Sleep and Sleep Disorders in Women

Abstract

Reproductive and hormonal status influences sleep and sleep-related problems in women. Women tend to be larks (morning-types) rather than owls and they may have a higher sleep need than men. Across the entire adult female life span, changing hormone profiles, sociological and psychological factors may all play a role in the greater female predisposition for insomnia. There is also a growing recognition of gender differences in symptom reporting, for example, in sleep-related breathing disorders. Furthermore, changes in hormone concentration or sensitivity to estrogen and progesterone in particular may underlie many of the symptoms experienced by women. Ideally, fluctuations in hormone levels and their influence on the body and brain are delicately balanced so as not to disrupt sleep. However, there are periods when sleep is adversely affected, such as sleep disturbance caused by pain at menstruation, physical changes particularly in the last trimester of pregnancy, or menopausal hot flashes. In addition, gynecologic conditions and a higher incidence of some medical disorders in women (such as obesity and depression) are associated with increased risk of certain sleep disorders. Possible gender differences in such factors as need for sleep, perception, and symptom reporting should also be considered. In this chapter, we outline normal changes in sleep across a woman’s adult life, gynecologic conditions associated with sleep disorders, and sleep disorders that may manifest at certain times.