Meir Kryger - Cant sleep, cant stay awake: a womans guide to sleep disorders

Cant Sleep,
Cant Stay Awake

A Womans Guide to Sleep Disorders

Meir Kryger, M.D.

Past President,
American Academy of Sleep Medicine

Foreword by Barbara Phillips, M.D., M.S.P.H.

Introduction by Richard Gelula, M.S.W.,
CEO, National Sleep Foundation

This book is dedicated to my wife, Barbara,
and my children, Shelley, Michael, and Steven.

M eir Kryger literally wrote the book about sleep medicine. He is the first editor and driving force behind the standard medical textbook, Principles and Practice of Sleep Medicine. Principles and Practice was a long overdue accomplishment; it pulled together the available knowledge about sleep and its disorders into one source, and is now widely acknowledged as the text of sleep medicine. Every sleep medicine clinician has a copy of that book readily available.

Cant Sleep, Cant Stay Awake is the same sort of accomplishment. Dr. Kryger has crafted this book in response to womens largely unaddressed needs regarding sleep. In addition to chapters about medically recognized sleep disorders such as narcolepsy and sleep apnea, he has included chapters on pregnancy, menopause, and family life. Although these are vital issues for most women at some time or another, most clinicians, even sleep clinicians, are not very good at addressing them.

The truth is, women sleep differently than men. A consistent finding in the medical literature has been that women report a greater need for sleep than do men. In surveys, women report spending more time in bed than do men, but also report more sleep problems, including inadequate sleep time and insomnia. However, studies of sleep quality by objective measurement tend to find very few objective differences between sleep quality in young men and women. With aging, it appears that women may actually fare better than men. Some (but not all) research indicates that older women who do not experience specific problems with sleep actually sleep more soundly than their male counterparts.

Among the reasons that women sleep differently from men are the facts that insomnia is clearly more prevalent in women than in men, and pregnancy and menopause appear to affect sleep. Nocturnal trips to the bathroom are a significant problem for both genders with aging, but younger women tend to find this less disruptive than do younger men.

is entitled Sleep Breathing Disorders: Snoring and Sleep Apnea. Although sleep apnea can be deadly, surveys of medical schools have repeatedly demonstrated that sleep disorders receive short shrift in the curriculums of doctors-to-be; the average medical student receives about one hour of education about sleep and sleep disorders. If the student learns about sleep apnea at all, he or she is likely to hear that sleep apnea is much more prevalent in men than in women. As a result, clinicians may overlook or discount symptoms related to sleep and breathing problems in women. However, recent work demonstrates that postmenopausal women have a risk of sleep apnea similar to that of men. Dr. Krygers chapter helps women to recognize signs and symptoms of this condition, and provides advice about when to seek help for herself or for a family member.

When I asked him why he wrote the book, Dr. Kryger said, Sleep disorders are very common at all stages of a womans life. Women have sleep problems men never have (pregnancy, menopause, as caregivers, etc.), and sleep problems frequently are seen as mens diseases, and women get missed or undiagnosed. Also the twenty-four/seven world has resulted in even more sleep deprivation in women since they are still usually the main caregiver in the family.

As a sleep clinician who is also a woman, I read this book with both professional and personal interest. And I learned a lot! You will, too.

Barbara Phillips, M.D., M.S.P.H., is currently Professor of Pulmonary and Critical Care Medicine in the Departments of Internal Medicine and Preventive Medicine at the University of Kentucky College of Medicine. Dr. Phillips is board certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine. She directs the Sleep Clinic and Sleep Fellowship at the University of Kentucky College of Medicine, and is Medical Director of the Sleep Disorders Center at Samaritan Hospital in Lexington. She is a past member and President of the American Board of Sleep Medicine, and currently serves on the boards of the American Academy of Sleep Medicine and the National Sleep Foundation.