Study finds men may miss nighttime awakenings when rating sleep

Women in a home sleep study rated their sleep worse than men did, even though recordings showed they generally slept better. The finding matters because self-reported sleep problems can shape whether people seek help for conditions tied to long-term health risks.

Torbjörn Åkerstedt, writing in The Conversation, said the study was designed to examine a long-standing mismatch in sleep research: women more often report disturbed sleep and make up a large share of sleep clinic patients, while some objective measures have shown poorer sleep in men.

The research included 238 randomly selected women and 238 men matched to them by age and body mass index, according to Åkerstedt. Participants slept at home while equipment recorded brain waves, muscle tension and eye movements, allowing researchers to measure sleep stages, waking time, sleep duration and how quickly people fell asleep.

A researcher fitted the devices in each participant’s home in the evening, then left before the participant slept on their usual schedule. In the morning, participants assessed several aspects of the night, including trouble falling asleep, restlessness, early waking, perceived awakenings, estimated sleep time and overall sleep quality.

Women slept longer and more efficiently

Åkerstedt said women gave lower ratings for their sleep quality than men. The physiological recordings, however, showed women had fewer awakenings, less light stage-one sleep, more efficient sleep and more deep stage-three sleep.

Women also slept longer on average, at 400 minutes compared with 382 minutes for men, according to the study. The one objective measure that pointed in the other direction was waking duration: when women woke during the night, they remained awake for about nine minutes on average, compared with just under seven minutes for men.

That difference may help explain why women remembered waking more often, Åkerstedt said. Research cited by him indicates that about five minutes awake during the night can be enough for a person to recall the episode the next morning.

The study found men underestimated their number of awakenings by 72%, while women underestimated theirs by 37%. For other estimates, including time needed to fall asleep, total sleep time and time awake, men and women were similarly accurate, according to Åkerstedt.

Short awakenings changed the comparison

Åkerstedt said men who woke for short stretches, around eight minutes at a time, often did not remember those awakenings. When researchers excluded that group of men from the analysis, the sex difference in reported sleep quality disappeared.

The authors interpret that result as evidence that short, forgotten awakenings may lead some men to rate their sleep more favorably than recordings would support. Women’s longer waking periods may make the interruptions more noticeable, lowering their own ratings even when objective sleep measures look strong.

The study also found that men’s recorded sleep worsened more quickly with age than women’s, especially for deep stage-three sleep. Among participants older than 65, women averaged about 80 minutes of stage-three sleep a night, while men averaged 53 minutes; among adults ages 30 to 50, both groups averaged about 70 minutes.

Åkerstedt cautioned that the study measured only one night of sleep, and said longer studies are needed to see whether the pattern holds. He also said future work should examine why men’s sleep appears to decline more with age, since the analysis adjusted for factors including alcohol use, smoking and BMI.

The findings suggest sleep quality depends on both recorded physiology and a person’s memory of the night, Åkerstedt said. If men often overrate their sleep, some may miss signs of sleep problems that could affect their health and well-being.

This story draws on original reporting from Medical Xpress.