Chapter 21 - Sleep in Women: Gender Differences in Health and Disease

Abstract

Studies of sleep in women, whether in health or disease, are affected by the distinct hormonal changes that occur throughout a woman's life cycle, including puberty, menses, pregnancy, and menopause. Differences exist not only between the sexes but within cohorts of women as they transition through these biologically determined milestones. Additionally, socioeconomic status, workplace, and familial roles influence observed gender differences. In the NSF 2007 poll, 30% of pregnant women and 42% of post-partum women reported rarely or never getting a good night's sleep, compared to 15% among all women; 25% of perimenopausal women and 30% of postmenopausal women reported getting a good night's sleep only a few nights a month or less. Not surprisingly, given their social and/or familial responsibilities, working mothers (72%) and single working women (68%) were more likely to experience sleep problems like insomnia. These sleep disturbances are not without consequences; in the NSF survey, women who experienced daytime sleepiness were more likely to report high stress (80%), drive drowsy at least once per month (27%), spend less time with friends and family (39%), be too tired for sex (33%), and be late for work (20%). Recently, studies recognize that men and women experience sleep and sleep disorders differently. They differ in the prevalence of certain sleep disorders and may have varying presentations and responses to therapies. This chapter serves to both review the existing literature on gender differences in sleep and highlight the considerable gaps in knowledge.