Women sleep objectively better than men and the sleep of young women is more resilient to external stressors: effects of age and menopause

The aims of this study were to: (i) assess gender differences of objective sleep patterns in a general population sample; (ii) evaluate the effects of menopause and hormone treatment (HT) on the sleep of the same cohort; and (iii) examine gender differences in sleep resilience towards external stressors. The participants were (i) 1324 subjects without sleep complaints, recruited from the general population of Central Pennsylvania that spent one night in the sleep laboratory and (ii) 66 young, healthy volunteers whose sleep was disturbed during night four by an external stressor, i.e. 24‐h blood drawing (average of nights 2 and 3 versus night 4). Women compared with men in the general population sample had significantly higher percentage of sleep time, lower percentage of stage 1, and higher percentage of slow wave sleep. Also, menopause, in the absence of HT, was associated with prolonged sleep latency and decreased deep sleep. Finally, young, healthy women compared with men experienced less sleep disturbance because of blood draws as indicated by a significantly smaller change in per cent sleep time, and percentage of stage 1 sleep. These findings suggest that women without sleep complaints sleep objectively better across age than men and the sleep of young women is more resistant to external stressors. Also, gonadal hormones exert a beneficial effect on women’s sleep. This gender dimorphism in sleep regulation may have been to protect women from the demands of infant and child care, and in part, might contribute to women’s lower cardiovascular risks and greater longevity.

[1]  K. Adam Sleep is changed by blood sampling through an indwelling venous catheter. , 1982, Sleep.

[2]  R. K. Watson,et al.  Evaluation and treatment of insomnia. , 1984, Connecticut medicine.

[3]  E. Bixler,et al.  Onset of Insomnia: Role of Life‐Stress Events1 , 1981, Psychosomatic medicine.

[4]  R. Thisted,et al.  Sleep and Psychiatric Disorders: A Meta-analysis , 1992 .

[5]  E. Wolpert A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[6]  P. Linkowski,et al.  Effects of intravenous catheter on sleep in healthy men and in depressed patients. , 1989, Sleep.

[7]  M. Kryger,et al.  Principles and Practice of Sleep Medicine , 1989 .

[8]  M. Scharf,et al.  Effects of estrogen replacement therapy on rates of cyclic alternating patterns and hot-flush events during sleep in postmenopausal women: a pilot study. , 1997, Clinical therapeutics.

[9]  F. Cirignotta,et al.  Some epidemiological data on snoring and cardiocirculatory disturbances. , 1980, Sleep.

[10]  Influences of Natural Menopause on Psychological Characteristics and Symptoms of Middle-Aged Healthy Women. , 1990 .

[11]  K. Matthews,et al.  Influences of natural menopause on psychological characteristics and symptoms of middle-aged healthy women. , 1990, Journal of consulting and clinical psychology.

[12]  E. Bixler,et al.  Prevalence of sleep-disordered breathing in women: effects of gender. , 2001, American journal of respiratory and critical care medicine.

[13]  T. Young,et al.  Hormone replacement therapy and sleep-disordered breathing. , 2003, American journal of respiratory and critical care medicine.

[14]  T. Young,et al.  Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study. , 2003, Sleep.

[15]  M. Vitiello,et al.  Estrogen replacement therapy moderates the sleep disruption associated with nocturnal blood sampling. , 2001, Sleep.

[16]  R. Hardy,et al.  Women's health in midlife: the influence of the menopause, social factors and health in earlier life , 1997, British journal of obstetrics and gynaecology.

[17]  M. Ohayon,et al.  Place of chronic insomnia in the course of depressive and anxiety disorders. , 2003, Journal of psychiatric research.

[18]  R. Stafford,et al.  Principles and Practice of Sleep Medicine , 2001 .

[19]  D J Kupfer,et al.  Effect of nocturnal intravenous cannulation upon sleep-EEG measures. , 1984, Biological psychiatry.

[20]  K. Ryan,et al.  Effects of estrogens on sleep and psychological state of hypogonadal women. , 1979, JAMA.

[21]  E. Bixler,et al.  Middle-aged men show higher sensitivity of sleep to the arousing effects of corticotropin-releasing hormone than young men: clinical implications. , 2001, The Journal of clinical endocrinology and metabolism.

[22]  T. Gislason,et al.  Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status? , 1997, Sleep.

[23]  R. Bootzin,et al.  Sleep and reported daytime sleepiness in normal subjects: the Sleep Heart Health Study. , 2004, Sleep.

[24]  T. Roth,et al.  Sex differences in the polysomnographic sleep of young adults: a community-based study. , 2006, Sleep medicine.

[25]  S. Borson,et al.  Objective sleep quality of healthy older men and women is differentially disrupted by nighttime periodic blood sampling via indwelling catheter. , 1996, Sleep.

[26]  C. Shapiro,et al.  ABC of sleep disorders. Impact and epidemiology of sleep disorders. , 1993, BMJ.

[27]  Valleyside Road,et al.  Objective , 1971 .

[28]  S. Weyerer,et al.  Prevalence and treatment of insomnia in the community: results from the Upper Bavarian Field Study. , 1991, Sleep.

[29]  E. Bixler,et al.  Effects of age on sleep apnea in men: I. Prevalence and severity. , 1998, American journal of respiratory and critical care medicine.

[30]  S. Redline,et al.  The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. , 2004, Archives of internal medicine.

[31]  E. Bixler,et al.  Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. , 2004, The Journal of clinical endocrinology and metabolism.

[32]  I. Oswald,et al.  Effect of oestrogen on the sleep, mood, and anxiety of menopausal women. , 1977, British medical journal.

[33]  C. Guilleminault,et al.  Prevalence of insomnia in a survey of 12 778 adults in France , 2000, Journal of sleep research.

[34]  P. Ganz,et al.  Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition * , 2003, Menopause.

[35]  G. B. Lopes,et al.  Effects of estrogen plus progestin on health-related quality of life. , 2004, The New England journal of medicine.

[36]  E. Bixler,et al.  Insomnia in central Pennsylvania. , 2002, Journal of psychosomatic research.