New research exploring the biological sex characteristics of sleep suggests that women and men sleep differently and therefore should not treat their sleep disorders in the same way.
Men are more likely to have obstructive sleep apnea, while women are more likely to have insomnia and report lower sleep quality.These were among the findings of a literature review published in the journal in April sleep medicine review.Researchers from Harvard University, Stanford University and the University of Southampton, UK
The study is as much about sleep differences between the sexes as it is about precision medicine, said co-author Dr. Len Kroc, a postdoc at the Stanford Center for Sleep and Circadian Science.
“We’re trying to move away from a one-size-fits-all approach,” she told us wealth. “[Medicine] Needs to be more tailored.
Understanding how and why biological sex affects various sleep disorders is a critical step toward personalized treatment. However, the chronic lack of female participation in biomedical and behavioral research is a barrier. It was not until 2016 that the National Institutes of Health required research on gender as a biological variable.
“The biggest finding is that we absolutely have to do a better job of including women in our study designs,” Locke said. “Historically, women haven’t been included as much as men, partly because it was always assumed that male results would automatically translate to women. But we’re starting to find more and more that’s not the case.
Sex and circadian rhythms
The mental, physical, and behavioral changes your body experiences over a 24-hour period are called circadian rhythms. Almost all organs and tissues have their own rhythms, and together they form a master circadian clock that is particularly sensitive to light and dark.
At night, your brain produces more of the sleep hormone melatonin, which makes you feel tired. In one study reviewed by Locke and her colleagues, women secreted melatonin earlier in the evening than men. This is consistent with other studies showing that men generally have a late-stage phenotype. That is, they go to bed and wake up later than women. So when men’s biological clocks don’t align with the traditional timing of social demands, such as a 9-to-5 job, their social jet lag tends to be more severe.
Another study showed that women’s core body temperature (which is highest before bed and lowest a few hours before waking) also peaks earlier. Other studies have found that women’s circadian cycle is about 6 minutes shorter than men’s: 24.09 hours compared to 24.19 hours.
“While the difference may be small, it is significant. Women have approximately five times the misalignment between their central circadian clock and sleep/wake cycle than men,” Locke said in a press release about her team’s work. “Imagine if someone’s watch continued to run six minutes faster or slower. Over the course of days, weeks, and months, this difference could cause a difference between the internal clock and external cues, such as light and dark. There is an obvious imbalance between them.
“Circadian rhythm disruptions are associated with a variety of health problems, including sleep disturbances, mood disorders, and impaired cognitive function. Even small differences in circadian rhythms can have a significant impact on overall health and well-being.
Cognitive behavioral therapy is an option to get your circadian rhythm on track, especially if your biological and social clocks don’t match up, says Dr. Alaina Tiny, a clinical psychologist at the Cleveland Clinic Sleep Disorders Center. situation.
“Each patient is different, but we have them take melatonin (supplements) earlier in the evening, and then we have them get some bright light exposure in the morning,” Tiani told wealth, refers to night owls who need to get up early. “Those two things help anchor their sleep window while they’re trying to change things up.”
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Work life stress may affect women’s insomnia
You may have experienced periods of acute insomnia, stressful periods in your life, difficulty falling asleep, difficulty staying asleep, or difficulty getting quality sleep. They may last only a few days or as long as a few weeks. However, chronic insomnia is when you experience disrupted sleep at least three times a week for more than three months, according to the National Heart, Lung, and Blood Institute. Additionally, chronic insomnia cannot be explained by other health problems you may have.
Previous research has shown that insomnia is approximately 1.5 times more common in women. Locke and her colleagues speculate that this may be due to certain risk factors that are more common in women, such as anxiety and depression.
Dr. Eric Sklar is a neurologist and medical director of the 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’s findings.
“There’s a high correlation with underlying mental illness and insomnia,” Sklar said. wealth. “Some of the underlying social pressures that men and women face may be different.”
Sklar noted that women are still often positioned in the role of family caregivers while also working their way up the career ladder, not to mention dealing with other stressors in life. Additionally, resting time at night is critical for a healthy circadian rhythm, which women sometimes have to work harder for, he said. When so-called “revenge bedtime procrastination” involves screen time, women may further disrupt their biological clocks.
The review shows that by some objective measures, women sleep better than men. Women have higher sleep efficiency, which refers to the percentage of time in bed actually spent sleeping. Women enter the rapid eye movement (REM) sleep stage earlier, where they dream more, and spend about eight minutes longer in non-rapid eye movement sleep. However, women self-report poorer sleep quality than men.
Tiani told new parents that although new parents face various sleep disorders wealth A group of her postpartum patients and women with young children reported decreased sleep quality.
“It’s almost like their brains are listening to their children in the middle of the night in case they need something,” Tiani said. Patients who were caregivers in other roles also reported the same thing, “eavesdropping at night.”
Why do men and women sleep differently?
Women do escape a common sleep disorder: obstructive sleep apnea, in which the upper airway is repeatedly blocked during sleep. The review noted that the disease is nearly three times more common in men, but is only associated with an increased risk of heart failure in women.
“It’s well known that men are at higher risk,” Sklar told us. wealth, adding that biological sex is used in sleep apnea risk assessment. “Men tend to have larger necks, and neck size is also a risk factor.”
Lok’s comments also noted sleep differences between genders, including:
Lok and her colleagues analyzed nearly 150 studies, and one key factor remained inconsistent: women’s menstrual periods. Menstruation is associated with many changes that affect sleep, such as increased body temperature during the luteal phase of the cycle. In addition, some studies failed to take into account participants’ oral contraceptive use, which may bias the results.
“It’s tricky because, for example, if someone is not using hormonal contraceptives, that means you have to include women who are on the same menstrual cycle,” Locke said. wealth. “Otherwise, you get all kinds of changes due to changes in hormonal levels.”
After overcoming some of the hurdles for the team moving forward, namely insufficient evidence for some biological sex differences, Locke is hopeful for future research.
In some cases, “we’re not sure whether there’s a sex difference because, simply put, no one has studied it,” Locke said. “At the same time, this is a very encouraging article because it clearly identifies the gaps that still exist.”
More information about biological sex and health:
