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Cited by 100Sleep and Wakefulness ResearchSleep and related disordersCircadian rhythm and melatonin

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Neurobiological and Hormonal Mechanisms Regulating Women’s Sleep

Open access
Dorsey, Alanna, de Lecea, Luis, Jennings, Kimberly J.·2021·Frontiers in Neuroscience
DOI 10.3389/fnins.2020.625397PMC PMC7840832
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Abstract

Sleep is crucial for optimal well-being, and sex differences in sleep quality have significant implications for women’s health. We review the current literature on sex differences in sleep, such as differences in objective and subjective sleep measures and their relationship with aging. We then discuss the convincing evidence for the role of ovarian hormones in regulating female sleep, and survey how these hormones act on a multitude of brain regions and neurochemicals to impact sleep. Lastly, we identify several important areas in need of future research to narrow the knowledge gap and improve the health of women and other understudied populations.

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Crossref · 10.3389/fnins.2020.625397

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FIGURE 1 Female hormonal transitions correspond with increased risk for sleep disorders and changes in sleep architecture. The luteal phase of the menstrual cycle, pregnancy, and menopause all increase prevalence of nocturnal awakenings. The luteal phase of the menstrual cycle is associated with increased risk for insomnia. Pregnancy, particularly the third trimester, increases risk of RLS and sleep apnea. The menopausal transition is associated with heightened prevalence of insomnia and SDB, particularly in postmenopause. Abbreviations: WASO, wake after sleep onset; REM, rapid-eye-movement sleep; NREM, non-rapid-eye-movement sleep; PMS, premenstrual syndrome; RLS, restless legs syndrome.
FIGURE 1 Female hormonal transitions correspond with increased risk for sleep disorders and changes in sleep architecture. The luteal phase of the menstrual cycle, pregnancy, and menopause all increase prevalence of nocturnal awakenings. The luteal phase of the menstrual cycle is associated with increased risk for insomnia. Pregnancy, particularly the third trimester, increases risk of RLS and sleep apnea. The menopausal transition is associated with heightened prevalence of insomnia and SDB, particularly in postmenopause. Abbreviations: WASO, wake after sleep onset; REM, rapid-eye-movement sleep; NREM, non-rapid-eye-movement sleep; PMS, premenstrual syndrome; RLS, restless legs syndrome.CC BY · PubMed Central
FIGURE 2 Female sex hormones act on neural regions associated with sleep and wakefulness to promote arousal and suppress sleep. Estradiol and progesterone suppress neural transmission of somnogens in the VLPO, weakening the sleep drive. The hormones also increase transmission of arousal-promoting substances in the LH, TMN, LC, as well as other regions not pictured to strengthen the arousal drive. Abbreviations: VLPO, ventrolateral preoptic nucleus; L-PGDS, lipocalin-type prostaglandin synthase; PGD2, prostaglandin H2; A2A, adenosine 2A receptor; LC, locus coeruleus; NE, norepinephrine; TMN, tuberomammillary nucleus; LH, lateral hypothalamus; HcrtR1, hypocretin receptor 1; REM, rapid-eye movement sleep; NREM; non-rapid-eye movement sleep.
FIGURE 2 Female sex hormones act on neural regions associated with sleep and wakefulness to promote arousal and suppress sleep. Estradiol and progesterone suppress neural transmission of somnogens in the VLPO, weakening the sleep drive. The hormones also increase transmission of arousal-promoting substances in the LH, TMN, LC, as well as other regions not pictured to strengthen the arousal drive. Abbreviations: VLPO, ventrolateral preoptic nucleus; L-PGDS, lipocalin-type prostaglandin synthase; PGD2, prostaglandin H2; A2A, adenosine 2A receptor; LC, locus coeruleus; NE, norepinephrine; TMN, tuberomammillary nucleus; LH, lateral hypothalamus; HcrtR1, hypocretin receptor 1; REM, rapid-eye movement sleep; NREM; non-rapid-eye movement sleep.CC BY · PubMed Central
FIGURE 3 Female sex hormones act on adjacent mechanisms to promote wake over sleep. Estradiol and progesterone modulate neurochemical transmission and morphology of synapses and glia. Hormone response elements such as estrogen response elements (EREs) directly impact gene expression, possibly regulating clock genes. Estradiol and progesterone also impact nest building and circadian rhythms, resulting in longer duration of wake than sleep.
FIGURE 3 Female sex hormones act on adjacent mechanisms to promote wake over sleep. Estradiol and progesterone modulate neurochemical transmission and morphology of synapses and glia. Hormone response elements such as estrogen response elements (EREs) directly impact gene expression, possibly regulating clock genes. Estradiol and progesterone also impact nest building and circadian rhythms, resulting in longer duration of wake than sleep.CC BY · PubMed Central

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  1. 2014, FDA approves new label changes and dosing for zolpidem products and a recommendation to avoid driving the day after using Ambien CR., Food Drug Adm. Drug Saf. Commun.

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Metadata

Authors
Dorsey, A., de Lecea, L., & Jennings, K. J.
Affiliations
Stanford Medicine (US)
Corresponding author
Jennings, Kimberly J.
ORCID
Venue
Frontiers in Neuroscience
Publisher
Frontiers Media SA
Published
2021-01-14
Volume
14
Pages
625397-625397
ISSN
1662-453X (ISSN-L)
DOI
10.3389/fnins.2020.625397
PMC
PMC7840832
OpenAlex
W3120986069
Cited by
100
References
261
Citations by year
2026: 19 · 2025: 33 · 2024: 21 · 2023: 14 · 2022: 8 · 2021: 5
FWCI
1.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Stanford Bio-X
  • National Institute of Mental Health
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • Rose Hills Foundation
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
sex differences in sleep, women's sleep, ovarian hormones, sleep regulation, aging, sleep quality, neurochemicals, brain regions

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