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Sleep Tight Every Night

In addition to food, water, and air, sleep is the one thing we truly can't live without. But experts say more and more women are falling short on shut-eye, and staring at the ceiling all night isn't just frustrating—it can also be life threatening. Studies show that one in six fatal car accidents are caused by sleep-deprived drivers, and according to the National Sleep Foundation (NSF), the 40 million Americans who now suffer from sleep disorders are at higher risk for a slew of serious health issues. Here, what's behind the insomnia epidemic, plus fast-acting solutions for getting quality sleep.

The Vitamin Z Deficiency

A growing number of nocturnal ailments are robbing women of critical slumber. To date, there are about 90 official sleep disorders, the three most common being insomnia, restless leg syndrome, and sleep apnea, a potentially life-threatening disorder in which people stop breathing during sleep, says Philip Westbrook, M.D., former president of the American Academy of Sleep Medicine.

New research has shed light on why sleep problems are skyrocketing. As with many health issues, stress is to blame. "Thanks to the economy, there's been a big increase in stress, especially in women," says Alan Lankford, Ph.D., president and CEO of the Sleep Disorders Center of Georgia. "And stress can have a huge impact on falling and staying asleep." When you're mentally keyed up at night, your body pumps out the stress hormone cortisol, which acts like an adrenaline shot that prevents snoozing.

Also contributing to sleepless nights is a genuinely modern double threat: overactive minds and underactive bodies. Thanks to our coffee culture, people tend to suck down jolts of energy well into the afternoon. "Any kind of caffeine, even the small amounts in hot chocolate and candy bars, can impair your sleep if ingested after 2 p.m.," says James Maas, Ph.D., coauthor of Sleep for Success! Everything You Must Know About Sleep But Are Too Tired to Ask.

Artificial blue light from a television or computer is another powerful mental stimulant that blocks production of the sleep hormone melatonin. So fiddling with your iPad or watching Conan within an hour of bedtime signals your brain to stay alert—and awake. This might not be such a big deal if we got off our butts more often. "Women evolved to be physically active from morning to night," says Westbrook.

"But today's desk-bound woman, even one who regularly hits the gym, still doesn't get the exercise her body was built for, and ample exercise is crucial for good sleep."

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A Wake-Up Call for Your Health

A solid third of your life should be spent in slumber, and not just so you can recover from those happy hours gone wild. Sleep is critical for overall health, says Maas, "and people are starting to realize it's a necessity, not a luxury." As you snooze, your body repairs errant cells, builds bone and muscle, consolidates memories, and stores up energy for the days, weeks, and years ahead. Sleep is so important, in fact, that some doctors consider how much you get to be a vital sign, on par with body temperature and blood pressure, says Lankford.

When you're spent, your healthy habits tend to disappear. Fatigue makes the body crave a quick hit of energy—otherwise known as a high-calorie carb-fest. (Ever hit a fast-food drive-through after a rough night?) Going to the gym, a smarter pick-me-up, can seem about as doable as taking a trip to Mars, which is why nearly 50 percent of women report skipping exercise when they're beat, according to the NSF.

Habitually skimping on shut-eye can also lead to chronic health problems or worsen preexisting ailments. "Sleep deprivation is cumulative," says Lankford.

"If someone needs eight hours a night and gets only six every night for a week, by Friday she will be functioning on sleep debt." Long term, that can spell malfunctioning hormones that pave the way for increased risks of depression, heart problems, gastrointestinal issues, type 2 diabetes, and breast and colorectal cancers. (Breast cancer, for example, has been linked to high levels of estrogen and low levels of melatonin; production of both of these hormones is affected when you're sleep deprived.)

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Hitting the Bottle

Tossing and turning night after night can make a person desperate enough to storm her doc's office. But instead of searching for the root causes of insomnia, many physicians simply whip out their prescription pads. "Until recently, many doctors were not trained in sleep treatment in med school," says Maas. "Of the 90 or so sleep disorders, most physicians can name around four. Many hand over pills because they don't know how else to solve the problem." To wit, a whopping 60 million sleep prescriptions were filled in 2009, according to research firm IMS Health.

