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Study reveals sex differences in sleep disorders

A recent study published in the journal Sleep Medicine Reviews has explored the main sex differences between the ways men and women experience sleep, the intrinsic differences in their circadian rhythms, and how this affects their metabolism. 

According to the experts, it is vital to take into consideration biological sex in diagnosing and managing sleep disorders, circadian disruptions, and metabolic diseases. 

Recognizing sex differences in sleep

“Lower sleep quality is associated with anxiety and depressive disorders, which are twice as common in women as in men,” said study senior author Sarah L. Chellappa, an expert in cognitive and affective neuroscience at the University of Southampton

“Women are also more likely than men to be diagnosed with insomnia, although the reasons are not entirely clear. Recognizing and comprehending sex differences in sleep and circadian rhythms is essential for tailoring approaches and treatment strategies for sleep disorders and associated mental health conditions.”

Women report poorer sleep quality 

The study reveals that women consistently report poorer sleep quality compared to men, with their sleep patterns notably fluctuating in tandem with the menstrual cycle. 

The prevalence of insomnia is higher among women, and the study further identifies a higher propensity in women for conditions like restless legs syndrome and sleep-related eating disorder. 

Men have a greater risk of obstructive sleep apnea 

In contrast, men exhibit a threefold increase in the likelihood of being diagnosed with obstructive sleep apnea (OSA), a condition that not only manifests differently between the sexes but also carries a significant risk of heart failure in women, highlighting the gender-specific impacts of sleep disorders.

Sex differences in circadian rhythms 

The scientists also discovered that differences between the sexes are also present in our circadian rhythms. For instance, melatonin, a hormone that helps with the timing of circadian rhythms and sleep, was found to be secreted earlier in women than men. 

Moreover, core body temperature, which is at its highest before sleep and its lowest a few hours before waking, appears to follow a similar pattern, reaching its peak earlier in women than in men. Finally, previous studies have found that women’s circadian periods are shorter than men’s by around six minutes.

Disruptions in circadian rhythms 

“While this difference may be small, it is significant. The misalignment between the central body clock and the sleep/wake cycle is approximately five times larger in women than in men,” said study lead author Renske Lok, a postdoctoral fellow at Stanford University.

“Imagine if someone’s watch was consistently 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 disorders, mood disorders, and impaired cognitive function. Even minor differences in circadian periods can have significant implications for overall health and well-being.”

Sex differences in sleep routines

Men often have a preference for later sleep schedules, choosing to sleep and wake up later compared to women. This preference can result in social jet lag, a condition where their natural sleep patterns clash with societal obligations, such as work schedules. Additionally, on a daily basis, men’s sleep and activity routines tend to vary more than those of women.

The study also ventures into the metabolic ramifications of sleep deprivation, particularly in the context of the obesity epidemic. Intriguingly, while sleep loss triggers increased brain activity in response to food in both sexes, men are more prone to overeating as a result. 

The research delves into the gender-specific risks associated with shift work, noting that while both female and male night shift workers face elevated risks for type 2 diabetes, men experience a higher susceptibility.

Gender-specific treatments for sleep disorders 

In addition, the researchers identified emerging evidence on the gender-specific responses to treatments for sleep and circadian disorders. 

For instance, weight loss was more successful in treating women with obstructive sleep apnea than men, while women prescribed an insomnia medication such as zolpidem may require a lower dosage than men to avoid lingering drowsiness the next morning.

“Most of sleep and circadian interventions are a newly emerging field with limited research on sex differences. As we understand more about how women and men sleep, differences in their circadian rhythms and how these affect their metabolism, we can move towards more precise and personalized healthcare which enhances the likelihood of positive outcomes,” Chellappa concluded.


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