Gender differences in objective and subjective sleep

Abstract It is not clear if gender differences in subjective sleep reflect polysomnographical (PSG) differences. We here investigated gender differences in PSG variables and their association with rated sleep quality for the recorded sleep. Participants were 238 women and 238 men who were recorded with polysomnography (PSG, home recordings) and gave sleep quality ratings for the recorded night. Analyses of variance showed that women reported significantly lower subjective sleep quality than men, but showed significantly better PSG sleep (lower number awakenings per hour, lower N1%, longer total sleep time, higher sleep efficiency, and more N3%, among others. However, men underestimated their objective number of awakenings and had a shorter objective time awake per objective awakening (6.4 ± .6 vs 8.2 ± .6 minutes for women, p<.05). Men with short awakenings (<7.8 min/awakening) had a high subjective sleep quality, in contrast to men with long awakenings or women regardless of duration of awakenings. When men with short awakenings were excluded, subjective sleep quality no longer differed between genders. Gender differences in PSG variables increased with age. In addition, better subjective sleep quality was associated with “better” PSG values for both genders. In conclusion, women reported poorer sleep quality than men, but showed better objective sleep. It is suggested that men’s better subjective sleep is associated with an inability to perceive/remember short awakenings. The findings open a new view of gender differences in sleep, and indicate a need for experimental studies on gender differences in the perception of awakenings, their duration, and rated sleep quality.