Differences In Sleep Disorders Research Articles

Sleep in women: a narrative review of hormonal influences, sex differences and health implications

Sleep is a fundamental biological behavior that affects various aspects of health and wellbeing. However, there are some differences in respect of sleep between men and women. Notably, there are sex differences in relation to sleep problems and the potential comorbidities, such as diabetes and cardiovascular diseases, that are associated with these problems, with some evidence suggesting that women may have a greater predisposition to sleep disturbances. This narrative review provides a comprehensive analysis of the literature in respect of sex differences in the sleep, with the main focus being on women. Basic research has investigated sex-specific distinctions in sleep architecture, sleep quality, and circadian rhythms, while clinical studies have examined sex differences in sleep disorders, such as insomnia, sleep apnea, and restless leg syndrome. This narrative review also highlights the impact of the periods of hormonal fluctuations that occur across a woman's lifespan - such as during the menstrual cycle, pregnancy, and menopause phase - and examines their effects on sleep. It also explores the influence of social and cultural factors on sleep patterns in women. Taken together, the evidence suggests that women may be more susceptible to sleep disturbance, and that gender-specific factors should be considered when evaluating sleep in clinical practice. Further research is warranted to elucidate the mechanisms that underlie this and help guide the development of sex-specific interventions to improve sleep quality and promote holistic health in women.

Neurological Insights into Sleep Disorders in Parkinson's Disease.

Parkinson's disease (PD) is a common multidimensional neurological disorder characterized by motor and non-motor features and is more prevalent in the elderly. Sleep disorders and cognitive disturbances are also significant characteristics of PD. Sleep is an important physiological process for normal human cognition and physical functioning. Sleep deprivation negatively impacts human physical, mental, and behavioral functions. Sleep disturbances include problems falling asleep, disturbances occurring during sleep, abnormal movements during sleep, insufficient sleep, and excessive sleep. The most recognizable and known sleep disorders, such as rapid-eye-movement behavior disorder (RBD), insomnia, excessive daytime sleepiness (EDS), restless legs syndrome (RLS), sleep-related breathing disorders (SRBDs), and circadian-rhythm-related sleep-wake disorders (CRSWDs), have been associated with PD. RBD and associated emotional disorders are common non-motor symptoms of PD. In individuals, sleep disorders and cognitive impairment are important prognostic factors for predicting progressing neurodegeneration and developing dementia conditions in PD. Studies have focused on RBD and its associated neurological changes and functional deficits in PD patients. Other risks, such as cognitive decline, anxiety, and depression, are related to RBD. Sleep-disorder diagnosis is challenging, especially in identifying the essential factors that disturb the sleep-wake cycle and the co-existence of other concomitant sleep issues, motor symptoms, and breathing disorders. Focusing on sleep patterns and their disturbances, including genetic and other neurochemical changes, helps us to better understand the central causes of sleep alterations and cognitive functions in PD patients. Relations between α-synuclein aggregation in the brain and gender differences in sleep disorders have been reported. The existing correlation between sleep disorders and levels of α-synuclein in the cerebrospinal fluid indicates the risk of progression of synucleinopathies. Multidirectional approaches are required to correlate sleep disorders and neuropsychiatric symptoms and diagnose sensitive biomarkers for neurodegeneration. The evaluation of sleep pattern disturbances and cognitive impairment may aid in the development of novel and effective treatments for PD.

Age and sex differences in sleep disorders as risk factors and markers of hypertension in young people with normal body weight

