How Sleep Disorders Affect Men And Women Differently
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In a recent study on sleep habits across the world, researchers found that, on average, women sleep 7.5 minutes more than men. Pair that with existing research that shows women outpacing men in other categories on the sleep leaderboard (shorter sleep-onset latency and higher sleep efficiency), and we have a pretty good picture of how sleep differs between the sexes. And while sleep disorders are common for both, research shows that the sleep disorders that affect women tend to differ from sleep disorders that affect men, and experiences often vary.
Sleep Disorders That Affect Women More Than Men
“Sleep disorders are highly prevalent, but certain sleep disorders disproportionately affect women more than men,” Dr. Heidi Riney, Chief Medical Officer of Nox Health, tells Sleepopolis. “This may be due to a variety of factors, including work/home responsibilities and stressors, hormonal changes around puberty, menses, pregnancy, perimenopause, and/or menopause.” Sleep disorders that affect women more than men are insomnia and restless leg syndrome.
“Women are much more likely to experience problems with insomnia versus their male counterparts,” says Riney. “This may be due in part to an increase in depression, chronic pain, and anxiety compared with men. Moreover, hormonal differences may make them more susceptible to insomnia during puberty, menses, pregnancy, and menopause.”
And study after study confirms just as much. Digging into the research, we find one meta-analysis on gender differences showing the prevalence of insomnia in women versus men was as high as 58 percent. Meanwhile, another study found that women were 1.3–2.0 times more likely to experience insomnia.
Historically, overweight, older men were considered most likely to develop sleep apnea — and that still is the group that’s most often diagnosed. However, there’s a growing body of research that suggests obstructive sleep apnea (OSA) is severely understudied in how symptoms present for women and minority groups. This means sleep apnea is likely undertreated for these groups, too.
“The most common misconception with sleep apnea is that you have to be older, you have to be overweight to have sleep apnea, and that couldn’t be further from the truth,” says Dr. Shelby Harris, Sleepopolis’ director of sleep health.
For instance, we know pregnant women are at a higher risk of developing sleep apnea due to weight gain, hormonal changes, and relaxed tissues in the airway. Luckily in this case, the condition is likely to resolve itself after childbirth.
Additionally, women experiencing perimenopause or menopause can also be at a higher risk for sleep apnea thanks to hormone changes and weight gain.
You can learn more about women and sleep apnea here.
Restless Leg Syndrome
Also known as Willis-Ekbom disease, restless legs syndrome (RLS) is a rare neurological movement disorder that can cause discomfort in your limbs.
“It’s a very common issue, especially for women,” says Harris. “The name is a bit of a misnomer. It can actually be your legs and arms — as the day goes on and the night gets closer, you feel this uncomfortable, restless feeling in your limbs. Everyone describes it differently… the only way it’s really relieved is by getting up, moving around, stretching.”
Restless leg syndrome is twice as common in women and often makes its first appearance during pregnancy. And while researchers have yet to definitively say why, some working theories include higher estrogen levels and/or iron deficiencies.
Typically, women store less iron than men due to monthly menstruation, and researchers believe that the cocktail of low iron levels and a substantial boost in estrogen is what triggers RLS in pregnant women.
Moreover, RLS has also been linked to some medications used to treat depression, and research shows that anxiety and depression tend to be more prevalent in women.
A Note On Hormones
Though not considered a sleep disorder, hormones have a much more significant impact on women’s sleep cycles than on men’s. Women experience significant hormonal fluctuations at many stages throughout their lives, starting at puberty — Harris says this is the point in time where boys’ and girls’ sleep patterns usually begin to differ, with girls seeing more sleep challenges.
Pregnancy, perimenopause, and menopause are also periods of significant hormonal changes, and research shows these life stages lead to a marked increase in poor sleep quality for women, as well as a rise in sleep disorders for post-menopausal women.
On top of that, women also experience shifts in their sleep patterns throughout their monthly menstrual cycle — Harris says some women even experience insomnia in the days leading up to menstruation.
Sleep Tips For Women
We know how hard it can be to prioritize a good night’s sleep — often, there are at least a dozen other things to focus on, and sleep falls on the backburner. But with one in three adults not getting enough sleep, there’s a definite need for change, and we have the tips to get your sleep schedule back on the right track.
Riney offers the following tips to help women improve their sleep.
Establish Boundaries Between Work And Home
Over the last few years, the clash of our personal and professional lives (with work-from-home setups) has left us with boundary issues that are disturbing our sleep. To keep the fallout in check, Riney suggests “delineating work schedules that are different from family/personal time.”
Do your best to actually sign off at the end of the day, keep spaces separate if you can, and don’t work from your bed.
Maintain A Consistent Sleep Schedule
A stable wake and sleep schedule helps to maintain your body’s internal clock, further promoting healthy sleep.
Soak Up The Sunshine
Getting out into the sun when you first wake up can also help keep your circadian rhythm working as it should. The morning sun will help you feel more alert as you start your day and appropriately sleepy when the evening rolls around.
Moderate Your News Intake
Riney also suggests “taking breaks from watching, reading, or listening to news stories, which can worsen anxiety and stress.” That doesn’t mean shutting the news off completely — just reducing the time you spend consuming stress-inducing content can help.
