Biological sex sleep differences: Insomnia in women, apnea in men

Men are more likely to develop obstructive sleep apnea, while women are more likely to develop insomnia and report poor sleep quality. These are among the findings of a literature review published in April in the journal Sleep medicine reviews. The researchers come from Harvard University, Stanford University, and the University of Southampton in the United Kingdom

The co-author says this research is as much about precision medicine as it is about sleep differences between the sexes Rensky Locke, Ph.DPostdoctoral Fellow at Stanford Center for Sleep and Circadian Science.

“We try to stay away from one-size-fits-all,” she says. luck. “(Medicine) needs to be more detailed.”

Understanding how and why biological sex affects different sleep disorders is a crucial step toward individualized treatment. However, the long-standing lack of inclusion of women in biomedical and behavioral research is an obstacle. The National Institutes of Health did not need to conduct studies Gender as a biological variable Until 2016.

“The biggest takeaway is that we definitely have to do better at including women in our research designs,” Locke says. “Historically, women have not been included as much as men, partly because it has always been assumed that the results achieved by men will automatically translate to women. We are starting to discover more and more that this is not the case.”

Sex and circadian rhythm

The mental, physical, and behavioral changes that your body goes through during 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 particularly sensitive to light and darkness.

At night, your brain produces more of the sleep hormone melatonin, making you feel tired. in One study As Locke and colleagues review, women secrete melatonin earlier in the evening than men. This is consistent with Other research Showing men are usually later chronological patterns; That is, they go to bed and wake up later than women. As such, men tend to have worse social dysregulation when their biological clock does not align with the traditional timing of societal demands, such as working a 9-to-5 job.

Another study showed that core body temperature — which is highest before sleep and lowest a few hours before waking — also peaks earlier in women. Other research It found that women's daily cycles were about six minutes shorter than men's: 24.09 hours compared to 24.19.

“Although this difference may be small, it is important. The mismatch between the body’s central clock and the sleep-wake cycle is about five times greater in women than in men,” Locke said in his report. New release About the work of her team. “Imagine if someone’s clock was 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.

“Disruptions in circadian rhythms have been linked to various health problems, including sleep disturbances, mood disorders, and impaired cognitive function. Even small variations in circadian rhythms can have significant effects on overall health and well-being.”

He says cognitive behavioral therapy is one option to get your circadian rhythm on track, especially if your biological and social clocks don't match. Alina Tiani, Ph.DClinical psychologist at Cleveland Clinic Sleep Disorders Center.

“It varies from patient to patient, but we have them take melatonin (supplements) early in the evening and then have them exposed to bright light in the morning,” Tiani says. luckIn reference to night owls who need to wake up early. “These two things help stabilize their sleep window while they work to change things.”

Work and life stress may affect insomnia in women

You may have had seizures Acute insomnia, stressful periods throughout your life when you have difficulty falling asleep, staying asleep, or getting quality sleep. It may only last for a few days or a few weeks. However, chronic insomnia occurs when you experience sleep disturbances at least three times a week for more than three months, according to the report. National Heart, Lung, and Blood Institute. In addition, chronic insomnia cannot be explained by other health problems you may have.

Insomnia is on the verge 1.5 times more common in womenPrevious research has shown. Locke and her colleagues hypothesized that this might be due to certain risk factors that are more prevalent in women, such as anxiety and depression.

Dr. Eric Sklar He is a neurologist and medical director of Inova Sleep Disorders Program In northern Virginia. Insomnia is one of the most common sleep disorders he treats, and he wasn't surprised by the review results.

“There is a strong relationship between underlying psychological disorders and insomnia,” Sklar says. luck. “Some basic social stressors for men and women may be different.”

Women are still often positioned in the role of family caregiver, while also working their way up the career ladder, Sklar points out, not to mention facing other life stressors. Additionally, pausing in the evening is essential for healthy circadian rhythms, and women sometimes have to fight for that, he says. When so-called “retaliatory bedtime postponement” involves screen time, women may further disrupt their body clocks.

The review shows that by some objective measures, women sleep better than men. Women have a higher Sleep efficiencyWhich indicates the percentage of time you spend in bed He actually slept. The woman entered the dream heavily Rapid eye movement (REM) The earlier the sleep stage, the longer it is spent about eight minutes in Non-REM sleep. However, the women themselves reported Poor sleep quality From a man.

While new parents face a variety of sleep disorders, Tiani says luck A large group of her postpartum patients and women with young children reported decreased sleep quality.

“It seemed like their brains were almost listening to their children in the middle of the night, in case they needed something,” Tiani says. Patients who were caregivers in other capacities reported the same thing, namely, “listening at night.”

Why do men and women sleep differently?

Women have gotten a break from this common sleep disorder: Sleep ApneaWhen the upper airway becomes repeatedly blocked during sleep. Turbulence is It is approximately three times more common in menHowever, it is only associated with Increased risk of heart failure in womenReview indicated.

“It is known that men are at greater risk,” Sklar says. luckAdding that biological sex is used to assess the risk of sleep apnea. “Men tend to have larger necks, and neck size is also a risk factor.”

Locke's review also noted sleep differences between the sexes, among other things:

One key factor remained inconsistent across the nearly 150 studies Locke and her colleagues analyzed: the phases of women's menstrual cycles. Menstruation is associated with many changes that affect sleep, such as an increase in body temperature during menstruation Luteal phase Of course. Furthermore, some research has failed to take oral contraceptive use into account, which may lead to skewed results.

“It's difficult because, for example, if a woman is not using hormonal contraception, that means you have to include women in the same menstrual phase,” Locke says. luck. “Otherwise you get all kinds of variations due to changes in hormonal levels.”

Having overcome some of the obstacles standing in her team's way, specifically subtle evidence that there are some biological differences between the sexes, Locke is hopeful about future research.

In some cases, “we're not sure there are any gender differences, simply because no one has looked at them before,” Locke says. “At the same time, it's a very encouraging article because it definitely identifies where gaps still exist.”

To learn more about biological sex and health: