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Erschienen in: Current Psychiatry Reports 9/2018

01.09.2018 | Sex and Gender Issues in Behavioral Health (CN Epperson and L Hantsoo, Section Editors)

Sex Differences in Insomnia: from Epidemiology and Etiology to Intervention

verfasst von: Sooyeon Suh, Nayoung Cho, Jihui Zhang

Erschienen in: Current Psychiatry Reports | Ausgabe 9/2018

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Abstract

Purpose of Review

Insomnia is approximately 1.5 times more common in women than in men. To date, research has advanced our knowledge about why women report significantly more sleep problems than men despite not being reflected in objective sleep measures. Precisely understanding the symptomatology and pathological mechanisms underlying sex differences is important for prevention and providing appropriate interventions.

Recent Findings

Sex differences found in insomnia goes beyond simple explanations and have been proven to be a complicated interplay of biological, psychological, and social factors that play different roles throughout the life span.

Summary

This paper will review sex differences in insomnia based on risk factors, mechanisms, and consequences, as well as treatment response. In addition, we will also discuss treatment recommendations when working with female populations at different stages in the life span that may be more vulnerable to insomnia. Future studies utilizing prospective, longitudinal designs are needed to understand the interactions of various factors that can explain existing sex differences in insomnia.
Literatur
2.
7.
Zurück zum Zitat Wever RA. Sex differences in human circadian rhythms: intrinsic periods and sleep fractions. Experientia. 1984;40(11):1226–34.PubMedCrossRef Wever RA. Sex differences in human circadian rhythms: intrinsic periods and sleep fractions. Experientia. 1984;40(11):1226–34.PubMedCrossRef
8.
Zurück zum Zitat Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004;27(7):1255–73.PubMedCrossRef Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004;27(7):1255–73.PubMedCrossRef
11.
Zurück zum Zitat Fricke-Oerkermann L, Pluck J, Schredl M, Heinz K, Mitschke A, Wiater A, et al. Prevalence and course of sleep problems in childhood. Sleep. 2007;30(10):1371–7.PubMedPubMedCentralCrossRef Fricke-Oerkermann L, Pluck J, Schredl M, Heinz K, Mitschke A, Wiater A, et al. Prevalence and course of sleep problems in childhood. Sleep. 2007;30(10):1371–7.PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat • Blank M, Zhang J, Lamers F, Taylor AD, Hickie IB, Merikangas KR. Health correlates of insomnia symptoms and comorbid mental disorders in a nationally representative sample of US adolescents. Sleep. 2015;38(2):197–204. https://doi.org/10.5665/sleep.4396. Nationally representative sample to demonstrate sex differences in insomnia among US adolescents. PubMedPubMedCentralCrossRef • Blank M, Zhang J, Lamers F, Taylor AD, Hickie IB, Merikangas KR. Health correlates of insomnia symptoms and comorbid mental disorders in a nationally representative sample of US adolescents. Sleep. 2015;38(2):197–204. https://​doi.​org/​10.​5665/​sleep.​4396. Nationally representative sample to demonstrate sex differences in insomnia among US adolescents. PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat • Kische H, Ewert R, Fietze I, Gross S, Wallaschofski H, Volzke H, et al. Sex hormones and sleep in men and women from the general population: a cross-sectional observational study. J Clin Endocrinol Metab. 2016;101(11):3968–77. https://doi.org/10.1210/jc.2016-1832. Large-scale population-based study to show sex-specific associations between hormones and sleep parameters. PubMedCrossRef • Kische H, Ewert R, Fietze I, Gross S, Wallaschofski H, Volzke H, et al. Sex hormones and sleep in men and women from the general population: a cross-sectional observational study. J Clin Endocrinol Metab. 2016;101(11):3968–77. https://​doi.​org/​10.​1210/​jc.​2016-1832. Large-scale population-based study to show sex-specific associations between hormones and sleep parameters. PubMedCrossRef
