Women's Initiative in Sleep Health (WISH)


Healthy sleep is essential to our mood, productivity, wellbeing, and health. It remains an underappreciated fact that more women than men are at risk of untreated sleep disorders. The majority of sleep care provided is based on evidence that comes from studies done predominately in men. However, biological conditions unique to women, like menstruation, pregnancy and menopause, can affect a woman’s sleep. Fortunately, there is a growing body of knowledge about women and sleep disorders and how they differ from men. Differences between women and men have been identified throughout the entire spectrum of sleep disorders including sleep apnea, insomnia, narcolepsy, restless leg syndrome, from risk factors to symptoms, and from diagnosis to treatment and outcomes.

Women are more prone to some sleep disorders such as insomnia, sleep related movement disorders, nocturnal pain, and nocturnal sleep-related eating disorder. Sleep disordered breathing is common in both men and women, and in women the risk increases more than three-fold after menopause. Sleep-disordered breathing is also seen during pregnancy, and may be a risk factor for poor maternal and fetal outcomes. And while the vast majority of shift workers are healthy, shift work poses specific risks to women including irregular menstrual cycles, difficulty getting pregnant, birth complications, and breast cancer.

Women are more likely to elude diagnosis because of non-classic complaints or symptoms. For example, while men with sleep apnea commonly report “typical” symptoms of snoring and daytime sleepiness, women with sleep apnea are more likely to report nonspecific complaints such as insomnia, depressed mood, and fatigue. As a result, the diagnosis is often delayed or missed in women, and women are more likely to receive alternative diagnoses such as depression for their sleep-related complaints.

The Women's Initiative in Sleep Health (WISH) at Yale is committed to improving the sleep health of women. We recognize that women are unique and experience different sleep related symptoms than do men. Evaluation and treatment needs to be specifically tailored for each individual woman. Our mission is to improve the sleep health of women by offering evidence-based, sex-specific, personalized, and comprehensive care of sleep disorders.

Fig: Sleep Disorders Model.