DrLullaby’s founder, Lisa Medalie, PsyD, DBSMcontributes to this Chicago Health article, explaining insomnia’s “three P’s”, its origins, and ways to put it to rest. “In general the prevalence of insomnia is higher in women than men,” says Lisa Medalie, PsyD, CBSM, a clinical psychologist and sleep specialist at University of Chicago Medicine. The margin is significant: Women are 1.3 times more likely to experience insomnia than men, according to the National Sleep Foundation (NSF). Apart from fatigue, irritability and difficulty concentrating, insomnia has been linked to a bevy of health problems including hypertension, diabetes and cardiovascular disease. Chronic insomnia also can be a precursor for psychiatric disorders, with more than 40 percent of people battling both, according to a 1989 Journal of the American Medical Association study. “If they are vulnerable to depression or anxiety, such symptoms are exacerbated with sleep loss,” Medalie says. Often, women have trouble sleeping when hormones fluctuate. Insomnia can increase during pregnancy (especially in the third trimester) and perimenopause, according to the Office on Women’s Health in the U.S. Department of Health and Human Services. “With menopause, often hot flashes wake up women from sleep and make it difficult to return,” Medalie says. Unfortunately, poor sleep is caused by more than just hormones. Insomnia is multifaceted, and sleep professionals try to understand it by what Medalie calls “the three P’s.” First there are predisposing factors, which are the underlying causes that make someone vulnerable to insomnia. These might include childhood symptoms of insomnia, hyperarousal and genetics. Next there are precipitating events that kick-start the initial bout of insomnia. These are plentiful: financial stress, divorce, medical problems, abuse. Environmental factors fall under this category as well, i.e., your noisy neighbor or even a restless newborn. Finally there are perpetuating factors: the clock-staring anxiety from not sleeping, daytime naps or anything else that “maintains the insomnia,” Medalie says. Blame Your Parents for Poor Sleep To some, the results aren’t surprising—“Many folks with insomnia have a family history of insomnia”— Medalie says, but they are useful in understanding the origin of insomnia. Put Sleeplessness to Rest Don’t Lie Awake in Bed “If you are awake for 15 to 20 minutes following your awakening, get out of bed,” Medalie says. Don’t stay in bed tossing and turning or scrolling through your phone. After 20 to 30 sleepless minutes, try getting up and wandering somewhere else to do a relaxing activity such as reading. Then return to bed when you feel tired. Lying awake in bed can create an unhealthy link between wakefulness and your sleep environment, according to the NSF. Cool Off Hot Flashes Hot flashes may wake you from sleep, but they don’t need to keep you awake. “If you wake from a hot flash,” Medalie says, “try to keep your frustration response low by taking 10 slow, deep breaths.” This will help to relax you, coaxing you back to sheep counting.