28.
Zurück zum Zitat Guidozzi F. Gender differences in sleep in older men and women. Climacteric. 2015;18(5):715–21.PubMedCrossRef Guidozzi F. Gender differences in sleep in older men and women. Climacteric. 2015;18(5):715–21.PubMedCrossRef
29.
Zurück zum Zitat Reyner LA, Horne JA, Reyner A. Gender- and age-related differences in sleep determined by home-recorded sleep logs and actimetry from 400 adults. Sleep. 1995;18(2):127–34.PubMed Reyner LA, Horne JA, Reyner A. Gender- and age-related differences in sleep determined by home-recorded sleep logs and actimetry from 400 adults. Sleep. 1995;18(2):127–34.PubMed
30.
Zurück zum Zitat • Obayashi K, Saeki K, Tone N, Iwamoto J, Miyata K, Ikada Y, et al. Lower melatonin secretion in older females: gender differences independent of light exposure profiles. J Epidemiol. 2015;25(1):38–43. https://doi.org/10.2188/jea.JE20140035. Large-scale study to demonstrate older females had a lower overnight urinary 6-sulfatoxymelatonin excretion and older males, independent of light exposure PubMedCrossRef • Obayashi K, Saeki K, Tone N, Iwamoto J, Miyata K, Ikada Y, et al. Lower melatonin secretion in older females: gender differences independent of light exposure profiles. J Epidemiol. 2015;25(1):38–43. https://​doi.​org/​10.​2188/​jea.​JE20140035. Large-scale study to demonstrate older females had a lower overnight urinary 6-sulfatoxymelatonin excretion and older males, independent of light exposure PubMedCrossRef
35.
Zurück zum Zitat Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31(4):473–80.PubMedPubMedCentralCrossRef Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31(4):473–80.PubMedPubMedCentralCrossRef
39.
Zurück zum Zitat Li RH, Wing YK, Ho SC, Fong SY. Gender differences in insomnia—a study in the Hong Kong Chinese population. J Psychosom Res. 2002;53(1):601–9.PubMedCrossRef Li RH, Wing YK, Ho SC, Fong SY. Gender differences in insomnia—a study in the Hong Kong Chinese population. J Psychosom Res. 2002;53(1):601–9.PubMedCrossRef
41.
Zurück zum Zitat Fang J, Fishbein W. Sex differences in paradoxical sleep: influences of estrus cycle and ovariectomy. Brain Res. 1996;734(1–2):275–85.PubMedCrossRef Fang J, Fishbein W. Sex differences in paradoxical sleep: influences of estrus cycle and ovariectomy. Brain Res. 1996;734(1–2):275–85.PubMedCrossRef
42.
Zurück zum Zitat Bitran D, Purdy RH, Kellogg CK. Anxiolytic effect of progesterone is associated with increases in cortical allopregnanolone and GABAA receptor function. Pharmacol Biochem Behav. 1993;45(2):423–8.PubMedCrossRef Bitran D, Purdy RH, Kellogg CK. Anxiolytic effect of progesterone is associated with increases in cortical allopregnanolone and GABAA receptor function. Pharmacol Biochem Behav. 1993;45(2):423–8.PubMedCrossRef
49.
Zurück zum Zitat •• Zhang J, Lam SP, Li SX, Ma RC, Kong AP, Chan MH, et al. A community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: sex and pubertal influences. J Clin Endocrinol Metab. 2014;99(6):2277–87. https://doi.org/10.1210/jc.2013-3728. Community-based study to demonstrate the association of insomnia with increased cortisol awakening response, with some sex- and pubertal-specific effects. PubMedCrossRef •• Zhang J, Lam SP, Li SX, Ma RC, Kong AP, Chan MH, et al. A community-based study on the association between insomnia and hypothalamic-pituitary-adrenal axis: sex and pubertal influences. J Clin Endocrinol Metab. 2014;99(6):2277–87. https://​doi.​org/​10.​1210/​jc.​2013-3728. Community-based study to demonstrate the association of insomnia with increased cortisol awakening response, with some sex- and pubertal-specific effects. PubMedCrossRef
50.
Zurück zum Zitat Borbely AA. A two process model of sleep regulation. Hum Neurobiol. 1982;1(3):195–204.PubMed Borbely AA. A two process model of sleep regulation. Hum Neurobiol. 1982;1(3):195–204.PubMed
55.
Zurück zum Zitat Dijk DJ, Beersma DG, Bloem GM. Sex differences in the sleep EEG of young adults: visual scoring and spectral analysis. Sleep. 1989;12(6):500–7.PubMedCrossRef Dijk DJ, Beersma DG, Bloem GM. Sex differences in the sleep EEG of young adults: visual scoring and spectral analysis. Sleep. 1989;12(6):500–7.PubMedCrossRef
59.
Zurück zum Zitat Edinger JD, Stout AL, Hoelscher TJ. Cluster analysis of insomniacs’ MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosom Med. 1988;50(1):77–87.PubMedCrossRef Edinger JD, Stout AL, Hoelscher TJ. Cluster analysis of insomniacs’ MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosom Med. 1988;50(1):77–87.PubMedCrossRef
63.
Zurück zum Zitat Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996;39(6):411–8.PubMedCrossRef Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996;39(6):411–8.PubMedCrossRef
64.
Zurück zum Zitat Weissman MM, Greenwald S, Nino-Murcia G, Dement WC. The morbidity of insomnia uncomplicated by psychiatric disorders. Gen Hosp Psychiatry. 1997;19(4):245–50.PubMedCrossRef Weissman MM, Greenwald S, Nino-Murcia G, Dement WC. The morbidity of insomnia uncomplicated by psychiatric disorders. Gen Hosp Psychiatry. 1997;19(4):245–50.PubMedCrossRef
66.
Zurück zum Zitat Buysse DJ, Germain A, Hall ML, Moul DE, Nofzinger EA, Begley A, et al. EEG spectral analysis in primary insomnia: NREM period effects and sex differences. Sleep. 2008;31(12):1673–82.PubMedPubMedCentralCrossRef Buysse DJ, Germain A, Hall ML, Moul DE, Nofzinger EA, Begley A, et al. EEG spectral analysis in primary insomnia: NREM period effects and sex differences. Sleep. 2008;31(12):1673–82.PubMedPubMedCentralCrossRef
68.
Zurück zum Zitat Luyster FS, Buysse DJ, Strollo PJ Jr. Comorbid insomnia and obstructive sleep apnea: challenges for clinical practice and research. J Clin Sleep Med. 2010;6(2):196–204.PubMedPubMedCentral Luyster FS, Buysse DJ, Strollo PJ Jr. Comorbid insomnia and obstructive sleep apnea: challenges for clinical practice and research. J Clin Sleep Med. 2010;6(2):196–204.PubMedPubMedCentral
69.
Zurück zum Zitat Lichstein KL, Riedel BW, Lester KW, Aguillard RN. Occult sleep apnea in a recruited sample of older adults with insomnia. J Consult Clin Psychol. 1999;67(3):405–10.PubMedCrossRef Lichstein KL, Riedel BW, Lester KW, Aguillard RN. Occult sleep apnea in a recruited sample of older adults with insomnia. J Consult Clin Psychol. 1999;67(3):405–10.PubMedCrossRef
70.
Zurück zum Zitat Krakow B, Melendrez D, Ferreira E, Clark J, Warner TD, Sisley B, et al. Prevalence of insomnia symptoms in patients with sleep-disordered breathing. Chest. 2001;120(6):1923–9.PubMedCrossRef Krakow B, Melendrez D, Ferreira E, Clark J, Warner TD, Sisley B, et al. Prevalence of insomnia symptoms in patients with sleep-disordered breathing. Chest. 2001;120(6):1923–9.PubMedCrossRef
