Gender differences in insomnia—a study in the Hong Kong Chinese population

Li, R.H.Y; Wing, Yun Kwok; Ho, Suzanne C.; Fong, SW

doi:10.1016/s0022-3999(02)00437-3

Cited by 229 publications

(207 citation statements)

References 34 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…An advance in the drive for alertness may conceivably explain the higher prevalence of difficulty maintaining sleep (19,20) and early-morning awakenings (20) reported in women vs. men. Additionally, we currently report that the amplitude of the variation was significantly increased in women vs. men due to a larger decline of alertness scores at night.…”

Section: Discussionmentioning

confidence: 99%

Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women

Boivin

Shechter

Boudreau

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

This study quantifies sex differences in the diurnal and circadian variation of sleep and waking while controlling for menstrual cycle phase and hormonal contraceptive use. We compared the diurnal and circadian variation of sleep and alertness of 8 women studied during two phases of the menstrual cycle and 3 women studied during their midfollicular phase with that of 15 men. Participants underwent an ultradian sleep-wake cycle (USW) procedure consisting of 36 cycles of 60-min wake episodes alternating with 60-min nap opportunities. Core body temperature (CBT), salivary melatonin, subjective alertness, and polysomnographically recorded sleep were measured throughout this procedure. All analyzed measures showed a significant diurnal and circadian variation throughout the USW procedure. Compared with men, women demonstrated a significant phase advance of the CBT but not melatonin rhythms, as well as an advance in the diurnal and circadian variation of sleep measures and subjective alertness. Furthermore, women experienced an increased amplitude of the diurnal and circadian variation of alertness, mainly due to a larger decline in the nocturnal nadir. Our results indicate that women are likely initiating sleep at a later circadian phase than men, which may be one factor contributing to the increased susceptibility to sleep disturbances reported in women. Lower nighttime alertness is also observed, suggesting a physiological basis for a greater susceptibility to maladaptation to night shift work in women.sex difference | circadian variation of sleep | circadian variation of alertness | core body temperature | melatonin A meta-analysis has indicated an overall increased risk ratio of 1.41 in women vs. men for experiencing insomnia, and this risk ratio increases to 1.64 when considering high-quality studies with rigorous methodology (1). The etiology of sex-based differences in vulnerability to sleep disturbances remains to be fully elucidated, but evidence points to a role for sex-based differences in sleep, its timing, and circadian rhythms as potential contributors (2).There is sufficient evidence to support a role for circadian factors in the pathophysiology of chronic insomnia, as the timing of sleep relative to the endogenous circadian system can substantially affect sleep initiation and maintenance (3). Interestingly, morphological differences, as well as variations in circulating hormones and their receptors, have been reported between sexes and can affect circadian physiology. For example, the localization of sex steroid receptors to the suprachiasmatic nucleus (SCN) and a sex difference in the expression of androgen and estrogen receptors there indicate a direct and differential role of specific gonadal steroid hormones in the circadian system (4). Moreover, a sexual dimorphism in structure and sex steroid receptor expression also exists in efferent targets of the SCN, including the preoptic area of the hypothalamus, which is known to influence sleep (4). In a recent postmortem brain study, the circadian vari...

show abstract

Section: Discussionmentioning

confidence: 99%

Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women

Boivin

Shechter

Boudreau

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

show abstract

“…The individuals with less education in general also correspond to those with a lower spending power and more prone to unemployment and consequently more exposed to anguish. Other investigators also demonstrated this association 14,23,27 .…”

Section: Discussionmentioning

confidence: 77%

“…Carvalho et al 28 studied personality traits of a sample of insomniac patients and found insecurity to deal with the day-to-day problems, inability to forget these problems at bedtime, worsening and maintaining the insomnia. Some works did not evidence a significant difference between the marital statuses and insomnia 13,19,23 .…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Analysis of the prevalence of insomnia in the adult population of São José do Rio Preto, Brazil

Marchi

Reimão

Tognola

et al. 2004

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-Objective: To establish the prevalence of insomnia in the adult urban population of São José do Rio Preto, Brazil and correlate it with the demographic data. Method: We evaluated 1105 individuals in to guarantee an error margin of 3% and a confidence level of 95% using a structured questionnaire and following the DSM-IV and DSM-III-R criteria, in the period from January 10 to February 28 2001. Results: We encountered a prevalence of 32% of insomnia, which was most commonly seen in women, single people, from the lower economical brackets, with a low level of schooling and it was less associated with younger adults (18-31 year-olds). Conclusion: Our findings indicate that the prevalence of insomnia in the adult population of São José do Rio Preto is comparable with other countries such as the USA and those of Europe and also with other cities in Brazil.KEY WORDS: insomnia; epidemiology, prevalence. Análise da prevalência da insônia na população adulta de São José do Rio Preto, BrasilRESUMO -Objetivo: Estabelecer a prevalência da insônia na população adulta urbana de São José do Rio Preto e correlacioná-la com os dados demográficos. Método: Avaliamos 1105 indivíduos em função de um erro de 3% e nível de confiança de 95%, usando um questionário estruturado e seguindo os critérios do DSM-IV e DSM-III-R, no período de 10/01 a 28/02/01. Resultados: Encontramos prevalência de 32% de insônia, sendo esta mais associada ao sexo feminino, aos não unidos, classes econômicas D/E, baixo nível de escolaridade e menos associada aos mais jovens (18-31 anos). Conclusão: Nossos achados indicam que a prevalência da insônia da população adulta de São José do Rio Preto é comparável a de outros países da América do Norte, Europa e também com outras cidades do Brasil.

show abstract

“…The prevalence of insomnia ranges from 11.7% to 37% in some European countries [3][4][5], 9.2% to 11.9% in Asia [6][7][8]. The prevalence varies considerably depending on the definition used.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial

Guo

Wang

Liu

et al. 2014

Deutsche Zeitschrift für Akupunktur

View full text Add to dashboard Cite

Objectives. To investigate the six-week influence of acupuncture on sleep quality and daytime functioning in primary insomnia. Methods. The study was a double-dummy, single-blinded, randomized, placebo-controlled clinical trial. A total of 180 patients with primary insomnia were randomly assigned to 3 groups: verum group underwent verum acupuncture plus placebo; estazolam group underwent estazolam plus sham acupuncture; sham group underwent sham acupuncture plus placebo. The outcome was measured by Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the 36-item short-form health survey (SF-36).Results. The three groups showed significant improvement compared with the pretreatment baseline. Compared with the other two groups, the verum group reported improved sleep quality (SQ) and vitality (VT), decreased daytime dysfunction (DD) and sleepiness (ESS score). The differences were kept from the treatment period to the end of the trial. Discussion. Verum acupuncture appeared to be more effective in increasing sleep quality and daytime functioning than sham acupuncture and estazolam. Trial Registration. The trial is registeded with ClinicalTrials.gov ISRCTN12585433.

show abstract

Gender differences in insomnia—a study in the Hong Kong Chinese population

Cited by 229 publications

References 34 publications

Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women

Diurnal and circadian variation of sleep and alertness in men vs. naturally cycling women

Analysis of the prevalence of insomnia in the adult population of São José do Rio Preto, Brazil

Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial

Contact Info

Product

Resources

About