October 30, 2018

Poor Sleep Makes You More Than Just Sleepy

swhr sleep cartoon

By Rebecca Nebel, PhD, SWHR Director of Scientific Programs

We’ve all experienced times where we haven’t gotten enough sleep, whether it’s pulling an all-nighter to cram for a test, caring for a newborn, or stressing about a project at work. Recently I attended NIH’s Sleep & the Health of Women Conference, where several presenters (some of the most prominent sleep researchers in the country) confessed they had not gotten much sleep the night before.

Not getting enough sleep may make you feel very tired the next day, which can negatively affect your productivity and impair your judgement. But in addition to these immediate consequences, poor sleep is also a risk factor for a host of diseases and conditions, including cardiovascular disease, dementia, and psychiatric diseases.

When assessing the causes of poor sleep, it’s critical to consider that women and men may have different sleep needs. Further, while they may suffer from the same sleep disorders, women and men may present with different symptoms, creating a need for unique screening, diagnosis, and treatment.

Sleep apnea is a prime example of this, as about 90 percent of women with sleep apnea go undiagnosed because they may not report “textbook” symptoms like snoring and feeling very sleepy during the day. SWHR’s Women & Sleep Apnea one-pager outlines some of these differences, and SWHR’s Women & Sleep guide explores 20 sleep health topics that affect women over the lifespan.

One of the topics highlighted in the guide is the impact of sleep on cardiovascular health. Chronic short sleep (which this study defines as 5 hours or less) is a risk factor for high blood pressure, with a stronger association in women than men. In addition, sleep disorders like sleep apnea increase risk for high blood pressure and stroke. Pregnancy is a particularly vulnerable time for women as sleep apnea is associated with pregnancy complications like gestational diabetes, high blood pressure, and preeclampsia, which can be deadly for some mothers and babies, and also elevates risk for cardiovascular events later in life.

The role of sleep in dementia risk has been a recent topic of interest for researchers. Sleep disorders like insomnia and sleep apnea are associated with increased risk for dementia. Additionally, quality sleep, and slow-wave sleep (or deep sleep) in particular, is important for clearance of the protein amyloid beta (Aβ) from the brain. In people with Alzheimer’s disease, Aβ clumps together to form plaques, which can disrupt brain function. Women have greater slow wave sleep activity than men, yet this declines for both women and men as we age.

Sleep disturbances are also closely connected with psychiatric disorders. For example, someone with insomnia is more than twice as likely to develop depression than someone without sleep problems. Conversely, nearly all patients with mental health problems experience some type of sleep disturbance and sleep problems are associated with poorer outcomes and response to treatment. Women are at greater risk for developing psychiatric conditions, which may in part be associated to their increased risk of sleep difficulties.

Importantly, treating sleep disorders like sleep apnea and insomnia can improve the course of diseases like psychiatric disorders and can also minimize risk for conditions later in life like cardiovascular disease and dementia. One study, for example, found that treatment of sleep apnea with continuous positive airway pressure delayed the onset of cognitive impairment.

Neglecting sleep can negatively affect your well-being and put you at risk for numerous diseases, yet our culture still perpetuates sleep deprivation as a badge of honor. As a society we must recognize the importance of good, quality sleep and prioritize getting enough sleep to the best of our ability. That includes all of you sleep researchers out there, too.