71.
Zurück zum Zitat Krakow B, Melendrez D, Sisley B, Warner TD, Krakow J, Leahigh L, et al. Nasal dilator strip therapy for chronic sleep-maintenance insomnia and symptoms of sleep-disordered breathing: a randomized controlled trial. Sleep & breathing = Schlaf & Atmung. 2006;10(1):16–28. https://doi.org/10.1007/s11325-005-0037-7.CrossRef Krakow B, Melendrez D, Sisley B, Warner TD, Krakow J, Leahigh L, et al. Nasal dilator strip therapy for chronic sleep-maintenance insomnia and symptoms of sleep-disordered breathing: a randomized controlled trial. Sleep & breathing = Schlaf & Atmung. 2006;10(1):16–28. https://​doi.​org/​10.​1007/​s11325-005-0037-7.CrossRef
78.
Zurück zum Zitat •• Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive behavioral therapy for insomnia comorbid with psychiatric and medical conditions: a meta-analysis. JAMA Intern Med. 2015;175(9):1461–72. https://doi.org/10.1001/jamainternmed.2015.3006. A meta-analysis demonstrating the effectiveness of Cognitive Behavioral Therapy for Insomnia in comorbidity of insomnia with psychiatric and medical conditions. PubMedCrossRef •• Wu JQ, Appleman ER, Salazar RD, Ong JC. Cognitive behavioral therapy for insomnia comorbid with psychiatric and medical conditions: a meta-analysis. JAMA Intern Med. 2015;175(9):1461–72. https://​doi.​org/​10.​1001/​jamainternmed.​2015.​3006. A meta-analysis demonstrating the effectiveness of Cognitive Behavioral Therapy for Insomnia in comorbidity of insomnia with psychiatric and medical conditions. PubMedCrossRef
81.
Zurück zum Zitat Smith MT, Edwards RR, McCann UD, Haythornthwaite JA. The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep. 2007;30(4):494–505.PubMedCrossRef Smith MT, Edwards RR, McCann UD, Haythornthwaite JA. The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep. 2007;30(4):494–505.PubMedCrossRef
82.
Zurück zum Zitat Miller MA, Kandala NB, Kivimaki M, Kumari M, Brunner EJ, Lowe GD, et al. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep. 2009;32(7):857–64.PubMedPubMedCentral Miller MA, Kandala NB, Kivimaki M, Kumari M, Brunner EJ, Lowe GD, et al. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep. 2009;32(7):857–64.PubMedPubMedCentral
84.
Zurück zum Zitat Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II study. Hypertension. 2007;50(4):693–700.PubMedPubMedCentralCrossRef Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II study. Hypertension. 2007;50(4):693–700.PubMedPubMedCentralCrossRef
85.
Zurück zum Zitat Stranges S, Dorn JM, Cappuccio FP, Donahue RP, Rafalson LB, Hovey KM, et al. A population-based study of reduced sleep duration and hypertension: the strongest association may be in premenopausal women. J Hypertens. 2010;28(5):896–902.PubMedCrossRef Stranges S, Dorn JM, Cappuccio FP, Donahue RP, Rafalson LB, Hovey KM, et al. A population-based study of reduced sleep duration and hypertension: the strongest association may be in premenopausal women. J Hypertens. 2010;28(5):896–902.PubMedCrossRef
86.
Zurück zum Zitat Mallon L, Broman JE, Hetta J. High incidence of diabetes in men with sleep complaints or short sleep duration: a 12-year follow-up study of a middle-aged population. Diabetes Care. 2005;28(11):2762–7.PubMedCrossRef Mallon L, Broman JE, Hetta J. High incidence of diabetes in men with sleep complaints or short sleep duration: a 12-year follow-up study of a middle-aged population. Diabetes Care. 2005;28(11):2762–7.PubMedCrossRef
88.
