By Dr. Rubin Naiman
This past year, I watched my daughter-in-law, Adriana, proceed through her second pregnancy, childbirth and the care of our family’s lovely newborn, Eva. I watched her struggle with some of the most common challenges of motherhood, including of course, disrupted sleep. As Mother’s Day draws near, I’m remembering the many mothers, both new and seasoned, who have come to me with sleep concerns.
Partially due to hormonal fluctuations, women have 40 percent more insomnia than men. Both menstruation and menopause are associated with an increased risk for occasional sleeplessness as well as insomnia. It’s not at all uncommon for teen girls to encounter sleep challenges with the start of menses. The majority of middle-aged women I worked with over the years had sleep problems stemming from perimenopausal symptoms.
Obviously, women are at even greater risk for insomnia when they become mothers. Because sleep struggles are so common during pregnancy, sleep doctors facetiously refer to it as a sleep disorder. And the normal feeding schedules of healthy infants will fragment mom’s sleep for those first few months, not to mention the throes of weaning and shifting routines. Even under the very best of circumstances and with optimal support of partners, spouses or other family members, pregnancy, childbirth, nursing and infant care will, to varying degrees, disrupt sleep.
It’s not at all surprising that women come to depend quite heavily on prescription sleeping pills. IMS Health reports this dependence peaks from age 40 to 59, resulting in more than 15 million prescriptions per year. And this figure does not account for millions of additional prescriptions of off-label sleep drugs, OTC medications and the excessive consumption of alcohol and marijuana as sleep elixirs.
The sleep loss normally associated with motherhood is, simply put, natural. Mother Nature (who also happens to be a mother) has genetically endowed women with the resilience to handle this. Adriana didn’t seem all that surprised when I explained that women are biologically programmed to obtain significantly more deep, slow-wave sleep than men both over the course of a night and a lifetime. As a result, women perform better and rebound more quickly than men when sleep-deprived. Still, when their energy does rebound, mothers tend to overdo it.
While archetypal images of motherhood like the Klimt painting above convey a sense of tranquility and serene union, the image of the modern mother is more of a sleepy-eyed pit bull with lipstick racing her minivan across town to get the kids to soccer. But what if the problem of maternal insomnia is not entirely about insufficient sleep and as much about the unmitigated expenditure of energy?
In nature all things ebb and flow. Contemporary culture encourages us to go with the flow, but offers little regard for the ebb. In contrast, the experience of menses, pregnancy, childbirth, nursing and infant care all insist that mothers learn to temper going with the flow by intentionally slowing with the ebb. Just as we must learn to walk before we can run, we must learn to slow before we can sleep.
Try to do so naturally, avoiding OTC and prescription sleeping medications whenever possible. In truth, they simply don’t work well and are detrimental to our long-term health. If necessary, consider the judicious use of more natural alternatives like melatonin, valerian, and L-theanine. Judicious means becoming well-informed and only using such alternatives in the context of a comprehensive sleep health program.
Be aware that, whether intentional or not, you are teaching your children about sleep through the critical process of role modeling. Do so consciously. Your attitude, practices and overall value of and relationship to sleep are potent lessons that will impact your child’s future sleep habits.
In contrast to prevailing beliefs, consider that sleep is inherently a social experience. Bear in mind that during pregnancy you are actually sleeping for two. Whenever possible, sleep when your infant sleeps. Many women look at their baby’s sleep time as an opportunity to catch up on their list of essential chores, tasks, and activities. Keep sleep at the top of this list.
Allow your child to teach you about sleep, as well. To remind you of the power, nearness and forgotten mystery of it. Take time to simply watch your baby sleep. Gaze into those fluttering eyes, cuddle those limp limbs and watch that twitchy breath find its restful rhythm. Children, especially very young ones, most beautifully demonstrate something so many adults seem to have lost touch with — that instinctual ability for absolute and unequivocal surrender to sleep.
Last night I watched Adriana gazing at Eva as she nodded off. This, I thought, is most certainly the essence of Mother’s Night.