Women's Health

by Laurie Wertich, Medically Reviewed by Dr. C.H. Weaver MD 3/2020

Some people believe that an alcoholic drink before bed, or “night cap,” helps them fall asleep. Alcohol poses a misleading conundrum: it appears to make you drowsy, but it actually interferes with deep sleep, leaving you groggy and sleep-deprived the next day.

While you may fall asleep faster, alcohol may disrupt your sleep later in the night, making that night cap a risk for poor-quality sleep. The bottom line: avoid alcohol late in the evening.

Bedtime Routine

Your bedtime routine can improve your chances of falling asleep easily and enjoying good-quality sleep. Behaviors intended to help you relax and wind down in preparation for sleep are known as “sleep hygiene.” The following is a list of sleep hygiene tips:

  • Go to bed at the same time each night and wake up at the same time each morning.
  • Make sure that your bedroom is quiet and dark and provides a relaxing environment (for example, keep the room free of clutter). The bedroom temperature should neither be too warm or too cold; some people sleep best in a room that is slightly cool.
  • Your bed should be comfortable and used only for sleep and intimacy. Do not read or watch TV in bed and keep computers, TVs, and other gadgets out of the bedroom.
  • Physical activity during the day may help you sleep, but don’t exercise within a few hours of bedtime, as this can make it difficult to fall asleep.
  • Don’t eat large meals before bedtime. You may find, however, that a light snack close to bedtime helps you sleep.
  • Avoid all caffeinated beverages as well as chocolate and tobacco late in the day (all three substances are stimulants).
  • Avoid alcohol before bedtime.
  • Avoid drinking too many fluids before bed to decrease your need to visit the bathroom during the night. You may find, however, that a small cup of herbal tea at bedtime helps you relax.
  • Avoid using bright lights in your home before bedtime.
  • Don’t work before bedtime and avoid any computer use.
  • Find a way to relax before you want to fall asleep. Examples include taking a warm bath, listening to calming music, or light stretching.
  • If you wake during the night, try lying still and relaxing in order to fall back to sleep. If, however, you’re still awake after 20 minutes, leave your bed, sit somewhere comfortable, and read or do something similarly quiet and calming until you feel sleepy again.
  • Avoid taking naps after 3 p.m. Late-afternoon naps can make it harder to fall asleep at night. When you do nap, do so for no more than an hour.

New research indicates that alcohol causes more sleep problems for women than men, possibly as a result of differences in metabolism.

The study involved 93 young men and women who spent two nights in a sleep lab. One night they consumed nonalcoholic drinks and the other night they consumed alcohol until they were drunk. The researchers then monitored their sleep.

Alcohol was linked to more deep sleep early in the night but more wakefulness later in the night. Although women became drowsier than men after consuming alcohol, they slept more poorly. The women had fewer hours of sleep and woke more frequently and for longer periods of time than the men. The researchers speculated that this may be due to the different ways that men and women metabolize alcohol.

The bottom line? If you want a good night’s sleep, alcohol is not your friend. To sleep well, take a few simple precautions:

  • Consume alcohol early in the evening.
  • Consume at least one glass of water for each glass of alcohol.
  • Consume alcohol with food.
  • Stop drinking several hours before bedtime.

Other "Truths" About Alcohol

For many of us, a glass of wine or a cold beer is an enjoyable part of a good meal. We drink for the taste and the experience, with the health benefits—and risks—a secondary consideration. As we consider how best to manage our health, however, we owe it to ourselves to understand the effects of alcohol on the body.There is so much conflicting information about alcohol. We’re told that a little red wine is good for the heart, but too much alcohol can increase our risk of cancer and heart disease. But how much is too much?

What is Moderate Alcohol Intake?

