Women and men sleep differently, so their sleep disorders should not be treated the same, new research examining the biological sex characteristics of sleep suggests.
Men are more likely to have obstructive sleep apnea, while women are more likely to have insomnia and report lower quality sleep. These are the findings of a literature review published in April in the journal Reviews of sleep medications. The researchers came from Harvard University, Stanford University and the University of Southampton in the UK.
“This study is not only about precision medicine, but also about sleep differences between the sexes,” says co-author. Renske Locke, Ph.D.postdoctoral fellow Stanford Center for Sleep and Circadian Sciences.
“We’re trying to move away from a one-size-fits-all approach,” she says. Luck. “[Medicine] should be more adaptable.”
Understanding how and why biological sex influences various sleep disorders is an important step toward personalized treatment. However, the long-standing lack of women’s participation in biomedical and behavioral research is a barrier. The National Institutes of Health did not require studies to explain gender as a biological variable until 2016.
“The most important takeaway is that we absolutely need to do a better job of including women in our research,” Locke says. “Historically, women have not been counted as often as men, in part because it has always been assumed that men’s performance will automatically transfer to women. And we are beginning to understand more and more that this is not the case.”
Sex and the circadian rhythm
The mental, physical, and behavioral changes your body experiences over a 24-hour period are called circadian rhythms. Almost all of your organs and tissues have their own rhythms, and together they form a kind of master biological clock that is especially sensitive to light and darkness.
At night, your brain produces more of the sleep hormone melatonin, which causes you to feel tired. IN one study According to Lock and her colleagues, women release melatonin earlier in the evening than men. This is consistent with other studies men are shown, usually of later chronotypes; that is, they go to bed and wake up later than women. Thus, men tend to have worse social jet lag when their biological clock is out of sync with traditional social demands, such as a 9-to-5 job.
Another study showed that core body temperature, which is highest before bed and lowest several hours before waking, also peaks earlier in women. Other studies found that women’s circadian periods were about six minutes shorter than men’s: 24.09 hours compared to 24.19.
“Although this difference may be small, it is significant. The misalignment between the central body clock and the sleep/wake cycle is about five times greater in women than in men,” Lock said in the report. news release about the work of her team. “Imagine someone’s watch constantly running six minutes faster or slower. Over the course of days, weeks, and months, this difference can lead to a noticeable misalignment between the internal clock and external cues such as light and darkness.
“Circadian rhythm disturbances are associated with a variety of health problems, including sleep disturbances, mood disorders and cognitive impairment. Even subtle differences in circadian timing can have significant implications for overall health and well-being.”
Cognitive behavioral therapy is one option to improve your circadian rhythm, especially if your biological and social clocks are out of sync, he says. Alaina Tiani, Ph.D.clinical psychologist Cleveland Clinic Sleep Disorders Center.
“It varies from patient to patient, but we have them take melatonin (supplements) earlier in the evening and then use bright light in the morning,” Tiani says. Luck, referring to night owls who need to wake up earlier. “These two things help them secure their sleep window while they work toward change.”
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Stress at work may affect women’s insomnia
You’ve probably had seizures acute insomnia, stressful times in your life when you had difficulty falling asleep, staying asleep, or getting quality sleep. They could last only a few days or several weeks. However, chronic insomnia is when you experience such sleep disturbances at least three times a week for more than three months, according to National Heart, Lung, and Blood Institute. In addition, chronic insomnia cannot be explained by other health problems.
Insomnia is about 1.5 times more common in women, as previous studies have shown. Locke and her colleagues suggested that this may be due to certain risk factors that are more common in women, such as anxiety and depression.
Dr. Eric Sklar neurologist and medical director of the clinic Inova Sleep Disorders Program in northern Virginia. Insomnia is one of the most common sleep disorders he treats, and he was not surprised by the review results.
“There is a high correlation with major psychiatric disorders and insomnia,” Sklar says. Luck. “Some of the major social stressors may be different for men and women.”
Women are still often relegated to the role of caretaker of the family while working their way up the career ladder, Sklar notes, not to mention other life stressors. Plus, evening rest is essential to maintaining healthy circadian rhythms, something women sometimes have to fight harder for, he says. And when so-called “bedtime procrastination revenge” involves screen time, women can further disrupt their body clocks.
According to some objective indicators, women sleep better than men, a review shows. Women have higher sleep efficiencywhat does the percentage of time spent in bed mean? actually slept. Women entered into a heavy dream rapid eye movement (REM) sleep phase earlier and spent about eight minutes longer in slow sleep. However, the women themselves reported deterioration in sleep quality than men.
According to Tiani, new parents face various sleep disorders. Luck a number of her postpartum patients and women with small children report worsening sleep quality.
“It was almost as if their brains were half-listening to the kids in the middle of the night in case they needed anything,” Tiani says. Caregivers in other capacities reported the same “listening at night.”
Why do men and women sleep differently?
Women did experience one common sleep disorder: obstructive sleep apneawhen the upper airway becomes repeatedly blocked during sleep. Disorder almost three times more common in menhowever it is only associated with increased risk of heart failure in womennoted in the review.
“It’s well known that men are at higher risk,” Sklar says. Luck, adding that biological sex is used in assessing the risk of sleep apnea. “Men tend to have larger necks, and neck size is also a risk factor.”
Locke’s review also noted the following sleep differences between the sexes:
One key factor remained controversial in the nearly 150 studies Lock and her colleagues analyzed: women’s menstrual phases. Menstruation is correlated with numerous changes that affect sleep, such as increased body temperature during menstruation. luteal phase cycle. Moreover, some studies did not take into account subjects’ use of oral contraceptives, which could bias the results.
“It’s difficult because, for example, if someone is not using hormonal contraceptives, that means you have to include women in the same menstrual phase,” Lock says. Luck. “Otherwise, you get all sorts of variations due to hormonal changes.”
Having overcome some of the obstacles standing in her team’s way, namely weak evidence for some biological sex differences, Locke is hopeful for future research.
In some cases, “we’re not sure if there are any sex differences because it’s just that no one has ever looked at it,” Locke says. “At the same time, this is a very encouraging paper because it definitely identifies where gaps still exist.”
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