Interaction of Sleep and Emotion in Women-Interaction of Sleep and Emotion in Women Slides

Interaction of Sleep and Emotion in Women Slides

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Jessica Meers, PhD (DBSM) presented an AADSM 2026 lecture on how sleep and emotion interact in women, emphasizing that reproductive hormones modify sleep continuity and emotional regulation across key life stages. Women experience insomnia at roughly twice the rate of men, emotional disorders increase after puberty, and sleep problems often cluster during hormonal transitions; obstructive sleep apnea (OSA) may also present differently in women and frequently co-occurs with insomnia.<br /><br />The talk proposes a reciprocal model in which sleep continuity, cognitive arousal, emotional regulation, and reproductive hormones influence one another, with hormonal stage increasing system “sensitivity.” Sleep helps stabilize emotional brain circuits (including prefrontal–amygdala connectivity) and supports stress processing, while sleep deprivation increases emotional reactivity and reduces resilience. Insomnia is framed as a hyperarousal disorder (cognitive and physiologic), creating a bidirectional amplification between poor sleep and negative emotion. Mechanistically, sleep continuity—measured by sleep onset latency, wake after sleep onset, total wake time, and night-to-night variability—predicts next-day emotional stability.<br /><br />Hormonal fluctuations (estradiol and progesterone) can reduce sleep efficiency; about one-third of women report premenstrual sleep disruption. Data across menstrual cycles show small but measurable increases in wake time during menses that coincide with reduced positive emotion and increased anger, suggesting phase-sensitive emotional regulation. Circadian factors (e.g., melatonin amplitude, social jet lag, cortisol awakening response) may further modulate symptoms.<br /><br />Pregnancy is described as a multi-system modifier (hormonal, respiratory, inflammatory, thermoregulatory) with high rates of insomnia, OSA, and restless legs syndrome; sleep disruption predicts maternal risks including hypertensive disorders, gestational diabetes, preterm birth, and postpartum depression symptoms. Perimenopause involves hormonal volatility, vasomotor symptoms, and hyperarousal, with 40–60% reporting insomnia and increased OSA risk post-menopause; hormone therapy is not recommended as an OSA treatment due to mixed evidence.<br /><br />For dental sleep medicine, Meers highlights a common “female phenotype” of mild-to-moderate OSA plus frequent awakenings, sleep anxiety, and emotional distress. Oral appliance therapy may improve AHI while insomnia persists, so clinicians should screen for reproductive stage and drivers of awakenings, and refer for behavioral sleep treatment (e.g., CBT-I) when insomnia indicators are present. Key takeaway: stabilizing sleep continuity improves emotional outcomes and requires collaborative, sex-specific precision care.

Keywords

women's sleep

sleep and emotion

reproductive hormones

insomnia hyperarousal

sleep continuity

menstrual cycle effects

pregnancy sleep disorders

perimenopause insomnia

obstructive sleep apnea in women

CBT-I and dental sleep medicine