Major Sleep Disorders Among Women

(Women's Health Series)

Sadeka Tamanna, MD, MPH; Stephen A. Geraci, MD

Disclosures

South Med J. 2013;106(8):470-478. 

In This Article

Abstract and Introduction

Abstract

Disruption of sleep causes adverse health outcomes and poor quality of life. People with sleep disruption have higher levels than people without disrupted sleep of depression and anxiety and increased rates of cardiovascular diseases. Women have a higher incidence than men of insomnia and depression related to poor sleep. The types of complaints differ significantly between the sexes. Women are more likely than men to complain of insomnia, headache, irritability, and fatigue than the "typical" symptoms of loud snoring and breathing cessation during sleep. Hormones play an important role in sleep in women. Reproductive hormones were found to have a protective effect on sleep apnea in women of premenopausal age. Pregnancy is another period when the prevalence of sleep apnea and restless leg syndrome increases from hormonal effect. Cardiovascular mortality is high in women with obstructive sleep apnea. Continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.

Introduction

Sleep is essential for normal physiologic function. Chronic sleep deprivation and poor-quality, fragmented sleep result in excessive daytime sleepiness, neurocognitive dysfunction, memory impairment, depression, anxiety, dysglycemia, systemic inflammation, heart rhythm abnormalities, atherosclerosis, and cardiovascular events.[1] Although the differences in sleep physiology between men and women are modest, the prevalence and presentation of sleep disorders vary considerably between the sexes. Women with obstructive sleep apnea (OSA) are more likely to present with atypical complaints than with the more classical symptoms usually seen in men.1a,2 Sleep duration also varies with sex and race. Reproductive hormones play important roles in sleep physiology for women at different ages and times of their lives. The epidemiology, risk factors, and treatment of the most common sleep disorders (insomnia, OSA, and restless leg syndrome [RLS]), complicated by the effects of menopause, pregnancy, and social factors, are essential issues in understanding sleep disorders in women.

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