What are the sexual predilections of sleep dysfunction?

Updated: Jan 31, 2019
  • Author: Gila Hertz, PhD, ABSM; Chief Editor: Selim R Benbadis, MD  more...
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Answer

In general, gender differences have been found in circadian rhythm regulation and the homeostatic sleep process. Specifically, chronotype studies have found that men have a stronger tendency toward eveningness compared with women.

Sex differences in the sleep-wake cycle appear to increase in response to sleep loss, suggesting different regulation of sleep homeostasis between men and women. Compared with men, women show more slow-wave sleep (SWS), more spindling activity during SWS, and slower age-related reduction of SWS. [24]

Poor sleep affects women more than men. Women who experience sleep disturbance are at higher risk for hypertension, diabetes type-2 weight gain, and psychological distress including anger hostility and depression.

Insomnia

Starting at puberty, the incidence of insomnia in females differs from that of males. At puberty, insomnia rates for girls are almost triple that of boys. As women, the difference is augmented to a 41% greater risk for the development of insomnia as compared with men, and by age 65 years, the risk is 73% greater as compared with men. Conditions such as bipolar disorder, stable coronary artery disease, and certain anxiety and depressive disorders that exhibit higher rates in women are associated with insomnia. [25]

Findings of increased prevalence of insomnia among women compared to men have been shown in Europe, Japan, and China. Findings in Europe show adolescent females as having the highest rate of reported insomnia.

Obstructive sleep apnea

Women are more likely to have UARS, less likely to have positional apnea, and more likely to have REM-related OSA. While women have less prevalence of OSA than men, pregnancy and menopause increase the risk for sleep apnea.

Narcolepsy

Men have a greater relative risk of narcolepsy with cataplexy (1.2:1).

Restless legs syndrome

Symptoms of RLS are more frequently reported by women. [26] During pregnancy, prevalence rates of 11-23% have been reported.


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