Back in 2020, Front Psychiatry published a paper that explored gender difference in the prevalence of insomnia, with the outcome that insomnia is more common in females than in males.
In this blog, Dr Lindsay Browning explores why this finding may be and how people born female can help to prevent and reduce the possibility of suffering from insomnia.
What did the study Gender Difference in the Prevalence of Insomnia find?
The Study by Zeng et al comprised meta-analysis of 13 articles. From their research, they suggested that “the pooled prevalence of insomnia in the general population was 22.0%….and females had a significantly higher prevalence of insomnia compared with males”.
The conclusion was that:
“Due to the negative effects of insomnia on health, regular screening, and effective interventions should be implemented in the general population particularly for females.”
As a sleep therapist, I found this conclusion interesting in consideration of how I help women, and I also wanted to explore why insomnia is more prevalent in women. However, it is also worth noting that this is the conclusion of one study and the research is not extensive. Apart from biological differences in women and men causing sleeping issues, the increased prevalence of stress related insomnia in women is not completely understood. More research is needed to understand why this difference exists and how we can best manage it.
Why do more women suffer from insomnia than men?
When reviewing the findings of the article, it’s interesting to consider why.
It is possibly due to that fact that women have gender specific characteristics that may contribute to a greater risk of insomnia.
People born female experience more hormonal fluctuations during their lifetime that people born male do not, for example, through their monthly menstrual cycle, during pregnancy and menopause. These fluctuations in hormone levels have been directly linked to sleeping problems.
Women’s increased insomnia risk, therefore, begins around the time women first go through puberty.
Pregnancy can also be a difficult time for getting a good night’s sleep. Not only can it be difficult to find a comfortable position, but also restless leg syndrome (RLS) is more common in women than in men, and especially during pregnancy. RLS is where someone feels the urge to move or rub their legs as they are falling asleep, making it harder to actually go to sleep.
In addition, women tend to be at a higher risk of mental health issues (such as depression and anxiety) which are linked to an increase in insomnia. Furthermore, those who take on a societally gender female role may experience greater stress as they tend to take on a larger share of caregiving responsibilities (both of their children and ageing parents).
What’s the difference between insomnia and a little trouble sleeping?
If someone takes more than 30 minutes to fall asleep, is awake for more than 30 minutes during the night, or wakes more than 30 minutes before their alarm and feels unrefreshed the next day, this is called insomnia.
To count as chronic insomnia, these issues must happen at least three times per week and have been happening for at least 3 months. If you are struggling to fall asleep or stay asleep and it is affecting your ability to function during the day, this is likely to be insomnia and should be taken seriously.
How can women reduce the risk of experiencing insomnia?
For women, insomnia is especially common during menopause when hormones can fluctuate wildly. In order to minimise the hormonal causes of insomnia, Hormone Replacement Therapy (HRT) can be a good solution for some women, if it is appropriate.
Also, improving your bedroom environment during menopause can also help – such as sleeping in moisture wicking natural fibres, keeping the room cool and using a water mist to help minimise night sweats.
In younger women, who are experiencing a monthly pattern to their insomnia, it may be worth speaking to your GP to see if there is anything that can be done to level out your hormones.
For both males and females, if your insomnia is stress linked, then it is important to identify areas in your life that are causing excess stress and try to reduce the stress, where possible.
It is also important to have general good sleep hygiene in place if your sleep is poor, such as increasing exercise levels during the day, avoiding caffeine near to bedtime and ensuring a wind-down time before bed. Also, if your mattress is uncomfortable or your room is too hot or too cold this can also negatively affect your sleep. So, do ensure you have a good bedroom environment too.
Getting help with insomnia
If your insomnia is particularly severe or your sleep problems have been going on for a long time, then good sleep hygiene alone is unlikely to help.
In this case, CBT-I (cognitive behavioural therapy for insomnia) is the NHS recommended treatment for insomnia. You should also speak to your GP to see if there are any other medical issues affecting your sleep, which may also need to be addressed too.