Do Men & Women Sleep Differently?

Written by Dr Hazel Wallace

It is pretty much undisputed that sleep is essential for health, allowing us to rest and recover - physically, mentally and emotionally - and perform at our best. I am pretty confident that every single person reading this has experienced at least one bad night of sleep - and pretty confident that you felt pretty rotten the next day too? One night of poor sleep can impair your concentration and judgement and make you more prone to mistakes and accidents, but long-term lack of sleep can increase the risk of a wide range of health problems including; heart disease and stroke, type 2 diabetes and obesity, depression and risk of death (1). It also suppresses your immune system, making you more susceptible to colds and flu, and lower your sex drive (2, 3).

Needless to say, this is one aspect of our lifestyle we shouldn’t overlook.

How well do women sleep compared to men?

Whilst we all need good sleep, there are important differences between men and women when it comes to how well we sleep. Surprisingly women sleep more overall (despite doing more unpaid work and having less leisure time) compared to men (4).

However, women also report poorer sleep quality including; difficulty falling asleep, waking up frequently in the night and having longer wakeful episodes (5). The latter is often made worse by the fact that many women experience overactive bladder (OAB) which means they typically wake up more times in the night to go for a wee (6,7). Women are also more likely to experience heartburn and acid reflux - which also interferes with sleep (8). 

How do hormones affect our sleep?

Sex hormones not only orchestrate reproductive function during the menstrual cycle, but have a big influence on sleep and our circadian rhythm. Oestrogen has been shown to decrease the length of time it takes to fall asleep, with fewer awakenings throughout the night, and increase total sleep time (9). To add to that, it plays a role in regulating body temperature at night and keeping it low - which is important for a sound sleep (9). Whereas progesterone has anti-anxiety and sedative effects (9). So it may come as no surprise that sex differences in sleep emerge only after puberty when rates of insomnia in girls surpassed those in boys and persist into adulthood (10).

Women also report more sleep disturbances during periods of major hormonal change such as menstruation, pregnancy, and menopause. For example, the most common time for women to report issues sleeping across the menstrual cycle are the days leading up to the period (late-luteal phase) and the first few days of the period (early follicular) (11). This is believed to be due to low levels of estrogen and progesterone during this time coupled with other PMS symptoms such as cramps, headaches and low mood. Nonetheless, sleep disturbances due to your menstrual cycle are not something you have to “just put up with” – there are absolutely actionable tools to learn & implement to mitigate sleep disturbance across your cycle.

What other factors are involved?

Of course, biology is not the only driver for this sleep gap between men and women - gendered social roles and cultural norms are also tied up in this. For example, women disproportionately act as informal caregivers for children, older adults and relatives – which means less time for sleep and more sleep interruptions (12).

The usual disclaimer applies here: we are speaking in general terms about what happens on average between men and women and does not apply to every individual. Also, like most other areas of research, the research related to sleep has focused disproportionately on males which leaves a large gaping hole in our knowledge (13).

How much sleep should we be aiming for?

In general, women and men need the same amount of sleep of 7-9 hours per night but simply counting the amount of hours spent in bed doesn’t necessarily mean you’re actually asleep for that length - so not only do we need the right quantity of sleep, we also want good quality sleep. This might be described as falling asleep within 10-30 minutes, not waking or waking up one time in the night - and for less than 20 minutes, and spending most of your time in bed asleep rather than awake.