Sleep Health in Nursing: Do Women and Men Face Different Challenges?
Sleep health study highlights gender differences; researchers offer tips to improve nurses’ sleep
By Melissa Wirkus Hagstrom
“Eat healthily, sleep well, breathe deeply, move harmoniously.”
― Jean-Pierre Barral
Sleep health is a common issue for nurses due to shift work, changing schedules, workplace stress and other factors disrupting the body's intrinsic circadian rhythm. But are gender and hormonal differences also affecting nurses’ sleep health? Do female nurses and patients face different sleep-related issues than their male counterparts?
A new report by the Society for Women’s Health Research (SWHR), published in the July issue of the Journal for Women’s Health, found that men and women do face different sleep challenges — but more research is needed to determine exactly how their sleep differs, and why.
The report, titled “Exploring Sex and Gender Differences in Sleep Health,” was authored by Monica Mallampalli, PhD, MSc, SWHR director of scientific programs, and Christine Carter, PhD, MPH, SWHR vice president of scientific affairs. It was borne out of a roundtable discussion in October 2013 that examined the knowledge gaps in sleep research, especially in regards to women’s health.
“We knew that not much had been done in this area,” Mallampalli said. “We really decided to explore sex and gender differences because sleep research mostly has been focused on sleep apnea, which is more prevalent in men. We looked at four different areas of sleep: what is happening at the basic science level; what is happening at the clinical site; what are the challenges that women face with sleep problems compared to men; and then what is happening with the treatment issues.”
The findings showed that, overall, women sleep differently than men―and there are a variety of biological, environmental and social factors that contribute to these differences.
Mallampalli said that busy lives, electronic devices and irregular sleep habits are all contributing to the sleep deficit that many Americans, including nurses, experience on a daily basis. “Particularly in women, stress, anxiety and being caregivers are big factors. What is really not known are the biological differences that can really influence sleep in women.”
Puberty, menopause and pregnancy are all key life stages that can have a hormonal effect on women’s sleep health.
For nurses, Mallampalli said awareness is a key to developing better sleep habits. Otherwise, nurses’ sleep deprivation can lead to medical errors and other risks to patient safety, physical/cognitive impairment, drowsy driving and poor personal health outcomes.
A MedScape report titled "A Wake-up Call For Nurses: Sleep Loss, Safety, and Health" compiled findings from several research studies on nurses and sleep over the years, and called out the dangers of fatigue and going longer than 24 hours without sleep — something that many RNs do regularly.
One of the studies cited in the report was a 1997 Nature study that found if an individual has been awake for just 17 hours straight, his or her cognitive and psychomotor performance deteriorates to that of someone with a blood alcohol level of .05 percent (like an adult consuming 1-2 alcoholic drinks). Most health care professionals wouldn’t dream of going to work under the influence of alcohol, yet many don’t blink an eye over working when they haven’t slept for 17 hours or longer.
“There are also long-term health consequences for sleep deprivation, especially in women compared to men,” Mallampalli said. “Women are at higher risk for breast cancer, shorter menstrual cycles, miscarriages and sub-fertility. I think really having the nurses be aware and making informed decisions about their schedules is key.”
Her advice to reduce fatigue and improve nurses’ sleep health: “Take breaks, don’t have too many back-to-back shifts, take naps and make sure you get enough sleep.” And that means daily.
Otherwise, she said, “There’s something called sleep debt, where your body keeps track of how much sleep you are missing.” And a 2003 study in the journal Sleep showed that ongoing sleep deprivation of as little as an hour a day can lead to a sleep debt over time that is not easily erased.
In addition to caring about their own sleep, nurses can play a pivotal role in promoting better sleep health in their patients. Mallampalli advises clinicians to begin asking about sleep habits as a routine part of the screening process. “Everyone pays so much attention to exercise, physical activity and nutrition, but having a medical professional place an equal emphasis on sleep is really essential.”
The SWHR report emphasizes that fact that sleep health, especially for women, needs greater national attention. As frontline caregivers, nurses can help promote this cause in their own lives and in the lives of the patients they work with on a daily (and nightly) basis.
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