January-February 2005
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Reviewed by Lynne Lamberg |
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A woman who drives a bus in both morning and evening rush hours sacrifices sleep to make her children's school lunches and handle other family chores. A lawyer with a new baby struggles to stay awake at work. A woman with untreated sleep apnea gives birth to a full-term but underweight baby. A woman whose son was murdered fears sleep, dreading the nightmares it brings. Stories like these start each chapter in this book. Meir Kryger invites readers to listen in as he and his patient work together to figure out what's wrong. Once Kryger's made a diagnosis, he tells what causes the problem and what can be done about it. By the end of each chapter, when he reveals how each woman's situation resolved, readers likely will have a better understanding of potential causes of sleep disturbances in their own lives, and know ways to avoid or remedy them. In surveying nearly all of the more than 80 disorders of sleep, Kryger also encompasses recent research findings. He is the chief editor of the sleep field's most widely used textbook, Principles and Practice of Sleep Medicine, and directs the sleep disorders center at the University of Manitoba in Winnipeg. Women experience more difficulty with sleep overall than men do, Kryger says. Some sleep problems, such as insomnia, occur more frequently in women than in men. Physicians, he says, sometimes fail to take note of symptoms in women that signal disorders they see mainly in men, such as sleep apnea. Many women not only work outside of the home, but also serve as primary household managers and caregivers for their families. They may be the first person in the family to arise, and the last to go to bed. Any illness that diminishes a woman's ability to perform this central role, Kryger says, also threatens the well-being of the rest of her family. He highlights events unique to female biology that may disrupt sleep, such as menstruation, pregnancy, and menopause. In pregnancy, for example, four in five women report trouble sleeping and excessive daytime sleepiness. Perhaps one in four pregnant women develops restless legs syndrome (RLS), which prompts an irresistible urge to move the legs at bedtime. Because it hinders sleep, it often leads to daytime sleepiness. In one study, women who developed RLS while pregnant proved to have had a deficiency in iron and/or folic acid before they conceived. "Common sense mandates that women who develop RLS during pregnancy have their iron status checked by a doctor," Kryger notes. Some may need to take iron. In most women, RLS disappears after childbirth. In talking to their physicians about sleep problems, Kryger notes, people often report they have "no energy." While some mean they feel extremely sleepy, physicians may hear those words and suspect depression. Rather than using terms such as "tired," "fatigued," or "exhausted," Kryger suggests, describe what happens: "I fall asleep at stoplights," "I fall asleep in the middle of a conversation," "I feel too weary to play bridge or even see my friends." The book includes a sleep diary and other self-evaluation tests, as well as information on sleep problems in husbands and children, a common contributor to sleep disturbance in women. Kryger discusses sleep disruption stemming from both medical and psychiatric illnesses and medications used to treat these illnesses. His chapter on sleep clinics and sleep laboratories includes photographs of patients wearing sleep monitoring equipment and a device used in the treatment of sleep apnea. He also lists websites and organizations that are good sources of further information. This book joins other recent substantive works on women's sleep by specialists in the field: A Woman's Guide to Sleep: Guaranteed Solutions for a Good Night's Rest, by Joyce A. Walsleben, PhD, and medical writer Rita Baron-Faust, and The Woman's Book of Sleep: A Complete Resource Guide, by Amy Wolfson, PhD. Readers are fortunate to have this abundance of choices. |
© 2005 WebSciences and Lynne Lamberg |
A WOMAN'S GUIDE TO SLEEP DISORDERS