There are a variety of sleep disorders that have a higher prevalence in women as opposed to men, and the resultant sleep deprivation and associated negative consequences tends to impact women’s quality of life to a greater degree.
Women tend to be more at risk than men from other conditions that can contribute towards disrupting sleep, particularly during natural life occurrences such as pregnancy and menopause.
Two-thirds of women report difficulty falling or staying asleep at least several times on a weekly basis, with roughly one-third stating that they felt poorly rested in general.
The Importance of Sleep
Regardless of gender, there are plenty of reasons that contribute to you not getting enough sleep. Sleep deprivation is associated with a host of negative short-term and long-term consequences, ranging from mild (irritability) to severe (increased risk of cardiovascular diseases over time).
Contrarily, restful sleep is associated with an increased ability to learn and process information, healthier eating habits and general well-being and health. Individuals who are getting the right amount of sleep are less likely to be involved in mishaps resulting from sleep deprivation, such as motor vehicle accidents.
But do women need more sleep than men? If so, are we are women getting enough shut eye? Let’s look deeper and find out.
Are We Getting Enough Sleep?
The National Sleep Association recommends between 7-9 hours of sleep nightly for the average adult between 26-64 years of age, allowing for a minimum of six hours and a maximum of 10 hours sleep per night. Individuals who are unable to sleep for more than six hours or feel that they’re only rested if they sleep for over 10 hours at once should consult with a sleep specialist, as under-sleeping and over-sleeping can be signs of underlying sleep disorders and other medical conditions.
Sleep disorders, certain medical conditions, inherent traits, certain prescription drugs and habits such as heavy alcohol consumption and the use of narcotics can reduce an individual’s ability to sleep, as well as impacting the overall quality of sleep. External factors can also influence how we sleep: jet-lag, a new environment, pain from an injury, or changing shifts at work can all negatively impact our ability to sleep well.
When it comes to how we sleep, gender does play a significant role: it’s been established that there’s a difference in the way that men and women sleep. Women have a higher risk of suffering from insomnia, and approximately 15 percent of women have reported having difficulty sleeping versus only 8 percent of men. Women also tend to have greater difficulties coping with sleep deprivation compared to their male counterparts.
Women are also more likely to suffer from sleep disorders that result in excessive daytime sleepiness (EDS), and although both men and women tend to report similar sleep disorders the effects of these disorders tend to present more strongly in women.
A study published by the American Academy of Sleep Medicine revealed that women overall tended to report feeling more burdened by the various consequences of sleep deprivation, such as irritability, difficulty functioning, and difficulty processing information. Sleep specialists place importance on identifying how various sleep disorders affect men and women differently to better develop long-term treatment plans that target gender-related symptoms and effects.
Women And Sleep Disorders
Women are more likely than men to suffer from insomnia; a sleep disorder that can be either acute (short term) or chronic (long term). Individuals with insomnia have difficulty falling asleep, staying asleep, and tend to suffer from broken, disrupted sleep. A 2002 poll revealed that women are 9 percent more likely than men to suffer from EDS resulting from insomnia and report more sleepless evenings a week.
Hormonal changes are one of the primary underlying causes of insomnia, and women experience hormonal fluctuations and changes consistently throughout their lives: menstruation, pregnancy, and menopause. Women are also at risk from female-specific hormonal disorders such as polycystic ovary syndrome and endometriosis, which can impact sleep quality.
The accompanying physical and emotional stresses of pregnancy are also associated with insomnia. Common pregnancy related conditions such as frequent urination, ongoing nausea, hormonal fluctuations, anxiety and general discomfort can severely disrupt sleep, with 78 percent of women reporting worsened or severe symptoms of insomnia during pregnancy.
Sleep deprivation following birth is to be expected, but for women with postpartum depression (PPD) the quality of sleep tends to worsen considerably as the symptoms of PPD manifest, as depression, loss of appetite, extreme fatigue, general difficulty bonding with the newborn baby, and mood swings. Sleep deprivation is also exacerbated by the demands of a newborn infant, and women suffering from PPD must take care to minimize sleep disturbances (i.e. loud noises, uncomfortable bed) as much as possible.
Many women report insomnia relating to premenstrual syndrome (PMS) right before or during their menstruation cycles. This is due to the hormonal changes incumbent with every cycle as well as coping with PMS symptoms such as cramping, bloating, heavy bleeding, and tender breasts that can range from mild to severe. As most women tend to feel more tired during their menstrual cycles, PMS-provoked insomnia can only worsen EDS and other consequences of sleep deprivation.
For women suffering from a more severe form of PMS, premenstrual dysphoric disorder (PMDD), their risk of developing sleep disorders increases substantially, particularly sleep-onset insomnia and periodic awakenings during the night. Women suffering from PMDD tend to respond less to melatonin; the hormone that contributes towards the regulation of sleep and wake cycles.
Menopause is another stage of a woman’s life where hormonal fluctuations play a key role, and can contribute towards disrupting a woman’s circadian rhythm, which is the internal body clock all human beings have that regulate sleeping and waking cycles. Hot flashes—which are adrenaline surges that cause sweating and increased body temperature—can also be disruptive to sleep, as when they occur it can take time for the adrenaline levels to return to normal.
