findings were then analyzed within different biological stages of their lives.

Women of childbearing age spend an average of seven hours, 32 minutes in bed¹ on weeknights, with 67 percent of these women reporting experiencing symptoms of insomnia at least a few nights each week. Of this group:

• 16 percent say they have missed work one or more days in the past month due to a sleep problem.
• 34 percent say they experience symptoms of a sleep disorder like snoring, sleep apnea and/or RLS.
• One-third of women of childbearing age (33 percent) say that their sleep is disturbed the week of their cycle.

Pregnant women spend the most hours in bed per weeknight (8 hours, 14 minutes on average), however most pregnant women (84 percent) report symptoms of insomnia a few nights each week, with 40 percent also reporting signs of a sleep disorder such as snoring, sleep apnea and/or restless leg syndrome (RLS). The sampling also showed:

• 30 percent of pregnant women report that they rarely or never get a good night’s sleep.
• Most pregnant women (82 percent) report getting significantly better sleep before their pregnancy.
• One percent of pregnant women report consuming alcohol, beer or wine within an hour of going to bed at least a few nights each week as a sleep aid.
• 54 percent of pregnant women report napping at least twice per week.

Post-partum women spend less time in bed on weeknights than pregnant women (7 hours, 46 minutes on average), but they report the same frequency of symptoms of insomnia (84 percent). Of the women in this group, 42 percent report that they rarely or never get a good night’s sleep — the highest frequency of all the groups.

• When asked what awakens them most during the night, 90 percent of post partum women say giving care to a child.
• Nearly one-half (47 percent) of post partum women say that they have no one helping them with childcare at night.
• 20 percent of post partum women say they have driven drowsy with children in the car.
• 35 percent of post partum women report experiencing symptoms of a sleep disorder such as snoring, sleep apnea and/or RLS.
• Among post-partum women with a child who is three months old or younger, the child is most often sleeping in a crib in the parent’s room (48 percent). Roughly one-fourth say their child sleeps in his/her own room (27 percent) or in the parent’s bed (22 percent).
• About two in ten (19 percent) women in this category say they experience post-partum blues or depression.

Peri-menopausal women (women during their menopausal transition years) spend the least amount of time in bed on weeknights of all the groups (7 hours, 12 minutes on average). More than half (59 percent) of women in this life stage say they experience symptoms of insomnia at least a few nights each week.

• 43 percent of peri-menopausal women report experiencing symptoms of a sleep disorder such as snoring, sleep apnea and/or RLS.
• Peri-menopausal women cite noise (36 percent) and co-sleeping pets (20 percent) as awakening them most during the night.
• 20 percent of women in this category say they have a difficult time sleeping due to hot flashes or night sweats at least a few nights each week.

Post-menopausal women generally spend more than 7 hours in bed on weeknights (7 hours, 19 minutes on average), but of all the groups, post-menopausal women report the highest incidence (50 percent) of a sleep disorder such as snoring, sleep apnea and/or RLS.

• 61 percent of women in this life stage report experiencing some symptoms of insomnia at least a few nights each week.
• 41 percent say they use a sleep aid at least a few nights per week — the highest frequency of all the groups.
• 22 percent of postmenopausal women say they have a difficult time sleeping due to hot flashes or night sweats. A similar proportion (22 percent) report experiencing restless legs syndrome (RLS) at least a few nights each week. Symptoms of RLS appear more frequently in these individuals than in other segments.
• Postmenopausal women report the highest BMI’s with 36 percent reporting that they are overweight and 30 percent that they are obese.

“Women are often blind-sided by life and biology,” said Meir Kryger, MD, director of research and education at the Gaylord Sleep Center and chair of the 2007 NSF Sleep in America poll task force. “As women go through different life stages, internal biological factors and external lifestyle factors have a huge impact on their ability to get a good sleep. Despite the life phase, it’s important for women to choose to make healthy sleep a priority.

Working, single women spend the least amount of time in bed, generally less than six hours per night and one-half (54 percent) of the women in this category say they wake up feeling un-refreshed at least a few days each week.

Seventy percent of working, single women say that they accept it and keep going when they are sleepy during the day. In addition, working, single women are also very likely to use caffeinated beverages when sleepy during the day (47 percent), consuming an average of 3.1 cups/cans per day. About one-third say they use the weekends to try to catch up on their sleep (31 percent) and these women are likely to spend time with their friends in the hour before going to bed (27 percent).

Working, married women with no children or grown children report getting better sleep than most groups, with 44 percent saying they get a good night’s sleep every night or almost every night, despite the fact that they report being in bed less than seven hours per night on average. They also report a low frequency of sleep problems (15 percent), but nearly one-half report that they do not have enough time for sleep (46 percent) or exercise (47 percent), and 38 percent say they don’t have sex because they are too sleepy or run out of time.

Stay-at-Home Moms (SAHMs) report that they rarely get a good night’s sleep, despite the fact that 61 percent report that they spend eight hours or more in bed each night, and more than one-half (57 percent) report napping at least once per week. Three-quarters (74 percent) of women in this category say they are experiencing symptoms of insomnia, with 59 percent saying they wake up feeling unrefreshed in the morning, and 56 percent reporting they wake frequently during the night. This segment of women is most likely to report sleeping with an infant or child, which likely accounts for many sleep disturbances throughout the night. Lack of sleep has a big impact on SAHMs who say they are unable to do leisure activities (43 percent) and/or have sex with their partner (39 percent) because they are too tired or ran out of time during the day.

