Abstract
Sexual hormones deeply influence the physiology of human sleep and alertness across the different phases of the female reproductive cycle. Estrogen has a REM-wake promoting effect which proves important for the female cognitive and mood profile, whereas progesterone mediates sedation by increasing NREM sleep and muscle relaxation. It also impacts blood gasses response during sleep and nocturnal ventilation. Women of increasing age are more likely than men to suffer from insomnia and depressive disorders. Daytime fatigue and excessive sleepiness occur more frequently in women with specific sleep disorders such as obstructive sleep apnea (OSA) and restless leg syndrome/Willis-Ekbom Disease (RLS/WED), to which women appear more prone during both pregnancy and menopause. The impact of OSA and RLS/WED on quality of life and health via induced hypertension and cardiovascular and metabolic risk increases the negative effects of poor sleep on general wellbeing. The load of organic and psychiatric co-morbid disorders associated with altered sleep is greater in women than in men, with a detrimental effect also on gender-specific therapeutic response which is less satisfactory and efficient in women compared to their male counterparts.
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Terán-Pérez G, Arana-Lechuga Y, Esqueda-León E et al (2012) Steroid hormones and sleep regulation. Mini Rev Med Chem 12:1040–1048
Van Cauter E, Spiegel K, Tasali E et al (2008) Metabolic consequences of sleep and sleep loss. Sleep Med 9:S23–S28
Lamarche LJ, Driver HS, Wiebe S et al (2007) Nocturnal sleep, daytime sleepiness, and napping among women with significant emotional/behavioral premenstrual symptoms. Sleep Res 16:262–268
Vgontzas AN, Legro RS, Bixler EO et al (2001) Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 86:517–520
Lin CM, Davidson TM, Ancoli-Israel S (2008) Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 12:481–496
Macnutt MJ, De Souza MJ, Tomczak SE et al (2012) Resting and exercise ventilatory chemosensitivity across the menstrual cycle. J Appl Physiol 112:737–747
Edwards N, Wilcox I, Sullivan CE (1998) Sleep apnoea in women. Thorax 53:S12–S15
Franklin KA, Holmgren PA, Jönsson F et al (2000) Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest 117:137–141
Edwards N, Blyton DM, Kirjavainen T et al (2000) Nasal continuous positive airway pressure reduces sleep-induced blood pressure increments in preeclampsia. Am J Respir Crit Care Med 162:252–257
Guilleminault C, Palombini L, Poyares D et al (2007) Pre-eclampsia and nasal CPAP: part 1. Early intervention with nasal CPAP in pregnant women with risk-factors for pre-eclampsia: preliminary findings. Sleep Med 9:9–14
Valipour A, Lothaller H, Rauscher H et al (2007) Gender-related differences in symptoms of patients with suspected breathing disorders in sleep: a clinical population study using the sleep disorders questionnaire. Sleep 30:312–319
Manconi M, Govoni V, De Vito A et al (2004) Pregnancy as a risk factor for restless legs syndrome. Sleep Med 5:305–308
Berger K, Luedemann J, Trenkwalder C et al (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164:196–202
Manconi M, Govoni V, De Vito A et al (2004) Restless legs syndrome and pregnancy. Neurology 63:1065–1069
Earley CJ, Kuwabara H, Wong DF et al (2013) Increased synaptic dopamine in the putamen in restless legs syndrome. Sleep 36:51–57
Allen RP, Barker PB, Horská A et al (2013) Thalamic glutamate/glutamine in restless legs syndrome: increased and related to disturbed sleep. Neurology 80:2028–2034
Rizzo G, Manners D, Testa C et al (2013) Low brain iron content in idiopathic restless legs syndrome patients detected by phase imaging. Mov Disord. doi:10.1002/mds.25576
Pennestri MH, Montplaisir J, Colombo R et al (2007) Nocturnal blood pressure changes in patients with restless legs syndrome. Neurology 68:1213–1218
Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32:589–597
Dzaja A, Wehrle R, Lancel M et al (2009) Elevated estradiol plasma levels in women with restless legs during pregnancy. Sleep 32:169–174
Manconi M, Ulfberg J, Berger K et al (2012) When gender matters: restless legs syndrome. Report of the “RLS and woman” workshop endorsed by the European RLS study group. Sleep Med Rev 16:297–307
Nagandla K, De S (2013) Restless legs syndrome: pathophysiology and modern management. Postgrad Med J 89:402–410
Ohayon MM (2006) Severe hot flashes are associated with chronic insomnia. Arch Intern Med 166:1262–1268
Xu M, Bélanger L, Ivers H et al (2011) Comparison of subjective and objective sleep quality in menopausal and non-menopausal women with insomnia. Sleep Med 12:65–69
Koo BB, Patel SR, Strohl K et al (2008) Rapid eye movement-related sleep-disordered breathing: influence of age and gender. Chest 134:1156–1161
Bixler EO, Vgontzas AN, Lin HM et al (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163:608–613
Manber R, Kuo TF, Cataldo N et al (2003) The effects of hormone replacement therapy on sleep-disordered breathing in postmenopausal women: a pilot study. Sleep 26:163–168
Cistulli PA, Barnes DJ, Grunstein RR et al (1994) Effect of short term hormone replacement in the treatment of obstructive sleep apnoea in postmenopausal women. Thorax 49:699–702
Greenberg-Dotan S, Reuveni H, Simon-Tuval T et al (2007) Gender differences in morbidity and health care utilization among adult obstructive sleep apnea patients. Sleep 30:1173–1180
Morrish E, Shneerson JM, Smith IE (2008) Why does gender influence survival in obstructive sleep apnoea? Respir Med 102:1231–1236
Silvestri R, Aricò I, Vita G et al. (2010) Hypertension in peri- and post-menopausal women is related to sleep quality and mood alteration. In: Paper presented at the XII congress of the European federation of autonomic societies (EFAS), Giardini Naxos
Silvestri R (2012) RLS and psychiatric co-morbidity: our center’s experience on prevalence, symptoms and interaction with psychotropic drugs. In: Paper presented at the annual European RLS study group, Munich
Ehlers CL, Kupfer DJ (1997) Slow-wave sleep: do young adult men and women age differently? J Sleep Res 6:211–215
Münch M, Cajochen C, Wirz-Justice A (2005) Sleep and circadian rhythms in ageing. Z Gerontol Geriatr 38:I21–I23
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Silvestri, R.C. (2014). Endocrine Brain: Gender Differences. In: Garbarino, S., Nobili, L., Costa, G. (eds) Sleepiness and Human Impact Assessment. Springer, Milano. https://doi.org/10.1007/978-88-470-5388-5_11
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DOI: https://doi.org/10.1007/978-88-470-5388-5_11
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