One drink is commonly defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. For women, the 2005 Dietary Guidelines for Americans define moderate drinking as no more than one drink per day. For men, moderate drinking is defined as no more than two drinks per day.Why should women drink less than men? For one thing, women tend to weigh less than men and also tend to have proportionately less water in their bodies to disperse the alcohol; this means that a single drink will, on average, have a greater effect on a woman than on a man. Furthermore, some studies have suggested that women tend to have lower levels of an enzyme that breaks down alcohol (alcohol dehydrogenase) in their stomachs. This would also increase the amount of alcohol that reaches the blood stream. (6,7)

Alcohol and Health Problems

Although moderate alcohol consumption is considered somewhat safe, alcohol has been linked to numerous health concerns, including cancer, heart disease, high blood pressure and stroke. (8) High levels of alcohol also have adverse effects on the liver and the brain. An important point for women is that many of these adverse effects tend to develop earlier in women than in men and at a lower level of alcohol intake.(9) In addition, drinking during pregnancy can cause a range of problems in the child, including Fetal Alcohol Syndrome. Finally, alcohol use can lead to dependence and alcoholism in some individuals. Women with a family history of alcoholism will need to be particularly cautious.

Alcohol and Health Benefits

The well-publicized link between moderate alcohol intake and a reduced risk of heart disease applies to both men and women. (10) This is an important benefit because heart disease is the number one killer in the United States. Alcohol is not the only way to reduce your risk of heart disease, however. Engaging in regular physical activity, avoiding tobacco smoke, and eating a healthy diet will reduce your risk even if you abstain from alcohol. It’s also important to realize that young women (those under the age of 40 or so) have a very low risk of heart disease and are therefore unlikely to derive a heart benefit from moderate alcohol intake. This means that in young women the risks of alcohol likely outweigh the benefits.Another measure of alcohol’s health effects is total mortality (risk of death from any cause). Numerous studies have reported that there is a “J-shaped” relationship between alcohol intake and risk of death: overall risk of death declines with light-to-moderate drinking but rises with heavier drinking.(11)

Balancing the Risks and Benefits

Although many people view red wine as a healthier choice than other types of alcohol, different types of alcohol appear to have similar health effects. For many women the decision about occasional use of alcohol will remain a personal one that’s best made in consultation with a physician. There are both risks and benefits, but the balance of risks and benefits varies by a woman’s health history and family history (including history of alcohol abuse), age, risk of conditions such as heart disease and breast cancer, and other medications she is taking. If you don’t currently drink, however, be reassured that there do not appear to be compelling reasons to start.(12)

Can Alcohol Actually Help You Live Longer?

References:

  1. Narcolepsy. National Heart, Lung, and Blood Institute website.
  2. Sleep Apnea. National Heart, Lung, and Blood Institute website.
  3. Restless Leg Syndrome. National Heart, Lung, and Blood Institute website.
  4. Your Guide to Healthy Sleep. National Heart, Lung, and Blood Institute website.
  5. Arnedt JT, Rohsenow DJ, Almeida AB, et al. Sleep following alcohol intoxication in healthy, young adults: effects of sex and family history of alcoholism. Alcoholism: Clinical & Experimental Research. 2011;35(5):870-78.
  6. Dietary Guidelines for Americans, 2005. US Department of Health and Human Services Web site. Available at: . Accessed September 22, 2010.
  7. Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. New England Journal of Medicine. 1990;322(2):95-99.
  8. Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation. 2007;116(11):1306-17.
  9. Alcohol: A Woman’s Health Issue (NIH Publication No. 04-4956). National Institute on Alcohol Abuse and Alcoholism Web site. Available at: . Accessed September 22, 2010.
  10. Hanksinson SE, Colditz GA, Manson JE, Speizer FE, eds. Healthy Women, Healthy Lives: A Guide to Preventing Disease from the Landmark Nurses’ Health Study. New York: Simon & Schuster Source; 2001.
  11. Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: An updated meta-analysis of 34 prospective studies. Archives of Internal Medicine. 2006;166(22):2437-45.
  12. Wright CA, Bruhn CM, Heymann H, Bamforth CW. Beer and wine consumers’ perceptions of the nutritional value of alcoholic and nonalcoholic beverages. Journal of Food Science. 2008;73(1):H8-11.

Resources

American Academy of Sleep Medicine

National Sleep Foundation

American Insomnia Association

American Sleep Apnea Foundation

Narcolepsy Network

Restless Legs Syndrome Foundation

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