Sleep in Women: A New Perspective
Biological conditions specific to women, including the menstrual cycle, pregnancy and menopause, can all affect how well a woman sleeps. The impact of these conditions on sleep in women can be due to both hormonal and physical changes. Scientific research has only recently focused on the incidence and causes of sleep problems in women, particularly sleep patterns and the changing needs and problems associated with sleep throughout women's life spans.
Grace Pien, assistant professor in the
Department of Medicine, is currently working
on several research questions in these areas.
Dr Pien is examining the relationship between
pregnancy and sleep-disordered breathing. Physiologic
changes that take place during pregnancy, including
gestational weight gain, pharyngeal hyperemia
and diaphragmatic elevation, may place pregnant
women at increased risk for the development
Because snoring and cases of
obstructive sleep apnea in pregnant women have
been reported to increase the likelihood of
adverse maternal-fetal outcomes (e.g. gestational
hypertension, preeclampsia and
small-for-gestational age births), this is
an important area of investigation. Dr.Pien
is nearing completion of a prospective cohort
study in which women are monitored for sleep-disordered
breathing with overnight sleep studies in early
and late pregnancy. She is also following these
pregnant women for other sleep problems, including restless
legs syndrome and difficulty sleeping.
Complaints of difficulty sleeping also increase among women during the menopausal transition, but the relationship between menopause and insomnia is poorly understood. To explore this issue, Dr. Pien is examining risk factors for poor sleep quality among perimenopausal women. In addition to trouble sleeping, the risk for developing obstructive sleep apnea increases approximately three-fold among postmenopausal women compared to premenopausal women. In order to better understand the mechanisms that lead to sleep apnea among postmenopausal women, plans are underway to study the relationship between the hormonal changes of menopause and changes in the upper airway during the menopausal transition.
Faculty in the Division of Sleep Medicine provide
care for women of all ages with sleep complaints,
including insomnia, sleep apnea, restless legs
syndrome, narcolepsy and other sleep disorders.
Dr. Pien's areas of special interest and expertise
include management of sleep problems in pregnant
women, including both women with preexisting
sleep disorders and those with pregnancy- related
sleep compaints. In addition, she provides evaluation
of sleep problems in perimenopausal and postmenopausal