What is the mortality and morbidity associated with sleep dysfunction in women?

Updated: Jan 31, 2019
  • Author: Gila Hertz, PhD, ABSM; Chief Editor: Selim R Benbadis, MD  more...
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Studies have shown that sleep problems are linked to more physical and emotional disturbances in women than in men. Among women, those with worse sleep showed more emotional distress and depression. They also had a higher BMI, more inflammation, and less sensitivity to insulin.

Insomnia is a significant comorbidity in many disorders. The most common disorders associated with insomnia are psychiatric illnesses. Major depression and dysthymia are most closely associated with insomnia. Numerous studies have also shown a close association of chronic pain syndromes with insomnia.

Most common comorbidities with sleep disorders

Snoring, often a sign of partial airway obstruction, has been shown to be associated with high blood pressure and increased risk for OSA. Snoring increases during pregnancy, particularly during the last trimester. It has been reported that about 14% of women who report habitual snoring during pregnancy have pregnancy-induced hypertension. In addition, snoring may be responsible for nighttime increases in blood pressure in preeclampsia. [30] Finally, it was found that infants born to mothers who were habitual snorers more frequently had low birth weights.

Snoring is also a risk factor in the development of OSA in postmenopausal women. Other contributing factors are weight and neck size. In addition to sleep disturbances and daytime sleepiness, OSA can lead to cardiovascular complications. [31]

Other common comorbidities include the following:

  • OSA has been associated with hypertension, as well as with insulin resistance and metabolic disease [32]

  • Older women who sleep more than 9 hours of sleep are at higher risk for ischemic stroke [33]

  • As mentioned, psychiatric conditions, particularly depression and anxiety disorders, are the most common comorbidities with insomnia

  • RLS may be secondary to medical conditions that have iron deficiency, including iron deficiency anemia, renal disease, and pregnancy

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