Objective. To assess age and sex differences in sleep disorders as risk factors and markers of hypertension (HTN) in 18–39-year old people with normal body weight. Design and methods. We performed a cross-sectional study based on the internet survey of 18–39-year-old people with body mass index of 18–25 kg/m2 (n = 2094). The unvalidated questionnaire included 42 questions about various types of sleep disorders and sleep-associated symptoms (0 — never, 1 — rarely, 2 — from time to time, 3 — quite often, 4 — almost all the time). Results. The probability of detecting HTN in young men with normal body weight is higher than in women with similar characteristics (p < 0,001). In women, the probability of detecting HTN decreases, starting with the youngest category (18–24 years old), reaching a minimum in the age group 30–34 years old and then starts to increase. By the age of 40, the indicators for men and women become similar. Based on a multivariate analysis, the risk of HTN in young people with normal body weight is associated with both gender and age (p = 0,022). The contribution of gender to age-related changes in sleep complaints was found for snoring (p < 0,001), sleep apnea (p < 0,001), early awakenings (p = 0,002). The contribution of gender was also noted for various symptoms — daytime sleepiness, some symptoms of restless legs syndrome (RLS), anxiety, depression, leg cramps (p < 0,001) and nocturnal heartburn (p < 0,001). The contribution of age was noted for snoring (p < 0,001), sleep apnea (p < 0,001), early awakenings (p < 0,001) and for a variety of symptoms — daytime sleepiness, some symptoms of RLS, anxiety, nocturnal cough, and nocturnal choking. Conclusions. Our data can be considered when developing measures for HTN prevention, can be recommended for clinical use, as well as in subsequent clinical studies using validated questionnaires.

Rural/Urban Differences in Sleep Disorders Among Older Adults in Ghana

Previous research suggests depressive symptoms and loneliness are increasingly prevalent among older adults living in lower-income neighborhoods. The purpose of this study was to examine the extent to which neighborhood socioeconomic status (SES) was associated with depressive symptoms and loneliness among a sample of older adults from the Healthy Heart and Mind Study (N = 165; mean age = 68.48 (SD = 6.26); 66.7% women; 40.6% African American). It was hypothesized that older adults living in neighborhoods with greater socioeconomic disadvantage would report more depressive symptoms and loneliness than those residing in neighborhoods with less socioeconomic disadvantage. Depression was assessed with the Beck Depression Inventory-II (BDI-II), and loneliness was assessed using the Revised University of California, Los Angeles (UCLA) Loneliness scale. Neighborhood SES was measured with the Area Deprivation Index (ADI), which allows rankings of neighborhoods by SES disadvantage both statewide and nationally. After controlling for demographic variables (age, sex, and race), linear regression analyses showed that greater neighborhood SES disadvantage was associated with higher depression scores (β = -.094; p = .041) and higher loneliness scores (β = -.258; p = .003). These findings highlight the importance of neighborhood context on mental health in older adults, as underserved populations are more likely to experience declines in mental health under strenuous circumstances. Future research should investigate the impact of neighborhood SES on mental health in aging adults.

Differences in Sleep Disorders between HIV-Infected Persons and Matched Controls with Sleep Problems: A Matched-Cohort Study Based on Laboratory and Survey Data.

Objectives: Sleep disturbances are prevalent problems among human immunodeficiency virus (HIV)-infected persons. The recognition of comorbid sleep disorders in patients with HIV is currently hampered by limited knowledge of sleep-related symptoms, sleep architecture, and types of sleep disorders in this population. We aimed to compare the differences in sleep-related symptoms and polysomnography-based sleep disorders between HIV-infected persons and controls. Methods: The study evaluated 170 men with a Pittsburgh sleep quality index scores greater than 5, including 44 HIV-infected men and 126 male controls who were frequency-matched by sex, age (±3.0 years) and BMI (±3.0 kg/m2). For all participants, an overnight sleep study using a Somte V1 monitor was conducted. Differences in sleep-related symptoms and sleep disorders between HIV-infected patients and controls were examined using t-tests or chi-square tests. Results: HIV-infected persons with sleep disturbances more often had psychological disturbances (72.7% vs. 40.5%, p < 0.001) and suspected rapid eye movement behavior disorder (25.0% vs. 4.8%, p < 0.01) than controls. Sleep-disordered breathing was less common in HIV-infected persons than in controls (56.8% vs. 87.3%, p < 0.001). The mean percentage of rapid eye movement sleep was higher among HIV-infected patients than among controls (20.6% vs. 16.6%, p < 0.001). Nocturia was more common in HIV-infected persons than in controls (40.9% vs. 22.2%, p = 0.02). Conclusions: Psychological disturbances and sleep-disordered breathing can be possible explanations of sleep disturbances in HIV-infected persons in whom sleep-disordered breathing is notable. Further studies are warranted to examine the underlying factors of rapid eye movement behavior disorder among HIV-infected persons with sleep disturbances.

