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Canadian survey (2011): 1 Insomnia criteria met by 15.6% of women and 11.0% of men (odds ratio 1.5) French study (2000): 2 Insomnia prevalence was 63 % higher in women than in men (22.8% vs. 14%; P < 0.0001)
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Canadian survey (2011):1 Insomnia criteria met by 15.6% of women and 11.0% of men (odds ratio 1.5) • French study (2000):2 Insomnia prevalence was 63% higher in women than in men (22.8% vs. 14%; P < 0.0001) • U.S. Penn State Sleep Cohort (2012):3 Incidence of insomnia in women (12.9%) more than twice that in men (6.2%) • Meta-analysis (2006):4 relative risk ratio for insomnia of 1.41 for women compared with men Insomnia is More Prevalent in Women than in Men 1.Morin CM et al. Can J Psychiatry. 2011;56(9):540-548. 2. Leger D et al. J Sleep Res. 2000;9(1):35-42. 3. Singareddy R et al. Sleep Med. 2012;13(4):346-353. 4. Zhang B, Wing Y-K. Sleep. 2006;29(1):85-93.
Relative risk for the development of insomnia* • Young adults (15–30 years) 1.28 • Middle-aged (31–64 years) 1.46 • Elderly (≥65 years) 1.73 • Increased incidence occurs long before menopause Significant Increase in Risk with Age * Compared with men Zhang B, Wing Y-K. Sleep. 2006;29(1):85-93.
Mood disorders1-4 • Family and social roles • Hyperarousal5 • Circadian influences: phase6,7 and period8 • Body mass and sleep duration9-11 Factors Contributing to thePredominance of Insomnia in Women 1. Hartz A et al. Sleep Med. 2012 Oct 4. [Epub ahead of print] 2. Singareddy R et al. Sleep Med. 2012;13(4):346-353. 3. Salo P et al. Sleep Med. 2012;13(3):278-284. 4. Baglioni C et al. SleepMedRev. 2010;14(4):227-238. 5. Bonnet MH, Arand DL. Sleep MedRev. 2010;14(1):9-15. 6. Mongrain V et al. J Biol Rhythms. 2004;19(3):248-257. 7. Cain SW et al. J Biol Rhythms. 2010;25(4):288-296. 8. Duffy JFet al. ProcNatlAcadSci U S A. 2011;108(suppl.3):15602–15608. 9. Lallukka T Sleep Med. 2012 Jul 24. [Epub ahead of print] 10. Vgontzas AN Sleep MedClin. 2009;4(1):65-75. 11. Fernandez-Mendoza J et al. Sleep. 2012;35(5):689-697.
Women: • Generally sleep for longer periods • Sleep time per night: 7.0 hrs (women), 6 hrs42 mins (men)1 • Have a higher subjective sleep need • Are ”larks” and morning-types • Typically self-select earlier bedtimes2,3 • Are more likely to have shorter intrinsic circadian period4 General Sleep Comparisons BetweenWomen and Men 1. National Sleep Foundation. 2002 “Sleep in America” Poll. 2. Mongrain V et al. J Biol Rhythms. 2004;19(3):248-257. 3. Cain SW et al. J Biol Rhythms. 2010;25(4):288-296. 4. Duffy JF et al. ProcNatlAcadSci U S A. 2011;108(suppl.3):15602–15608.
Menstrual cycle1,2 • Pregnancy2,3 • Menopause4-7 • Hormone replacement and alternative therapy6 Hormonal Influences Baker FC, Driver HS. J Psychosom Res. 2004;56(2):239-243. Parry BL et al. Sleep MedRev. 2006;10(2):129-144. Sloan EP. Sleep Med Clin. 2008;3(1):73-80. KravitzHM et al. Arch Intern Med. 2005;165(20):2370-2376. KravitzHM et al. Menopause. 2003;10(1):19-28. Polo-Kantola P. SleepMed Clin. 2008;3(1):121-131. Pien GW et al. Sleep. 2008;31(7):991-999.
Regular sleep/rise routine Dark bedroom Avoid the supine position if pregnant, overweight/obese, prone to snoring/OSA, and for comfort Snoring and OSA should be assessed and treated Avoid caffeine, especially after midday Practical Strategies to Improve Sleep OSA = obstructive sleep apnea
Assess and treat restless leg syndrome • Smoking cessation • Practice exercises such as yoga • Management options: • Cognitive behavioural therapy • Benzodiazepine receptor agonists (short-term or intermittent use) Practical Strategies to Improve Sleep (cont.)
