Why women sleep worse than men and 8 ways to battle the health risks

Research by Columbia University Irving Medical Center suggests there really is a gender sleep gap. Scientists at the university examined the effect of long-term mild sleep deprivation on women’s blood vessels and compared it with those who slept adequately. Examining the participants’ endothelial cells (the layer of cells that makes up the inner lining of blood vessels), they found that oxidative stress levels increased by 78 per cent after sleep restriction in healthy women. Over time, this can lead to cardiovascular diseases such as atherosclerosis and high blood pressure. 

Heart health is terrible in my family. My father and all my grandparents died of heart attacks early in life, so I need to be careful.

Playing it down

A major function of healthy sleep is the prevention of oxidative stress. Experts recommend adults have between seven and nine hours. But compared to men, women more frequently report sleep disturbances. “Insomnia is a female-dominant disorder: our clinic is 65 per cent women, 35 per cent men,” says Dr Guy Meadows, a sleep physiologist who has been running workshops for chronic insomnia sufferers since 2011.

And yet we play it down – and override our biological need for sleep.  “As women, we often put our own health aside and just cope and cope,” says Dr Swapna Mandal, a consultant respiratory, sleep and ventilation physician at the Cleveland Clinic London. “But we’ve known for a long time that interruption of sleep causes systemic inflammation, which makes inflammatory markers rise, and that predisposes you to things like plaque formation that block up your arteries.”

She explains that our constant wakefulness is not a full arousal from sleep, but a series of micro-arousals that are enough to disrupt the quality of sleep.

“As we age, we find it harder to fall and stay asleep due to reductions in the release of melatonin, the sleep-promoting hormone,” says Dr Meadows. “But women get a worse deal.”

“One of the primary reasons is the fluctuations in powerful female hormones,” he says. “Progesterone and oestrogen play such an important role in sleep, and fluctuate on a monthly basis. They fluctuate with pregnancy and then, of course, they fluctuate and then decline with menopause.” 

Bearing the brunt

Women are also likely to experience more stress and anxiety, says Dr Meadows. “You wake in the middle of the night, mind racing,” he says. “Your body is flooded with cortisol and adrenaline, pushing you closer towards insomnia. And then women bear the brunt of looking after children and elderly parents, which means less time for prioritising sleep and self-care activities.”

Not only do midlife women experience broken sleep, those declining hormones can leave us feeling like we’re going crazy.

“Progesterone plays a really important role in the production of gamma-aminobutyric acid (GABA) – one of the inhibitory transmitters in the brain and  spinal cord that helps us to fall asleep – but also helps us to feel relaxed, and when progesterone decreases in menopause, you’re getting reduced capital,” explains Dr Meadows. “Meanwhile you’re losing oestrogen, which plays a key role in serotonin production, which is really important in management of mood. And the more sleep-deprived you are, the more you knock out the rational emotional-regulator of the brain, your prefrontal cortex, and get pushed into your amygdala, the more reactive part of your brain, which again leads to more hyper-arousal.”

Going to bed late adds to the hormonal disadvantage. By going to bed later than 11pm (and ideally it should be 10pm), I’m seriously compromising my sleep.