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Review
. 2024 Mar 13;60(3):474.
doi: 10.3390/medicina60030474.

Sex Differences in Insomnia and Circadian Rhythm Disorders: A Systematic Review

Affiliations
Review

Sex Differences in Insomnia and Circadian Rhythm Disorders: A Systematic Review

Evelina Pajėdienė et al. Medicina (Kaunas). .

Abstract

Insomnia and circadian rhythm disorders are increasingly common in modern society and lead to significant challenges for people's health and well-being. Some studies suggests that men and women differ in neurohormonal secretion, biological processes, and brain morphology. Thus, such differences may affect the etiology, manifestation, and course of sleep disorders, including insomnia and circadian rhythm. This systematic review aims to synthesize the existing literature on sex differences in insomnia and circadian rhythm disorders. PubMed, MEDLINE, Epistemonikos, and Cochrane databases were searched for articles published from inception until 5 September 2023, not older than five years. We performed a systematic search using MESH and non-MESH queries: (sex differences) or (male and female differences) or (men and women differences) or (men and women) AND (insomnia) or (sleep wake disorder*) or (sleep wake rhythm disorder*) or (circadian rhythm disorder*) or (sleep cycle disruption) or (sleep cycle disorder*). Out off 2833 articles screened, 11 studies were included. The prevalence of insomnia is higher among women, and their sleep is more regular and stable compared to men. Studies evaluating the impact of the stressful situation associated with the lockdown on women's and men's insomnia present discordant results concerning sex differences. Women's circadian rhythm was found to be more stable and less fragmented than men's. However, the progression of peak activity time with age was more pronounced in men. The current literature suggests that risk factors for insomnia and circadian rhythm disorders affect men and women differently. These include cerebrovascular and cardiometabolic factors, shift work, and infections. The long-term effects of insomnia seem to be more relevant for the male sex, shortening lifespan more than in women. By summarizing and analyzing existing studies, we highlight the need for further research to improve understanding of the interaction between sex and sleep.

Keywords: circadian rhythm disorders; insomnia; sex differences.

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Conflict of interest statement

The authors declare that there are no conflicts of interest associated with the conduct and reporting of this systematic review.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for the identification of the studies included in the systematic review.
Figure 2
Figure 2
Risk of bias in cohort studies: [19,21,22]. (A) Traffic light plot of the summary of the authors’ judgments about risk of bias items for each included cohort study. (B) Risk-of-bias graph: The authors’ judgments regarding each risk-of-bias item presented as percentages across all included studies. (C) Risk-of-bias graph: summary of the total percentage assessment of all risk of bias elements for each study separately.
Figure 3
Figure 3
Risk of bias in cross-sectional studies: [14,15,16,17,18,20,23,24]. (A) Traffic light plot of the summary of the authors’ judg-ments regarding each risk-of-bias item for each included study. (B) Risk-of-bias graph: The authors judgments regarding each risk-of-bias item presented as percentages across all included studies.

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References

    1. Buysse D.J. Insomnia. JAMA. 2013;309:706–716. doi: 10.1001/jama.2013.193. - DOI - PMC - PubMed
    1. Knutson K.L., Van Cauter E., Rathouz P.J., DeLeire T., Lauderdale D.S. Trends in the prevalence of short sleepers in the USA: 1975-2006. Sleep. 2010;33:37–45. doi: 10.1093/sleep/33.1.37. - DOI - PMC - PubMed
    1. Perlis M.L., Posner D., Riemann D., Bastien C.H., Teel J., Thase M. Insomnia. Lancet. 2022;400:1047–1060. doi: 10.1016/S0140-6736(22)00879-0. - DOI - PubMed
    1. Kim J.H., Elkhadem A.R., Duffy J.F. Circadian Rhythm Sleep-Wake Disorders in Older Adults. Sleep Med. Clin. 2022;17:241–252. doi: 10.1016/j.jsmc.2022.02.003. - DOI - PMC - PubMed
    1. Sarber K.M., Lam D.J., Ishman S.L. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; Amsterdam, The Netherlands: 2021. Sleep Apnea and Sleep Disorders; pp. 215–235.

Grants and funding

This research received no external funding.

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