Psychoemotional Status of Schoolchildren before and during Distance Learning at the Time of 2020 Coronavirus Lockdown

Introduction: During lockdown, a student is influenced by a combination of external factors including family environment, increased social and emotional stress, higher educational and computer load, and higher responsibility for doing homework, which inevitably changes his psychoemotional sphere and coping behavior. In order to study characteristics of psychoemotional and behavioral reactions of schoolchildren before and during 2020 COVID-19 lockdown, we conducted a questionnaire-based survey of 1,160 fifth to eleventh graders aged 11–18 in the city of Chelyabinsk. Results: We established a high level of reactive anxiety in 7.9 % and 9.9 % and a low level in 63.4 % and 59.4 % of schoolchildren before and during lockdown, respectively. A high level of personal anxiety was observed in 33.6 % and 42.6 % of children and a low level – in 19.8 % and 16.8 % of schoolchildren before and during lockdown, respectively. Higher levels of reactive and personal anxiety were more prevalent in girls than in boys. We noted a high and increased levels of aggression in 78.6 % and 80.5 % and very high and high levels of neuroticism in 44.6 % and 44.4 % of the respondents before and during school closure, respectively. A high level of emotional excitability and neurotization was observed in one third of the surveyed schoolchildren. The number of respondents with a high level of neurotization and emotional excitability rose by 7.5 % and 4.0 % during lockdown, respectively. The proportion of successful distance learning schoolchildren increased by 16.8 %. Conclusions: Lockdown contributed to the increase in the levels of anxiety, aggressiveness, and neuroticism in school-age adolescents. The number of respondents complaining of sleep disturbance, visual impairment and headaches became 2.7, 1.1, and 1.1 times higher during lockdown. We revealed significant differences in sleep disorders, headaches, dizziness, complaints of vision impairment, fatigue, and irritability between successful and unsuccessful schoolchildren (p &lt; 0.05).

Pain and Psychological Distress: Effect of Microvascular Decompression on Sleep Disorders and Obsessions in Trigeminal Neuralgia.

Objective This study was aimed to investigate the effects of microvascular decompression (MVD) on sleep disorders and obsessions in trigeminal neuralgia. Methods Clinical data from 115 patients with trigeminal neuralgia treated with MVD from August 1, 2017 to May 31, 2018 at Jining First People's Hospital were analyzed retrospectively. The preoperative and postoperative risk factors for sleep disorders and obsessions, as well as the effects of MVD on sleep disorders and obsessions, were examined. Results In 115 patients, there were significant differences in preoperative sleep disorders associated with sex, monthly household income, pain in multiple branches, visual analog scale (VAS) score, and Self-Rating Depression Scale (SDS) score ( p < 0.05). Preoperative obsessions were significantly different according to age, gender, pain in multiple branches, monthly household income, VAS score, and Self-Rating Anxiety Scale (SAS) score groups ( p < 0.05). A 1-year recurrence was positively correlated with sleep disturbance (odds ratio = 3.829) and obsessions (odds ratio = 4.507). In addition, the results revealed a negative correlation between the manipulation of trigeminal neuralgia and postoperative sleep disorders ( B ≥ 1.043). Moreover, there was a significant difference in sleep disorders and obsessions before and 1 year after MVD ( p < 0.05). Conclusion For patients with trigeminal neuralgia, pain caused by sleep and obsession disorders should be examined early to identify an effective solution. Moreover, MVD, as a first treatment, is valuable for improving the physiological and psychological prognosis of patients.