Zurück zum Zitat Greenblatt DJ, Harmatz JS, von Moltke LL, Wright CE, Durol AL, Harrel-Joseph LM, et al. Comparative kinetics and response to the benzodiazepine agonists triazolam and zolpidem: evaluation of sex-dependent differences. J Pharmacol Exp Ther. 2000;293(2):435–43.PubMed Greenblatt DJ, Harmatz JS, von Moltke LL, Wright CE, Durol AL, Harrel-Joseph LM, et al. Comparative kinetics and response to the benzodiazepine agonists triazolam and zolpidem: evaluation of sex-dependent differences. J Pharmacol Exp Ther. 2000;293(2):435–43.PubMed
94.
Zurück zum Zitat Cincotta AL, Gehrman P, Gooneratne NS, Baime MJ. The effects of a mindfulness-based stress reduction programme on pre-sleep cognitive arousal and insomnia symptoms: a pilot study. Stress Health. 2011;27(3) Cincotta AL, Gehrman P, Gooneratne NS, Baime MJ. The effects of a mindfulness-based stress reduction programme on pre-sleep cognitive arousal and insomnia symptoms: a pilot study. Stress Health. 2011;27(3)
95.
Zurück zum Zitat Currie SR, Wilson KG, Curran D. Clinical significance and predictors of treatment response to cognitive-behavior therapy for insomnia secondary to chronic pain. J Behav Med. 2002;25(2):135–53.PubMedCrossRef Currie SR, Wilson KG, Curran D. Clinical significance and predictors of treatment response to cognitive-behavior therapy for insomnia secondary to chronic pain. J Behav Med. 2002;25(2):135–53.PubMedCrossRef
96.
Zurück zum Zitat Espie CA, Inglis SJ, Harvey L. Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analysis of outcome data at 12 months posttreatment. J Consult Clin Psychol. 2001;69(1):58–66.PubMedCrossRef Espie CA, Inglis SJ, Harvey L. Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analysis of outcome data at 12 months posttreatment. J Consult Clin Psychol. 2001;69(1):58–66.PubMedCrossRef
97.
Zurück zum Zitat Espie CA, Inglis SJ, Tessier S, Harvey L. The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behav Res Ther. 2001;39(1):45–60.PubMedCrossRef Espie CA, Inglis SJ, Tessier S, Harvey L. The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behav Res Ther. 2001;39(1):45–60.PubMedCrossRef
98.
Zurück zum Zitat Gagné A, Morin CM. Predicting treatment response in older adults with insomnia. J Clin Geropsychology. 2001;7(2):131–43.CrossRef Gagné A, Morin CM. Predicting treatment response in older adults with insomnia. J Clin Geropsychology. 2001;7(2):131–43.CrossRef
99.
103.
Zurück zum Zitat Verbeek I, Schreuder K, Declerck G. Evaluation of short-term nonpharmacological treatment of insomnia in a clinical setting. J Psychosom Res. 1999;47(4):369–83.PubMedCrossRef Verbeek I, Schreuder K, Declerck G. Evaluation of short-term nonpharmacological treatment of insomnia in a clinical setting. J Psychosom Res. 1999;47(4):369–83.PubMedCrossRef
109.
110.
Zurück zum Zitat Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A, American Academy of Sleep M. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29(10):1263–76.PubMed Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A, American Academy of Sleep M. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29(10):1263–76.PubMed
111.
Zurück zum Zitat Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause. 2003;10(1):19–28.PubMed Kravitz HM, Ganz PA, Bromberger J, Powell LH, Sutton-Tyrrell K, Meyer PM. Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause. 2003;10(1):19–28.PubMed
Metadaten
Titel
Sex Differences in Insomnia: from Epidemiology and Etiology to Intervention
verfasst von
Sooyeon Suh
Nayoung Cho
Jihui Zhang
Publikationsdatum
01.09.2018
Verlag
Springer US
Erschienen in
Current Psychiatry Reports / Ausgabe 9/2018
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-018-0940-9

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