Purpose of review
To evaluate recent evidence regarding gender differences in sleep.
Women have better sleep quality compared with men, with longer sleep times, shorter sleep-onset latency and higher sleep efficiency. Despite this, women have more sleep-related complaints than men. The amount of slow-wave sleep decreases with age in men and women. Normal physiologic periods, including puberty, menstruation, pregnancy, and menopause, are associated with alterations in sleep patterns.
Gender differences in normal sleep may underlie the observed differences in risk of sleep disorders. Studies of insomnia support a female predominance, with increased divergence of prevalence between men and women with older age. Recent findings for the gender differences in obstructive sleep apnea have focused on differences in local neuromuscular reflexes and central ventilatory control. Restless legs syndrome has a slight female predominance, whereas rapid eye movement sleep behavior disorder and Kleine–Levin syndrome are more common in men.
Gender differences in sleep become apparent after the onset of puberty. Menstrual cycles, pregnancy, and menopause can alter sleep architecture. Gender-related differences in sleep disorders, such as obstructive sleep apnea, insomnia, and restless legs syndrome, include differences in prevalence, pathophysiology, clinical presentation, and response to therapy.