Shakespeare once described sleep as the “Chief nourisher in life’s feast.” Like good food, good sleep is vital to be nourished and healthy. If you’re going hungry, so to speak, the downstream effects poor sleep has on your body and spirit can be devastating.

For women experiencing hormonal changes, sleep is even more important … and often more elusive.

Because sleep is so critical to our well-being, we asked our awesome physical therapists, Bri and Meagan, to help us understand why sleep is often interrupted and what we can do about it.

Why is sleep so important?

When the body is at rest, we’re regulated by the parasympathetic nervous system, says our PTs; this is the “rest and digest” system that calms the body, decreases heart rate, relaxes muscles, and allows us to digest our food and restore our bodies to their factory settings.

When we don’t get adequate rest, a whole chain of negative effects can follow, including:

  1. Compromised immune system. If you’re not getting enough sleep, you may find you get sick more often.
  2. Inflammation. Poor sleep increases cortisol levels, Bri says; and that can increase inflammation throughout our entire system. If we constantly have elevated levels of cortisol, our sleep never gets to those baseline resting levels where the body benefits most. As Meagan says, for their patients with pelvic pain, staying chemically wound up from elevated cortisol can increase pain and impact gastrointestinal and genital-urinary systems. When those systems are inflamed, we end up getting up more often in the night to pee, further disrupting our sleep.
  3. Reliance on sleep surrogates. It’s a bad cycle to get into: when we don’t sleep well, we tend to rely on caffeine or sugary drinks to keep us going. Unfortunately, those choices are irritants that can get us into the vicious cycle of urgency that results in painful urination that ends up causing more inflammation.
  4. Increased risk of disease, stress, and anxiety. Says Bri, if you’re not getting enough sleep, your parasympathetic system can’t do its job well, you’re not getting the restoration of tissue or the good blood flow your body needs to recover from the day. Those who don’t sleep enough may be at greater risk of depression, hypertension, diabetes, and digestive issues, among other concerns.

What will I really gain from getting more sleep?

So yeah, you can avoid all that bad stuff, but what good stuff do you get?

How about reduced pain? “When you have repeated nights of poor sleep, your senses get revved up,” Meagan says. “Pain that’s just a whisper now gets a little louder after one bad night, but after a week or a month of not enough sleep, that whisper is at a screaming-through-a-megaphone level of magnitude. Your neurological system can’t cope, it’s now a physiological problem. Once you start sleeping again, the pain loses volume, becomes a whisper again, and now you can ignore it and get back to a regular sleep cycle and a less-painful life.”

“She got two good nights in a row,
and her pain went from 8 out of 10 to a 4.”

One of Bri’s patients was in post-operation recovery and feeling considerable pain. “She got two good nights in a row, and her pain went from 8 out of 10 to a 4. It’s amazing what restful sleep can do for your body. As a healing mechanism, sleep is absolutely vital, but we underestimate how important and effective it is.”

Another benefit: better emotional health. There’s a good cycle and a bad one, our PTs note: “Poor sleep results in poor eating habits because you want sugar and carbs for energy.” Bri says. “You want to be active, but your workouts are compromised because you’re tired and eating a bad diet. So you do less because you’re tired, which leads to declining health, which leads to feeling unhappy with yourself. And that extra anxiety further interrupts your sleep. Sometimes all you need to break out of that cycle is sleep.”

Good sleep supports better overall health. As PTs, Meagan and Bri are often involved in helping patients reduce pain so they can sleep better. “We help with pelvic pain, with fluid intake and timing so our patients get better sleep. That creates a positive ripple effect that leads to better food choices, better activity tolerance because they have more energy, better exercise, better health. We’ve taken out their coffee after dinner and addressed pelvic floor spasms, so now they can sleep longer and deeper and begin to heal.”

Sold. How do I sleep better?

Because sleep is involuntary, we tend to assume we have little to no control over it. But there are things we can do to promote better sleep.

According to Meagan, having good sleep hygiene is really important. Create a routine and keep to it every night, even on weekends. Do the same things, in the same order, and as close to the same time every night as is possible.

Adjust your fluid intake to promote uninterrupted sleep – no caffeine in the evenings, reduce fluid intake in the time just before bed.

Turn off devices that create a stimulating light (cell phones, tables, laptops, televisions) early enough to reduce the impact on your nervous system. “Lots of people take their screens to bed with them,” says Bri. “We don’t want to miss out on what’s happening in our social networks. But it’s important to remember the bedroom is for sleeping and sex, not tweeting or TV, so turn off your screens sooner in the evening to unwind in time for bed.”

Kegel breathing is a technique our PTs use with patients: by coordinating the pelvic floor with breathing, you stimulate the parasympathetic nervous system, which promotes rest. Plus, says Meagan, “it gets mentally boring, so you can count Kegels like sheep until you drift off!”

Tip for better sleep: do Kegels
and count the repetitions like sheep. 

Prioritize sleep. Women in particular, and even more, moms, tend to prioritize other things, says Meagan. We think we have to get things done, be productive, clean the house, catch up on work. “But when you start chipping away at sleep, the quality of all your other work gets compromised. If you get one more hour of good rest a night, it’ll take you so much less time to do those other things. And you’ll feel better doing them! Shift your to-do list to make sleep a priority.”

In our hyper-productive culture, sleep can feel like a waste of time or worse, like weakness. ‘Fess up: how often has someone called you and woken you up, and you lied and said you weren’t sleeping? How often do you hear people bragging about how little sleep they get? But the truth is, sleep is nourishment, and without enough of it, our bodies, minds, and spirits are far less healthy than they could be. Sleep truly is the chief nourisher in life’s feast – dig in!



Shannon Perry

Shannon is a celebrated author and global educator. Whether she’s interviewing a physician or producing a podcast, her appetite for research, facts, and truth culminates in credible health education and programming that women can rely on. An avid runner, cyclist, and climber, Shannon knows a thing or two about thriving in midlife and lives in Seattle with her cat, dog and boyfriend.


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