Which clinical history findings are characteristic of sleep dysfunction in women?

Updated: Jan 31, 2019
  • Author: Gila Hertz, PhD, ABSM; Chief Editor: Selim R Benbadis, MD  more...
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Women typically present with 1 or a combination of the following symptoms.

Difficulty falling asleep

The inability to fall asleep suggests psychophysiologic or primary insomnia. Typically, this type of insomnia, often termed "learned" insomnia, is more frequent in younger individuals. It is characterized by an initial level of increased somatized and psychological tension, which may lead to occasional sleep disturbance and later may be reinforced by maladaptive behavior targeted at preventing the sleep disturbance. Often, a learned insomnia is associated with anxiety disorder, certain personality styles, and a stressful lifestyle.

Difficulties maintaining sleep

Multiple awakenings during sleep are more frequent in older individuals and suggest major sleep disorders, such as OSA or PLMD, as well as other medical and psychiatric conditions. Older women who suffer from arthritis and other painful conditions, women on certain medications, and women in their last trimester of pregnancy are some of the groups likely to present with difficulties in maintaining sleep.

Excessive daytime sleepiness

In older postmenopausal women, excessive daytime sleepiness suggests SDB and PLMD. Severe sleepiness in young women is more likely to be associated with sleep deprivation or narcolepsy.

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