SAHMs report that in the hour before going to bed, they are completing household chores (71 percent) and/or doing activities with their children (71 percent).

Many women today choose to work part-time while raising their children. Part-time working mothers say they are sleeping well and one-half (50 percent) report typically being in bed for more than eight hours per night. These women are among the least likely to be told by their doctor that they have a sleep problem (16 percent) and this segment of women are less likely to say they are unable to do things because they run out of time or are too tired.

Like other women, part-time working mothers also say they accept it and keep going when tired during the day (68 percent), but they frequently use napping (60 percent taking at least one nap per week) and caffeinated beverages to cope (40 percent). In the hour before going to bed, the majority report watching television (88 percent).

Women who are married, with school-aged children and working full-time report being in bed less than 6 hours per night on weeknights and are less likely to nap. Women in this segment are most likely to report symptoms of insomnia with more than one-half (56 percent) saying they often wake up feeling unrefreshed and one-half (54 percent) saying they frequently wake up during the night. 70 percent of women say they just accept it and keep going when they are sleepy during the day. These women are the most likely segment to use caffeinated beverages when sleepy during the day (56 percent), consuming an average of 2.7 cups/cans per day. Women in this group are most likely to drive drowsy (35 percent) and to feel that they don’t have time for the following: sleep (60 percent), exercise (60 percent), spending time with family and friends (52 percent), leisure activities (49 percent), and have sex with their partner (44 percent). This segment of women is also most likely to report mood disturbances, specifically being bothered or troubled by worrying too much about things (37 percent).

After going through one or more of these life phases, women begin to approach retirement age. 50-something women have the highest frequency of sleep problems, though they report spending more than 8 hours in bed per night on weeknights (66 percent) and say they often nap at least once per week (61 percent). As a group, women in this segment frequently use sleep aids (41 percent) and approximately one-fourth (26 percent) of these women have been told by their doctor that they have a sleep problem. When sleepy during the day, 50-something women rarely just accept it and keep going; instead they choose to do less during the day (20 percent) and/or nap to catch up on their sleep(16 percent).

Other Poll Highlights

• Women who allow children (9 percent) or pets (14 percent) to share their bed have the most disturbed sleep.
• It’s a myth that men snore and women do not. Nearly one-third of women (31 percent) responded that they snore at least a few nights per week, likely disturbing their own sleep and the sleep of their partner.
• 29 percent of women report using some type of sleep aid at least a few nights per week.
• About two in ten women (19 percent) report experiencing symptoms of restless leg syndrome (RLS). Women who experience RLS at least a few nights a week are more likely than those who experience RLS with less frequency to
• Experience symptoms of insomnia at least a few nights a week (90 percent vs. 62 percent)
• Experience daytime sleepiness at least a few days a week (44 percent vs.17 percent)
• Consume more caffeine per day (3.71 cups/cans vs. 2.27)
• Use sleep aids at least a few nights a week (47 percent vs. 25 percent)

Tips for Healthy Sleep

According to the National Institutes of Health, approximately 70 million people in the United States are affected by a sleep problem, with women suffering from lack of sleep more often than men and with increasing frequency as they age. If you have difficulty with your sleep for any reason, here are some tips that may help you get a better night’s sleep

1. Try to have a standard relaxing bedtime routine and keep regular sleep times. Make sure your bedroom is dark, cool and quiet and that your pillows, sleep surface and coverings provide you with comfort.
2. Exercise regularly, but finish your workout at least three hours before bedtime.
3. Avoid foods and drinks high in caffeine (coffee, colas, tea and chocolate) and alcohol a few hours before bedtime. Caffeine and alcohol disturb sleep. Nicotine may make it difficult to fall asleep and lead to fragmented sleep; those who smoke should get help to quit.
4. If you have a new infant in the family, arrange for some help from family or friends in order to get a few more hours of sleep each week until your infant is sleeping through the night. When you return to work, additional assistance during this transition may be essential for keeping you safe at work and on your commute.

NSF released the poll findings as part of its 10th annual National Sleep Awareness Week campaign, held March 5-11th. For more sleep tips for women, as well as the Summary of Findings for the 2007 Sleep in America poll, visit the NSF’s Web site.

Methodology

The 2007 Sleep in America poll was conducted for the National Sleep Foundation by WB&A Market Research. Telephone interviews were conducted between September 12 and October 28, 2006, with a targeted random sample of 1,003 women ages 18-64. A random sample of telephone numbers was purchased from SDR Consulting,Inc. and quotas were established by region, with pregnant (n=150) and post partum (n=151) women being over-sampled. The response rate for this study was 20.4 percent (number of completed interviews divided by the number of completed interviews plus the number of contacted households who refused participation or did not complete appointments, factored by the overall incidence of 69 percent). The data was weighted to reflect equal proportions of respondents by age based on the U.S. Census. The poll’s margin of error is plus or minus 3.1 percent at the 95 percent confidence level.

Footnotes

1 Attention should be given to the fact that the poll respondents were asked to provide their usual bedtime and usual wake-time which were used in calculating their “number of hours in bed.” This tends to be reported more accurately than estimates of “number of hours slept.”