Table Of ContentSleep and Women’s
Health
Sleep and Women’s
Health
Zippi Dolev, MD
Private Practice in Reproductive Psychiatry
Tel Aviv, Israel
Translated by Mordechai Zalesch
Translation edited by Judy Kupferman
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Library of Congress Cataloging-in-Publication Data
Names: Dolev, Zippi, author.
Title: Sleep and women’s health / Zippi Dolev ; translated by Mordechai Zalesch ; translation
edited by Judy Kupferman.
Description: Boca Raton : CRC Press, [2020] | Includes bibliographical references and index. |
Identifiers: LCCN 2019034167 (print) | LCCN 2019034168 (ebook) | ISBN 9780367322144
(paperback ; alk. paper) | ISBN 9780367322212 (hardback ; alk. paper) | ISBN 9780367822811
(ebook)
Subjects: MESH: Sleep Wake Disorders | Women | Women’s Health
Classification: LCC RA786 (print) | LCC RA786 (ebook) | NLM WL 108 | DDC
613.7/94082--dc23
LC record available at https://lccn.loc.gov/2019034167
LC ebook record available at https://lccn.loc.gov/2019034168
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Contents
Acknowledgments ....................................................................................................vii
1 Why Do I Write about Sleep Disturbances in Women? .................................1
2 What Actually Is Sleep? .....................................................................................5
3 Women and Sleep ............................................................................................19
4 Types of Sleep Disturbances in Women .........................................................23
5 Sleep Disorders during the Menstrual Cycle ................................................43
6 Sleep Disturbances during Pregnancy ...........................................................49
7 Postpartum Sleep Disorders ...........................................................................59
8 Sleep Disturbances and Menopause ..............................................................69
9 Sleep Disturbances Related to Physical Diseases .........................................85
10 Sleep Disturbances and Mental Disorders ....................................................97
11 Treatment of Sleep Disturbances .................................................................111
12 On Women and Dreams ................................................................................121
13 A Few Closing Words ....................................................................................131
Bibliography ...........................................................................................................133
Index .......................................................................................................................139
v
Acknowledgments
The quotation from J.-B. Pontalis is reproduced from Windows, translated by Anne
Quinney: the English translation is copyright 2003 by the Board of Regents of the
University of Nebraska; the text was originally published as Fenêtres and is copyright
2000 by Editions Gallimard.
The quotation from Simone de Beauvoir is from The Second Sex, published by Vintage,
and reproduced by permission of The Random House Group Ltd. ©2015.
The quotation from Meir Shalev is reproduced from My Russian Grandmother and
Her American Vacuum Cleaner: A Family Memoir, published in 2011 by Schocken,
with permission from Penguin Random House LLC.
The quotation from Key Redfield Jamison is reproduced from An Unquiet Mind: A
Memory of Moods and Madness, published in 1995 by Vintage, with permission from
Penguin Random House LLC.
vii
1
Why Do I Write about Sleep
Disturbances in Women?
“We go to bed. He’s asleep before his head hits the pillow. I can’t believe that the heated
argument we had two hours ago isn’t keeping him awake. I am still seething from the
argument, and am also going over many other things that happened during the day, and
I’m really unable to fall asleep. Remembering the phone call with my mother, that made
me so sad, thinking about my son in the army who hasn’t been in touch for 2 days, worried
about a lecture I’m giving tomorrow and the few corrections I still need to make. And he?
He’s already snoring deeply. I prod him so that he makes less noise. He stirs but doesn’t
wake up. I think to myself: how can he be sleeping so deeply, without a worry in the world,
when it will take me hours to clear my mind before I can fall asleep?”
I hear so many variations of this story from patients that I have seen with sleep
disturbances. I listen, and I always give the same answer: “Yes, there are significant
differences between men and women, even in the very neglected area that we call
sleep.”
Gender differences between men and women regarding sleep are primarily
recognizable after puberty. They are a combination of many factors, including:
• The effect of hormones related to fertility in a woman’s life cycle.
• Differences in male and female sleep structures.
• Multiplicity of roles in women’s lives which affect stress and sleep levels.
• Tendency to depression and anxiety, which is twice as common in women
as in men.
• Women’s physical and mental diseases affecting sleep (Figure 1.1).
My field of expertise as a psychiatrist is reproductive psychiatry, and it deals with
the connection between hormonal and mental changes in the course of a woman’s
life—that is, mental changes during the menstrual cycle, pregnancy, postpartum, and
menopause. I was introduced to this field combining gynecology and psychiatry, which
was new in psychiatry at the time, during a 2-year fellowship program in New York,
and it fascinated me. I felt I had found my place and calling after many years of
uncertainty about my chosen profession.
At a stand of professional books at a conference I attended in the United States,
the book Depression in Women (2001) by psychiatrists Meir Steiner and Kimberly
Yonkers, which deals with the relationship between hormonal and mental changes
caught my eye. The book addresses all the stages in the life of a woman, from puberty
to menopause. It touches on both normative and non-normative mental changes and
1
