Are women more at risk for insomnia?


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Carolyn M. D’Ambrosio, an associate professor of medicine and director of the Center for Sleep Medicine at Tufts Medical Center, fills us in Women have a higher risk than men of developing insomnia at some time in their lives. Insomnia is a common sleep disorder characterized by the inability to obtain sufficient sleep— typically seven to eight hours for adults, enough to feel refreshed and alert throughout the day—and leads to associated symptoms such as excessive daytime sleepiness. Patients with insomnia dedicate enough time to sleep, but they either cannot fall asleep easily (known as sleep onset insomnia), or they wake up and can’t fall back to sleep easily (sleep maintenance insomnia). Some have both. There is a tendency for insomnia to run in families, although the genetic component is not yet known. There are two types of insomnia—primary and secondary. Primary insomnia occurs spontaneously, meaning that nothing in the environment, including medical issues, is to blame. Secondary insomnia is far more common than the primary variety. Causes include depression, anxiety, chronic pain from conditions such as arthritis or fibromyalgia, dementia, sleep apnea and restless leg syndrome. Some medications and too much alcohol, caffeine or nicotine also can lead to secondary insomnia. Some causes of secondary insomnia, such as depression, night sweats, hot flashes and fibromyalgia, are more common in women. Restless leg syndrome is often the result of iron deficiency anemia, which occurs more often in women than men. Menopause—and the hormonal changes during menopause—are often associated with insomnia. Many menopausal women say hot flashes wake them up at night, while others report insomnia at different times during their menstrual cycles. Pregnancy, too, can create discomfort that disrupts sleep and is also associated with a higher risk of restless leg syndrome and sleep more