Three Decades of Progress in Sleep Disorders and Sleep Health for Women

Over the past 3 decades, significant strides have been made in the field of sleep medicine for women. The impact of sex and gender on sleep health and sleep disorders received little attention in the early 1990s, but driven by policies ensuring inclusion of women in medical research, more recent studies have identified sex differences in sleep and investigated gender differences in sleep disorders. Nevertheless, disparities remain: diagnosis of sleep disorders, such as obstructive sleep apnea, narcolepsy, and rapid eye movement (REM) sleep behavior disorder are often delayed and underdiagnosed in women. Future research should continue to examine how biological sex and identity across the gender spectrum influence sleep health and sleep disorders, allowing for more personalized health care for all patients.

Impact of Sleep Disorder as a Risk Factor for Dementia in Men and Women.

Sleep is an essential physiological process, especially for proper brain function through the formation of new pathways and processing information and cognition. Therefore, when sleep is insufficient, this can result in pathophysiologic conditions. Sleep deficiency is a risk factor for various conditions, including dementia, diabetes, and obesity. Recent studies have shown that there are differences in the prevalence of sleep disorders between genders. Insomnia, the most common type of sleep disorder, has been reported to have a higher incidence in females than in males. However, sex/gender differences in other sleep disorder subtypes are not thoroughly understood. Currently, increasing evidence suggests that gender issues should be considered important when prescribing medicine. Therefore, an investigation of the gender-dependent differences in sleep disorders is required. In this review, we first describe sex/gender differences not only in the prevalence of sleep disorders by category but in the efficacy of sleep medications. In addition, we summarize sex/gender differences in the impact of sleep disorders on incident dementia. This may help understand gender-dependent pathogenesis of sleep disorders and develop therapeutic strategies in men and women.

اضطرابات النوم وعلاقتها بالمشکلات السلوکیة لدى عینة من أطفال التوحد بمنطقة جدة sleep disorders related to behavior problems in a sample of children with autism in Jeddah city

هدفت هذه الدراسة إلى التعرف على اضطرابات النوم والمشکلات السلوکية الأکثر شيوعا لدى أطفال التوحد في منطقة جدة، وهل تختلف هذه المتغيرات باختلاف الجنس والمرحلة العمرية، ومدى إمکانية التنبؤ بالمشکلات السلوکية من خلال اضطرابات النوم، ولتحقيق أهداف الدراسة تم اتباع المنهج الوصفي حيث تم بناء مقياس اضطرابات النوم لأطفال التوحد والذي تکون من خمسة أبعاد رئيسية وتم التحقق من خصائصه السيکومترية من صدق (بطريقة المحکمين، صدق المحتوى) والثبات (بطريقة الاتساق الداخلي کرونباخ ألفا حيث بلغت قيمته (0.742) وکذلک تم استخدام اختبار المشکلات السلوکية الذي تم إعداده مسبقا، أما مجتمع الدراسة فقد تکون من ثمانية مراکز وتم اختيار العينة بطريقة قصديه حيث بلغت 40 من أولياء الأمور الذين لديهم أطفال يعانون من التوحد في منطقة جدة وتم تطبيق المقياسين عليهم، وللإجابة عن أسئلة الدراسة تم استخدام الأساليب الإحصائية المناسبة (متوسطات حسابية – انحرافات معيارية – اختبار T للعينات المستقلة، واختبار تحليل التباين المتعدد (MANOVA) وتحليل الانحدار)، وأظهرت النتائج أن اضطرابات النوم الأکثر شيوعا هي مشکلات النوم تلاها وقت النوم ثم ثبات موعد النوم وتليه الاستيقاظ نهارا وجاء في المرتبة الأخيرة النوم أثناء النهار، أما المشکلات السلوکية فتبين أن اکثر مشکلة شيوعا هي الصعوبة في التحدث عندما يريد شيئا، و مشارکة الأطفال الآخرين في اللعب، واقل مشکلة من حيث الشيوع هي الخمول البدني الزائد، أما فيما يتعلق بالفروق بين الجنسين فتبين وجود فروق حيث کانت الإناث تعاني مشاکل اضطرابات نوم اکثر من الذکور وعدم وجود فروق تعزى للجنس على المشکلات السلوکية، وفما يتعلق بالتفاعل بين الجنس والعمر فأشارت النتائج إلى وجود فروق في اضطرابات النوم وعدم وجودها في المشکلات السلوکية، وأخيرا أظهرت النتائج عدم القدرة على التنبؤ بالمشکلات السلوکية من متغير اضطراب النوم. The purpose of this study was to identify the sleep disorders and behavioral problems most common among autistic children in the Jeddah area. Are these variables different according to sex and age range, and the extent to which behavioral problems can be predicted through sleep disorders? The sleep disorders of autistic children, which are of five main dimensions and verified their psychometric characteristics from sincerity (in the manner of arbitrators, content validation) and consistency (in the internal consistency method Kronbach Alpha, where the value of (0.742) (40) of the parents who had children with autism in the Jeddah area, and the measures were applied to them. To answer the questions of the study, the appropriate statistical methods were used (arithmetic averages) The most common sleep disorders were sleep problems followed by sleep time, sleep time stability followed by waking up during the day, and the most common sleep during the day. The most common problem is the difficulty of talking when he wants something, the participation of other children in play, and the least common problem is the excessive physical inactivity. As for the differences between the sexes, there are differences where females suffer from problems of sleeping disorders more than males and the absence of gender differences on behavioral problems, and with regard to the interaction between sex and age, the results indicated differences in sleep disorders and lack of behavioral problems, and finally the results showed the inability to predict the behavioral problems of sleep disturbance variable.