Despite sleep apnea rates being less prevalent in adult women than in men, a woman’s risk of sleep apnea rises to the same as a man’s once she reaches menopause. During pregnancy, the risk of sleep apnea is also increased due to hormonal changes. Women tend to have high mortality rates due to cardiovascular diseases provoked by obstructive sleep apnea, when the muscles in the throat intermittently contract and relax during sleep, causing difficulty breathing.
Women are also more susceptible to sleep-related eating disorder (or so-called night eating). SRED is a form of sleepwalking, manifesting as excessive eating while asleep. Individuals with SRED may consume items that are non-edible, such as plastic or tissue paper, and foods that they do not normally eat during the day. The disorder is rare, with only one to three percent of the population being affected.
An estimated 10 to 15 percent of individuals coping with eating disorders such as bulimia and anorexia are affected by SRED. Bulimia and anorexia tend to be far more common in women than men, with approximately 10 million women in the U.S. suffering from an eating disorder compared to one million men, making the risk factor of contracting SRED higher for women in general.
Restless leg syndrome (RLS) is a sleep disorder which causes an intense urge to move or shift the legs, and may also cause unpleasant sensations such as pain, tingling, itching or a creeping feeling. The symptoms tend to manifest in the evening and tend to increase during long periods without movement or lying down, causing frequent awakenings during sleep.
RLS may affect individuals of any age, but typically occurs in elderly adults, and is more common in women than men. The risk of developing RLS increases exponentially in women who are more than 20 weeks pregnant.
Depression is another condition which tends to produce insomnia that women are more at risk from as it may be provoked by hormonal fluctuations during puberty, pregnancy, and menopause. Women are approximately twice as likely as men to suffer from depression, particularly during the teenage years (ages 14 to 18), and one in every eight women is expected to develop depression at some point in their lives.
Other conditions that are not categorized as sleep disorders but that can contribute towards disrupting sleep such as tension headaches, migraines, migraines with aura, arthritis and rheumatism, and heartburn also tend to affect women to a greater degree than men.
Do Women Need More Sleep?
Dr. Jim Horne, an expert in the field of sleep medicine and research, estimates that the average woman requires at least 20 minutes more sleep than a man does, allowing for higher rates of sleep disruption. In his study investigating the issue, Dr. Horne determined that due to the aforementioned increased risk factors for sleep disorders and related conditions affecting sleep, women tended to sleep longer than men.
Although a study of working-age adults in the U.S. revealed that men tended to report getting less sleep than their female counterparts—up to 11 minutes less an evening—women tended to report more incidences of interrupted sleep than men, and were also more prone to napping during the day.
A 2016 study revealed that treatment of sleep disorders must also be tailored depending on gender, as women tend to metabolize certain sedatives, such as zolpide, at a slower rate than men, resulting in increased serum levels (approximately 50 percent higher than those of men taking the same drug).
However, the same study notes that there are significant research gaps in the field of sleep medicine when it comes to understanding how gender impacts sleep, and how men and women may have different requirements when it comes to sleeping. Despite the existence of research proving women in general tend to suffer more than men from disturbed sleep—whether due to a medical condition or simply due to natural and expected hormonal fluctuations—there still needs to be further study.
Another recent study revealed that women have a tendency to sleep earlier and wake up earlier than men, and report feeling more tired even after relatively undisturbed sleep. The study’s lead researcher, Dr. Diane Biovin, discovered that circadian rhythms appear to be regulated differently depending on gender, and thus affect how men and women sleep as well as their levels of alertness.
Most research into how gender impacts sleep agrees that despite women tending to sleep longer than men, they experience a poorer quality of sleep, experiencing light sleep (non-REM sleep) and more slow-wave (deep) sleep. Quality is far more important than quantity when it comes to sleep—six hours of unbroken rest is far more beneficial than nine hours of interrupted sleep with frequent awakenings.
It’s important to note that treatment plans and care do exist for all of the aforementioned sleep disorders and medical conditions, and seeking medical advice to determine the best course of action to reduce symptoms, particularly those that disrupt sleep, can dramatically increase your quality of life.
For women suffering from insomnia related to PMS, PMDD, pregnancy, menopause, or hormonal disorders a variety of treatments exist to improve sleep quality and reduce sleep disturbances due to intrusive symptoms, ranging from prescription drugs to alternative, non-medical remedies and adopting routines to that promote good sleep hygiene.
Following good health practices such as getting regular exercise (preferably earlier in the day, as exercise in the evening can contribute towards wakefulness at night); following a diet low in sugars and greasy, high-fat foods; avoiding excess alcohol consumption; and refraining from harmful habits such as smoking and the use of narcotics can also significantly benefit sleep.
Although sleep institutions provide a general recommendation of how much sleep you should be getting every evening, every person is unique. Whether male or female, it should be a priority to take note of how alert and well-rested you feel on varying amounts of sleep, and attempt to regulate your sleep habits and routine to get the optimal amount of good-quality sleep!