All this pill popping has ushered in a new set of problems. For one thing, some sleep drugs are addictive, especially older ones such as benzodiazepines. Even the new class of nonbenzos can be habit forming, says sleep doctor Shelby Freedman Harris, Psy.D., director of behavioral sleep medicine at Montefiore Medical Center's Sleep-Wake Disorders Center in New York City. "Though people are not hooked on them physiologically, they can develop a psychological dependence and think they'll never sleep if they don't take a pill," she says. Rare but scary side effects include things like memory loss and sleepwalking, sleep driving, or sleep sex. Plus, says Westbrook, no studies show what extended use of these drugs does to your body.

"The bottom line is that prescription sleeping pills are a short-term solution," says Maas. Simply put, drugs may be a godsend for temporary insomnia, but continuous use could be dangerous.

"Taking a pill won't get to the underlying issue," says Westbrook. Most frightening of all, "insomnia can be a symptom of depression, and depressed patients who take sleeping pills have an increased risk of suicide." Likewise, sleep apnea, when treated with Rx sleep meds, can turn fatal.

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Put Sleep Issues to Rest

A safer and more effective cure for sleep problems lies in improving what doctors call sleep hygiene, a combination of natural snooze-inducing practices. Clean up your slumber routine with these tricks:

Stick to a regular schedule. "Routine is so important," says Maas. "You have one biological clock—not one for the workweek and one for the weekend. You need to synchronize it and go to sleep around the same time every day." Changing up your snooze schedule confuses your brain's sleep center and promotes restless nights.

Keep things cool. When you nod off, your core body temperature drops by about a degree and a half, says Lankford. Encourage the process by setting your bedroom thermostat to around 68°F. If you still feel hot at night, you could be smothering yourself under a comforter that's too warm, so switch to a lighter one. Another trick: Take a hot bath before bed. As your body cools, it transitions more easily into sleep mode once you lie down.

Don't be afraid of the dark. Artificial light messes with your internal clock and acts as a stimulant, inhibiting the flow of melatonin. "An hour before bed, turn off your iPad or computer, and don't text or watch TV," says Harris. And by all means, stop watching the clock! Not only do digital versions give off a melatonin-disrupting glow, but watching 20 minutes tick by can lead to more hours of sleepless anxiety.

Exercise earlier. Working out soothes insomnia-fueling stress and eventually lowers your body's built-in thermostat, a necessary pre-sleep step, explains Robert Oexman, D.C., director of the Sleep to Live Institute in Joplin, Missouri. Just finish off your cardio at least four hours before bed—any later and your body temp will still be too high, keeping you awake.

Try some pillow talk. If adopting the sleep-hygiene guidelines above doesn't leave you well rested, you may want to look into cognitive behavioral therapy, in which you learn to challenge, then change, your negative sleep-related thoughts, says Harris. Acupuncture, massage, meditation, or simply taking a series of slow, deep breaths before bed may also help soothe you into sleep. If your insomnia sticks around for more than three weeks, seek out a doctor who is trained in sleep medicine.

Less Sleep, More Pounds

The reason you can't lose weight may lie between the sheets. The less you sleep, the more of the appetite-revving chemical ghrelin your body makes, and the lower your output of leptin, the hormone that signals you're full, says Lee A. Surkin, M.D. This weight-gain double whammy leaves you craving fatty, salty, carb-filled foods, making it practically impossible to pass up that high-calorie breakfast sandwich.

Plenty of women get up before dawn to slip in a workout. But if they aren't going to bed early enough, their weight-loss efforts may be in vain. A study in the Annals of Internal Medicine found that sleep-deprived people on low-cal diets lost 55 percent less body fat than those who were well rested. What they did shed, sadly, was lean muscle mass.