Gender differences in sleep disorders in the US military

ObjectivesThe purpose of this study is to compare sleep disorders between male and female military personnel. Comorbid behavioral health disorders and chronic pain were also studied in relation to sleep disorders. DesignWe conducted a retrospective review of military personnel who underwent a sleep medicine evaluation and an in-laboratory attended polysomnography. Initial sleep questionnaires, demographics, polysomnographic variables, and comorbid disorders of interest were reviewed and compared for each sex. SettingAll patients were referred to the Wilford Hall Ambulatory Surgical Center Sleep Disorders Center for evaluation of sleep disturbance. ParticipantsOur cohort consisted of 209 military personnel with 51.7% men. The cohort was relatively young with a mean age of 34.3 years. Men had a significantly higher body mass index at 29.4 vs 27.3 in women. ResultsInsomnia was diagnosed in 72 women and 41 men (P< .001), whereas obstructive sleep apnea (OSA) was diagnosed in 92 men and 50 women (P< .001). Depression and anxiety were more common in women. Women had an average of 1.76 ± 1.36 comorbid conditions compared with 1.08 ± 1.19 in men. In patients diagnosed with both insomnia and OSA, women were more likely to have post-traumatic stress disorder, depression, and anxiety. Neither the Epworth Sleepiness Scale (12.8 ± 4.88) nor the Insomnia Severity Index (16.9 ± 5.33) differed between sexes. ConclusionsGender-related differences in sleep disorders are present in active-duty personnel. Behavioral health disorders were frequent comorbid disorders, and women diagnosed with both insomnia and OSA manifested greater psychiatric comorbidity. The frequent association between sleep and behavioral health disorders in military personnel requires further study.

Seasonal variations in sleep disorders of nurses.

To investigate the difference between nurses and the general population regarding seasonal variations in sleep disorders during 2004-2008. The effects of season and group interaction on sleep disorders with regard to different comorbidities were also examined. Studies on seasonal variations in sleep disorders were mainly conducted in Norway for the general population. Furthermore, whether different comorbidities cause seasonal variations in sleep disorders in nurses remains unknown. A retrospective study. Data from the Taiwan National Health Insurance Research Database were used in generalised estimating equationPoisson distribution models to investigate the differences in sleep disorders between nurses and the general population diagnosed with sleep disorders (each n=7643) as well as the interaction effects of sleep disorders between the groups with respect to different seasons. Furthermore, the interaction effects between groups and seasons on sleep disorders in the subgroups of comorbid anxiety disorders and depressive disorders were studied. Both the nurses and the general population had fewer outpatient visits for sleep disorders in winter than in other seasons. The nurses had fewer outpatient visits for sleep disorders than the general population did in each season. The nurses had more outpatient visits for sleep disorders in winter than in summer compared with the general population in the comorbid depressive disorder subgroup but not in the comorbid anxiety disorder subgroup. Nurses and the general population exhibited similar seasonal patterns of sleep disorders, but nurses had fewer outpatient visits for sleep disorders than the general population did in each season. For nurses with comorbid depressive disorders, outpatient visits for sleep disorders were more numerous in winter than in summer, potentially because nurses with comorbid depressive disorders are affected by shorter daylight exposure during winter. Depression and daylight exposure may be considered in mitigating sleep disorders in nurses.

