Insomnia in women
Sleep Research Laboratory, Duke University Medical Center, Durham, North Carolina, USA.Clinical Cornerstone 02/2003; 5(3):41-50. DOI: 10.1016/S1098-3597(03)90034-2
Insomnia is a highly prevalent disorder that can lead to substantial impairments in quality of life and functional capacity. This condition occurs significantly more frequently in women than men. An important contributing factor is that insomnia can occur in association with hormonal changes that are unique to women, such as those of menopause or the late-luteal phase of the menstrual cycle. Another consideration is that women are more likely to suffer from major depression and anxiety disorders, which are also associated with insomnia. The reasons are unclear as are the reasons why women are at increased risk of primary insomnia. These conditions are frequently encountered in clinical practice and present a challenge to the practitioner because there is a striking lack of research data to serve as a guide. For example, there are no published studies to indicate how to safely and effectively manage insomnia that often occurs late in pregnancy. This article reviews the available literature related to these conditions with a focus on the epidemiologic data and diagnosis and treatment of insomnia and highlights the need for further research.
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- "Insomnia affects up to 30% of adult population affecting more women than men. In the United States of America (USA) the economic effects of insomnia has been estimated to range from US$ 92 to 107 billion. "
ABSTRACT: Sleep is an essential part of life. Lack of sleep has been linked with increased morbidity and mortality. The objective of this study was to determine the sleep quality of older adults residing in a private elderly care institution in Malaysia. This cross sectional study was conducted among consenting residents of a 200-bed non-governmental charity old folks home in Penang, Malaysia. The sleep quality of the respondents was measured using the Pittsburgh Sleep Quality Index (PSQI). Quality of life (WHOQOL-BREF), their attitude to ageing (AAQ), Barthel index (Activities of Daily Living) and body mass index were also measured. Data was analysed using PASW. The PSQI score ranged from 0 to 16 with a mean score of 7.1 (SD 3.4) and 76.8% (116) had scores ≥ 5. The differences in the mean score for chronic illness (t = 0.14/P = 0.04), the people that could be counted on for help (t = 4.09/P = 0.02) and the feasibility of getting practical help from fellow residents (t = 4.41/P = 0.01) were statistically significant. There was a negative correlation between the PSQI score and the WHOQOL-BREF score (-0.318/0.00) and AAQ score (-0.332/0.00). Staff working in an elderly care institution should understand the important relationship of illnesses, social support and sleep hygiene in the wellbeing of the residents.
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- "Gender was also controlled. A large body of evidence has found the frequency of insomnia to be higher among women than among men (e.g., Krystal  and Voderholzer et al. ). "
ABSTRACT: This prospective study was designed to test the hypothesis that burnout and insomnia predict each other's incidence and intensification across time. Burnout is conceptualized as representing individuals' unique affective response to their exposure to chronic stressors. Apparently healthy respondents (1356) completed questionnaires during periodic health examinations undergone at two time points T(1) and T(2), about 18 months apart. Burnout was assessed by the Shirom-Melamed Burnout Measure, while insomnia was assessed by the Brief Athens Insomnia Scale. Depressive symptomatology, neuroticism, body mass index, age, gender, follow-up duration, and T(1) levels of the criterion were controlled. Burnout and insomnia were found to be only moderately associated at T(1). However, logistic regression results indicated that burnout significantly predicted the development of new cases of insomnia at 18-month follow-up [odds ratio (OR)=1.93; 95% confidence interval (95% CI)=1.45-2.58], even after adjusting for depression and other potent confounders. Likewise, insomnia significantly predicted the onset of new cases of burnout at 18-month follow-up (OR=1.64; 95% CI=1.30-2.08). Hierarchical regression results indicted that T(1) burnout significantly predicted an increase in T(2) insomnia (beta=.05, P<.05), and that T(1) insomnia significantly predicted an increase in T(2) burnout (beta=.07, P<.05). The results indicate that burnout and insomnia recursively predict each other's development and intensification over time, thus suggesting that either might be a risk factor for the other across time. Possible mechanisms of link between burnout and insomnia, as well as the clinical implications of the findings, were suggested.
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- "Rates of sleep disturbance for women with breast cancer are well above those for the general adult population and higher than the above average rates for cancer patients in general. The prevalence of chronic insomnia in adults overall is about 10% (Roth and Roehrs, 2003), and it increases with age (Ohayon and Roth, 2003) and is higher for women (Martikainen et al., 2003) possibly due to hormonal changes such as those accompanying menopause (Krystal, 2003). Koopman et al. (2002) found that 63% of a sample of metastatic breast cancer patients reported one or more types of sleep disturbance. "
ABSTRACT: Sleep disturbances are common among women with breast cancer and can have serious consequences. The present study examined depression, pain, life stress, and participation in group therapy in relation to sleep disturbances in a sample of women with metastatic breast cancer. Ninety-three women with metastatic breast cancer participated in a large intervention trial examining the effect of the group therapy on their symptoms. They completed measures of depression, pain, life stress, and sleep disturbance at baseline, 4, 8 and 12 months. The results showed that higher initial levels of depression at baseline predicted problems associated with getting up in the morning, waking up during the night, and daytime sleepiness. Increases in depression over the course of 12 months were associated with fewer hours of sleep, more problems with waking up during the night and more daytime sleepiness. Higher levels of pain at baseline predicted more problems getting to sleep. Increases in pain predicted more difficulty getting to sleep and more problems waking up during the night. Greater life stress at baseline predicted more problems getting to sleep and more daytime sleepiness. Depression, pain, and life stress scores were each associated with different types of negative change in self-reported sleep disturbances. Depression, especially worsening depression, was associated with the greatest number of types of negative change. The relationships found between sleep disturbance and depression, pain, and life stress suggest specific ways to address the problem of sleep disturbance for women with metastatic breast cancer and show how different types of disturbed sleep may be clinical markers for depression, pain, or life stress in this population.
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