Endocrine brain: Gender differences

Abstract

Sexual hormones deeply influence the physiology of human sleep and alertness across the different phases of the female reproductive cycle. Estrogen has a REM-wake promoting effect which proves important for the female cognitive and mood profile, whereas progesterone mediates sedation by increasing NREM sleep and muscle relaxation. It also impacts blood gasses response during sleep and nocturnal ventilation. Women of increasing age are more likely than men to suffer from insomnia and depressive disorders. Daytime fatigue and excessive sleepiness occur more frequently in women with specific sleep disorders such as obstructive sleep apnea (OSA) and restless leg syndrome/Willis-Ekbom Disease (RLS/WED), to which women appear more prone during both pregnancy and menopause. The impact of OSA and RLS/WED on quality of life and health via induced hypertension and cardiovascular and metabolic risk increases the negative effects of poor sleep on general wellbeing. The load of organic and psychiatric co-morbid disorders associated with altered sleep is greater in women than in men, with a detrimental effect also on gender-specific therapeutic response which is less satisfactory and efficient in women compared to their male counterparts.