Racial/Ethnic Differences in Sleep Disorders and Reporting of Trouble Sleeping Among Women of Childbearing Age in the United States.

Objectives Whether racial/ethnic differences in prevalence/reporting of sleep disorders exist in pregnant women/women of child-bearing age is unknown. Study objectives were to estimate prevalence of sleep disorders and to examine racial/ethnic differences in sleep disorders, reporting of sleep issues, and amount of sleep among women of child-bearing age (15-44years) in the US. Methods Through a secondary analysis of the National Health and Nutrition Examination Survey 2005-2010 (3175 non-pregnant, 432 pregnant women in main analysis), prevalence of sleep disorders, reporting of sleep disorders to a physician/health professional, and amount of sleep were estimated overall, by pregnancy status, and by race/ethnicity stratified by pregnancy status. Racial/ethnic differences in reporting of trouble sleeping by pregnancy status were examined using univariate and multivariate logistic regression. Results Prevalence of diagnosed sleep disorders among women of childbearing age was 4.9% [3.9% pregnant; 5.1% non-pregnant (p<0.01)]. Significantly fewer pregnant and non-pregnant minority women reported adequate sleep (7-8h) than non-Hispanic white (white) women (p<0.05). Among non-pregnant women, odds of report of trouble sleeping were significantly higher for white compared to black (aOR 0.47 [95% CI 0.36, 0.61]) or Mexican-American women (aOR 0.29 [95% CI 0.21, 0.41]); non-pregnant minority women were also significantly less likely to report trouble sleeping than white women when controlling for amount of sleep. Among pregnant women, these same trends were found. Discussion Compared to white women, minority women, despite reporting less adequate sleep, are less likely to report trouble sleeping, providing evidence of an important health disparity.

Gender differences in obstructive sleep apnea and the associated public health burden

Obstructive sleep apnea, (OSA) is a sleep disorder traditionally associated with high blood pressure, cardiovascular disease, and/or obesity in which an obstruction of the upper respiratory airflow occurs in patients. This airflow disruption is repeated resulting in a cyclical breathing pattern that leads to frequent arousals during sleep. Epidemiological analyses of OSA have found that the disorder occurs more frequently in men than women. Yet, the severity of OSA-associated comorbidities are worse in women than in men upon initial OSA-diagnosis. The primary reasons for sex differences in OSA are thought to be associated with variations seen in normal sleep between men and women, distinctions in the clinical manifestations of sleep disturbances, and in the prevalence of risk factors for sleep disorders. However, it has also been suggested that this sex difference is due to an under-diagnosis of OSA in women during the early stages of the disease, as initial presentation of female patients with OSA has often been interpreted as depression and/or insomnia. Due to the risk factors associated with OSA, heart disease as the leading cause of death in both men and women in the United States, and the commonality of sex differences in sleep disorders, we examined the literature to determine what may contribute to these sex differences in OSA. This brief review summarizes what may be the causes of sex differences in normal sleep, sex differences that are associated with OSA, and whether this sex difference may be primarily due to an under-diagnosis of OSA in women.