Skip The Screens
Beyond moderating your news intake, Riney suggests eliminating the use of devices at least an hour before bed. Instead of doomscrolling into the wee hours, she suggests using that time to “reflect, meditate, read, or do something non-engaging and relaxing.”
Research has shown that companionship can improve nighttime sleep. So, Riney suggests reaching out to some of your favorite people every day. Whether it’s by phone, text, facetime, or email, do what you can to keep your social connections going.
Try Some Lifestyle Changes
The foods you eat and the activities you choose to participate in can have a profound effect on your forty winks. For that reason, Riney suggests “taking time to eat healthily, meditate, and find activities you enjoy.” She also advises curbing your alcohol intake, which can also affect your sleep.
Sleep Disorders That Affect Men More Than Women
Sleep disorders that affect men more than women include obstructive sleep apnea, delayed sleep-wake phase disorder, and REM sleep behavior disorder.
Obstructive Sleep Apnea
“Men are two to three times more likely than women to experience obstructive sleep apnea,” Dan Ford, Sleep Psychologist and Clinical Director of The Better Sleep Clinic, tells Sleepopolis. “This is often attributed to differences in male physiology, such as males carrying more visceral fat and upper body fat (which correlate with more severe OSA), differences in upper airway size, length, and structure contributing to airway collapsibility, and estrogen protecting the female airway.”
Delayed Sleep-Wake Phase Disorder
According to Ford, delayed sleep-wake phase disorder is more common in men than women. He says that overall, men are more likely to show a stronger “evening” preference, while women have earlier peaks in alertness during the day and sleepiness at night.”
REM Sleep Behavior Disorder
Though REM Sleep Behavior Disorder is rare — The Cleveland Clinic says it affects about 1 percent of the population, and 2 percent of people aged 50 or older — research shows that more than 85 percent of the patients with REM sleep behavior disorder (RSBD) are men. Ford speculates that this is at least in part due to “a bias toward diagnosing the condition in men,” but more research is needed before researchers reach a definitive conclusion.
Sleep Tips For Men
In addition to the usual suspects of lifestyle changes and modifications to sleep hygiene to improve their sleep, like maintaining a consistent sleep-wake schedule, exercising, eating right, and getting some daily sunshine, Ford tells Sleepopolis that men, in particular, should address snoring, weight, and alcohol use.
“Men should pay attention to snoring (and partner complaints of snoring),” says Ford, who advises an overnight sleep study as a first step to rule out obstructive sleep apnea.
“If OSA is identified, they should follow their physician’s advice on treatment. If OSA is not indicated, men should still seek to address snoring,” he says. “This is because snoring is an indicator of upper airway resistance irrespective of an OSA diagnosis, and airway resistance can impact sleep quality. There are a number of different ways to address simple snoring, ranging from nasal strips to tongue retainers, or mandibular advancement devices.”
“Males should also pay attention to their weight,” says Ford. “Not only can exercise (either aerobic or resistance training) help with weight management, but exercise is also associated with deeper sleep and better sleep quality.”
Ford tells Sleepopolis that “alcohol use is more common in males, and it’s a big sleep disruptor, often contributing to insomnia, OSA, and parasomnias.”
For that reason, Ford suggests that men pay attention to their alcohol consumption and ensure they remain within healthy alcohol consumption guidelines or minimize alcohol consumption altogether if need be.
How Sleep Disorders Affect Men And Women Differently
While there are minimal differences in sleep architecture — which describes the general structure of your sleeping patterns — and sleep disorders in young kids, significant changes often begin at puberty, and the chasm only widens with age.
While we know that menstrual cycles, pregnancy, and menopause can alter sleep architecture, new research suggests that sleep disorders manifest themselves more profoundly for women in their waking lives.
First, the study showed that women were “more likely to have sleeping disorders associated with daytime sleepiness and trouble sleeping at night (hello, insomnia). Moreover, the same study showed that women had more difficulty with focus and memory as a result of their sleep disorders, and the “burden of their symptoms” tended to affect them more than their male counterparts.
And while this study revealed a litany of issues for women as they relate to sleep disorders, it only showed that men snored more than females, so much so that their bed partners were often forced to sleep in different rooms.
A Note On Gender Disparities In The Diagnosis Of Sleep Disorders
While our research indicates that some sleep disorders are more common in men while others are more common in women, Dan Ford leaves us with one important caveat. The numbers indicating a prevalence one way or another may be skewed as a result of underdiagnosis, particularly as it relates to women. If we look at sleep apnea, for example, based on the research, men are 2 to 3 times more likely to have OSA. But Ford notes that “it may simply be that women are under-diagnosed with OSA, as males are more likely to be referred to a sleep clinic for their symptoms than women — and the presentation of OSA in women is relatively under-studied.”
The Last Word From Sleepopolis
Beyond known differences in sleep architecture and quality, men and women are prone to different sleep disorders. While insomnia and restless leg syndrome are more prevalent in women, delayed sleep-wake phase disorder, obstructive sleep apnea, and REM sleep behavior disorder are more common in men. For both sexes, better sleep may lie in a few lifestyle changes, a little sleep hygiene recalibration, or help from a medical professional when all else fails.