Why sleep is one of the most overlooked wellbeing issues for midlife women

Sleep issues (getting too little or too much) are associated with health problems. When sleep issues become chronic, women are at higher risk for increased inflammation, problems related to weight gain, increased sensitivity to pain, fatigue, the risk for injury, and reduced cognitive and physical functioning. [1] Poor sleep also impacts employee performance, productivity, and increases absenteeism.

The role of work in midlife sleep issues

A Finnish study of over a thousand middle-aged working men and women found that while both groups got less sleep during the week, women were at higher risk of sleep loss on workdays. The researchers suggested that long hours, excessive work demands, and stress might be why so many women had work-week sleep debt. [2] Several studies found that women who had a shorter sleep on workdays tended to compensate by sleeping longer on their days off. As sleep disruptions increase during the menopausal transition, midlife women may be at the highest risk of work-related sleep loss.

In mid to later life, women have a unique set of circumstances hampering their ability to get restful sleep, and perimenopause can make things even worse. About 30% of the general population have trouble sleeping, but the number skyrockets to 50% in peri and postmenopausal women (with postmenopausal women having the worst overall self-reported sleep). Changes in estrogen impact both the normal sleep cycle and natural melatonin release, while physiological changes related to aging shorten sleep time and increase the likelihood of early morning waking.

Other variables that can impact sleep quality are health habits (i.e., being regularly physically active help, while alcohol and tobacco can interfere with sleep), physical health (e.g., managing a chronic health condition), and psychosocial health (typically lower sleep quality occurs for those dealing with anxiety or depression).[3] Modern life adds a further complication with increased electronic use before bedtime and screens in the bedroom.

Unfortunately, sleep issues can also worsen experiences of the menopausal transition. According to researchers looking at sleep in midlife, “Women presenting sleep disturbances displayed a 2-fold increase in the severity of menopausal symptoms…which was translated into a 6–8 times higher risk of impaired quality of life.” [4]

Why is sleep important to health?

Some of the benefits of improved sleep include:

• the maintenance of the immune system,
• the reduction of risk for cardiovascular disease,
• the contribution to a healthy metabolism and body weight,
• the contribution to better neurological functioning and potentially reducing risk for Alzheimer’s disease, [5]
• improved motor tasks, particularly driving, and
• plays an essential role in stress management and good mental health.

How employers can help

There are some important things that employers can do to support midlife women with sleep:

1.     Several studies looking at sleep in perimenopausal working women stressed the importance of leisure days to sleep quality. Women in midlife need uninterrupted days away from work to make sure that they are getting recovery time from lost weekday sleep. Researchers connected leisure time recovery with increased work productivity.

 2.     Flexible start times can help women who struggle with falling asleep (or sleep who have interruptions and early morning waking) to have time to adjust to sleep changes. 

3.     Consider adding sleep education/support to your workplace well-being programs. Training on good sleep hygiene and stress reduction is crucial. Connecting the impact of healthy living on sleep is also key.

References 

[1] Ingiosi, A. M., Opp, M. R., & Krueger, J. M. (2013). Sleep and immune function: Glial contributions and consequences of aging. Current Opinion in Neurobiology, 23(5), 806–811. https://0-doi-org.orca.douglascollege.ca/10.1016/j.conb.2013.02.003

[2] Polo-Kantola, P., Laine, A., Kronholm, E., Saarinen, M. M., Rautava, P., Aromaa, M., & Sillanpää, M. (2016). Gender differences in actual and preferred nocturnal sleep duration among Finnish employed population. Maturitas, 94, 77–83. https://doi.org/10.1016/j.maturitas.2016.09.002

[3] Blümel, J. E., Cano, A., Mezones-Holguín, E., Barón, G., Bencosme, A., Benítez, Z., Bravo, L. M., Calle, A., Flores, D., Espinoza, M. T., Gómez, G., Hernández-Bueno, J. A., Laribezcoa, F., Martino, M., Lima, S., Monterrosa, A., Mostajo, D., Ojeda, E., Onatra, W., & Sánchez, H. (2012). A multinational study of sleep disorders during female mid-life. Maturitas, 72(4), 359–366. https://doi.org/10.1016/j.maturitas.2012.05.011

[4] Xu, Q., Lang, C. P., & Rooney, N. (2014). A systematic review of the longitudinal relationships between subjective sleep disturbance and menopausal stage. Maturitas, 79(4), 401–412.

[5] van Dijk, G. M., Kavousi, M., Troup, J., & Franco, O. H. (2015). Health issues for menopausal women: the top 11 conditions have common solutions. Maturitas, 80(1), 24–30. https://0-doi-org.orca.douglascollege.ca/10.1016/j.maturitas.2014.09.013