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

Previous attempts have been made to address sleep disorders in women; however, significant knowledge gaps in research and a lack of awareness among the research community continue to exist. There is a great need for scientists and clinicians to consider sex and gender differences in their sleep research to account for the unique biology of women. To understand the role of sex differences in sleep and the state of women's sleep health research, the Society for Women's Health Research convened an interdisciplinary expert panel of well-established sleep researchers and clinicians for a roundtable meeting. Focused discussions on basic and clinical research along with a focus on specific challenges facing women with sleep-related problems and effective therapies led to the identification of knowledge gaps and the development of research-related recommendations. Additionally, sex differences in sleep disorders were noted and discussed in the context of underlying hormonal differences. Differences in sleep behavior and sleep disorders may not only be driven by biological factors but also by gender differences in the way women and men report symptoms. Progress has been made in identifying sex and gender differences in many areas of sleep, but major research gaps in the areas of epidemiology, sleep regulation, sleep quality, diagnosis, and treatment need to be addressed. Identifying the underlying nature of sex and gender differences in sleep research has potential to accelerate improved care for both men and women facilitating better diagnosis, treatment, and ultimately prevention of sleep disorders and related comorbid conditions.

Sleep Complaints in Italian Olympic and Recreational Athletes

The aim of the study was to evaluate sleep complaints in two groups of subjects all involved in sport but differing with respect to their level of commitment and weekly amount of practice. The first group was composed of 103 elite Italian Olympic athletes. The second group consisted of 198 recreational athletes, divided into two subsets on the basis of their self-reported habitual weekly amount of exercise. Subjects were requested to complete a short questionnaire (SDQ) assessing the presence and intensity of sleep disorders according to DSM-IV-TR and ICSD-2 criteria. A logistic regression was carried out to assess any differences in sleep disorders between Olympic and recreational athletes. The Olympic athletes were more likely to show no sleep disorders and less likely to show chronic or occasional sleep disorders as compared to both the other groups of athletes. No differences were found between the two subsets of recreational athletes.

Gender differences in sleep disorders

To evaluate recent evidence regarding gender differences in sleep. Women have better sleep quality compared with men, with longer sleep times, shorter sleep-onset latency and higher sleep efficiency. Despite this, women have more sleep-related complaints than men. The amount of slow-wave sleep decreases with age in men and women. Normal physiologic periods, including puberty, menstruation, pregnancy, and menopause, are associated with alterations in sleep patterns. Gender differences in normal sleep may underlie the observed differences in risk of sleep disorders. Studies of insomnia support a female predominance, with increased divergence of prevalence between men and women with older age. Recent findings for the gender differences in obstructive sleep apnea have focused on differences in local neuromuscular reflexes and central ventilatory control. Restless legs syndrome has a slight female predominance, whereas rapid eye movement sleep behavior disorder and Kleine-Levin syndrome are more common in men. Gender differences in sleep become apparent after the onset of puberty. Menstrual cycles, pregnancy, and menopause can alter sleep architecture. Gender-related differences in sleep disorders, such as obstructive sleep apnea, insomnia, and restless legs syndrome, include differences in prevalence, pathophysiology, clinical presentation, and response to therapy.

SLEEP DISTURBANCES IN ELDERLY: A SUBJECTIVE EVALUATION OVER 65

Sleep in elderly people shows progressive changes caused by general aging processes. Several alterations are described in medical literature: changes of sleep/wake rhythm and modifications both in sleep duration and in sleep architecture. The aim of our study was to evaluate sleep disturbances in elderly people, with and without cognitive impairment,through a sleep questionnaire. Our population included 1000 subjects, over 65 years of age, stratified by sex and age. The first 600 interviews were included in this report. All patients underwent a mini mental state examination (MMSE) and a questionnaire concerning excessive daytime sleepiness. In our total sample, we found a high prevalence of excessive daytime sleepiness, insomnia, nighttime awakenings, snoring, restlessness and periodic leg movements during sleep. Patients with cognitive dysfunctions showed less difficulty in falling asleep and fewer nighttime awakenings; they snored less frequently and were the only ones to present enuresis and to fall off the bed. Moreover, patients with cognitive impairment presented excessive daytime sleepiness with variable intensity and frequency. In conclusion, our results indicate significant differences in sleep disorders between healthy subjects and patients cognitively impaired. Besides, our subjective evaluation seems to be a useful method to perform an assessment of sleep disturbances in elderly people.