Preliminary studies show that nighttime exposure to light—e.g., the kind your computer, cell phone, or TV emits—may lead to obesity. Melatonin, your body's sleep-inducing hormone, is extra-sensitive to any kind of glow. Even barely there lights can disrupt melatonin production, leaving you wide awake and more likely to raid your secret candy stash.

The Stages of Sleep

Stage 1 straddles the line between alert and asleep.

Stage 2 is when your body temp cools and you're oblivious to your surroundings.

Stages 3 and 4 send you into deeper levels of sleep. Your breathing slows, your blood pressure drops, and your muscles relax.

You then move into rapid eye movement (REM) sleep for anywhere from five to 40 minutes at a time. "In REM sleep, the brain is awake but you're unaware of your surroundings, unconscious in one sense but totally conscious in another," explains Philip Westbrook, M.D. The stage occurs every 90 minutes throughout the night, and it's during REM that you have your most vivid dreams.

Once you've snoozed your way through each level, you typically go from REM right back into stage two. It all tapers off in the a.m., when your body releases cortisol to help you shrug off sleepiness as you open your eyes.

What Your Sleep Style Says About You (And Your Health)

Do you opt for the full fetal position in bed, or are you the sleeper who is invariably splayed out as if about to make snow angels with the top sheet? Although we may get feedback from the person we share a bed with, most of us don't give a second thought to which way our bodies lie after we slip off into dreamland. But according to one sleep expert, the position you prefer during slumber says a lot about your personality... and your health. Here, three of the most common poses, and what they say about you.

Stomach If you prefer a prone position (lying nearly facedown), you're likely a perfectionist who is compulsive, persistent, and goal oriented, says psychiatrist Samuel Dunkell, M.D., a sleep expert in New York City. These qualities may be good for your career, but they don't do your body any favors. Sleeping on your stomach can twist your neck into an awkward position, put excess pressure on your spine, and make it more difficult to inhale, says Lee A. Surkin, M.D. To avoid waking up all achy, gently nudge yourself into sleeping in a fetal pose by lying on your side with one pillow between your knees and another behind your back.

Back Staring straight up at the ceiling can signal an adventurous, confident, and receptive personality, says Dunkell. Catching Z's on your back also keeps pressure off your jaw, which is crucial for people with painful temporomandibular joint (TMJ) disorder. But back sleeping triggers undue stress on your airway, so it's a bad idea for snorers. If you're a noisy breather, try the pillow trick explained above or buy a full-body pillow that will keep you on your side.

Side Some 73 percent of women and 50 percent of men spend the night on their sides. Most curl into a semi-fetal pose, with their knees just slightly bent, says Dunkell. According to his research, such people tend to be compromising and appeasing, whereas those who snooze in full fetal (with their knees practically hugged to their chest) are introspective and intense. Healthwise, sleeping on either side curtails snoring, and resting on your left side keeps your stomach active and eases heartburn, according to the Journal of Clinical Gastroenterology.

The Broken Marriage Bed

Don't let your need for quality Z's tear you and your mate apart. One in four couples nod off in different bedrooms because of sheet-sharing pitfalls. Avoid that fate by following proper sleep hygiene and trying these strategies:

The average person moves 65 times a night, says James Maas, Ph.D. Invest in a mattress that's big enough to keep you from feeling each other flail around. Also, try using two separate comforters or blankets to avoid a tug-of-war.

If snoring is an issue, the snorer should first try nasal strips and sleeping on their side. If that doesn't work, hit the pharmacy for silicone earplugs, which mold to the shape of the ear and cancel out up to 50 percent of noise, says Shelby Freedman Harris, Psy.D. (Consistent heavy snoring should be checked out by a doctor, who can prescribe treatment that will help keep things quiet.)

People may say that sleep is the new sex, says Maas, but one can actually lead to the other. Your body releases feel-good hormones, stress, and tension during orgasm, which makes you fall asleep faster and more soundly. Just sayin'.

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