Differences Between Men’s and Women’s Sleep

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Do women need more sleep than men? Theories about sleep for men versus women abound, and many wonder what the science says. Research has shown that sex and gender differences do influence sleep. Hormones, anatomy, and other physiological differences between men and women can affect the way they sleep and the likelihood of experiencing certain sleep problems.

Women and men also face different societal and familial expectations, with corresponding demands on time and mental energy. Although sleep patterns are influenced by a myriad of factors, it's helpful to know how sex and gender may play a role.

Men Spend Less Time in Deep Sleep

Women tend to sleep for longer (1) and spend more time in the restorative deep sleep stage compared to men. Differences in sleep quality become more marked starting between age 30 and 40 (2), when men start to spend progressively less time in deep sleep and rapid eye movement (REM) sleep. In turn, menopause (3) brings changes for many women, who spend less time in deep sleep and take longer to fall asleep.

Women Are More Likely to Report Sleep Problems

Despite obtaining better-quality sleep as measured by objective instruments, women are more likely to report having sleep problems, and they are approximately 40% more likely to have insomnia. Women suffer disproportionately from overactive bladder syndrome (4), which can cause frequent bathroom trips, disrupted sleep, and even chronic insomnia. Changes throughout a woman's reproductive cycle may also contribute to poor sleep quality.

The Female Reproductive Cycle Contributes to Sleep Problems

Sleep problems related to cramps, bloating, and headaches plague an estimated one-third of women before or during their period. Discomfort, frequent nighttime bathroom trips, fetal movements, and certain sleep disorders like restless legs syndrome and obstructive sleep apnea can interfere with women's sleep during pregnancy, especially in the third trimester. Night sweats (5), fluctuating hormone levels, and other changes connected to menopause can also raise the risk of sleep disturbances and sleep disorders.

Men May Be More Vulnerable to Sleep Disturbances

One study found that external stressors during sleep exerted a stronger negative effect on men's sleep quality compared to women's. Some researchers have proposed that women may have evolved to better manage the stress of sleep disturbances because they needed to stay alert to watch over the children.

For men, excessively high or low testosterone (6) levels might also influence sleep.

Women Have a Shorter Circadian Rhythm

On average, women have a circadian rhythm that is about six minutes shorter (7) than men's. The circadian rhythm is responsible for keeping the sleep-wake cycle anchored to environmental cues for day and night. Due to their slightly shorter cycle, women are naturally inclined to fall asleep and wake up earlier, and they are more likely to identify as morning people. When women stay up later than their biological clock would have liked, they may have trouble getting a full night’s sleep, as their body tells them to wake up earlier.

Societal Gender Expectations Influence the Sleep-Wake Cycle

Women get an average of 11 minutes more sleep (8) between naps and nighttime sleep, but this number can vary from five minutes to almost half an hour depending on their age, their relationship status, whether they have children, and whether they work.

Men have traditionally faced more societal pressure to seek paid employment, with rigid schedules that may leave less time for sleep. On the other hand, mothers are more often expected to wake up during the night to breastfeed (9) or take care of the children. These mothers may suffer disrupted sleep, and compensate by taking naps during the day. Women are also more likely to be informal caregivers, which causes stress and affects sleep as well.

Of course, every situation is different, and more research must be done to see how increasing numbers of women in the workforce and changing family dynamics affect sleep for all genders.

Women Are More Likely to Have Insomnia

Women are more likely to have insomnia (10), which often goes hand-in-hand with anxiety, depression, and chronic diseases. For some women, insomnia may be a secondary effect of anxiety and depression as these mood disorders are also more commonly diagnosed in women. Studies have shown that women with depression sleep better than men with depression, suggesting that women generally have a stronger sleep drive.

Men Are More Likely to Have Obstructive Sleep Apnea

Men are more likely to be diagnosed with obstructive sleep apnea (11), a sleep disorder that causes fragmented sleep due to lapses in breathing. Researchers have long attributed this difference in part to hormones and anatomical differences in the airway (12). However, sleep apnea may be more common in women than previously thought. Snoring (13) occurs in comparable levels among women and men, but women may be less likely to be diagnosed with sleep apnea because they experience and report their symptoms differently.

Women Are More Likely to Have Restless Legs Syndrome

Changing iron and estrogen levels in pregnancy and menopause leave women at a higher risk of developing restless legs syndrome (14), a sleep disorder that causes difficulty sleeping due to an irresistible urge to move the legs. Individuals with restless legs syndrome also have a higher risk of suffering from migraines, depression, and anxiety, and all of these conditions are more common in women. That said, certain antidepressants (15) are connected with restless legs syndrome in men, but not in women.

Sleep Deprivation May Affect Men and Women Differently

Studies on the effects of sleep deprivation in men versus women are inconclusive. One study found that women gain greater benefits than men from recovery sleep (16) after sleep deprivation. However, due to differences in their circadian rhythm, women may have a tougher time adjusting to nonstandard shift work (17). Research also suggests that women may be at a greater risk for high blood pressure after sleep deprivation, especially after menopause (18).

Sleep Medications Work Differently for Men and Women

Recent studies have discovered that women may metabolize sleep medications differently than men. The Food and Drug Administration (FDA) now requires manufacturers to state a lower recommended dose of zolpidem (19) for women because the drug takes longer to clear their systems. More research is needed to understand whether metabolism differences in men versus women could extend to other sleep medications.

Additionally, treating women for sleep disorders is often more complicated than treating men because doctors must consider whether medication may harm a developing fetus, pass into a mother's breast milk, or interact with birth control medication. Because of these considerations, sleep medication may not be an option for many women.

Alcohol and Tobacco Use May Disproportionately Affect Men's Sleep

Statistically, men are more likely to drink excessive amounts of alcohol (20). They are also slightly more likely to smoke cigarettes (21). Tobacco (22) and alcohol (23) are both associated with poor sleep.

More research needs to be done on women and sleep, as research has traditionally focused on men. However, it's encouraging to see that researchers are devoting increased attention to sleep differences for people of different sexes and genders. A clearer understanding of these issues may help illuminate the best ways to approach treatment for sleep problems in each individual.

References

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  20. 20. Accessed on March 29, 2021.https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm
  21. 21. Accessed on March 29, 2021.https://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm?s_cid=osh-stu-home-spotlight-001
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