Sleep medicine is a relatively young field, but it has not been immune to gender bias. For example, the original scoring rules for OSA developed by Rechtschaffen and Kales were based on sleep recorded in a group of healthy college students that were exclusively men. Symptoms typical of obstructive sleep apnea, when expressed by women, were once disregarded by some health care professionals resulting in a longer time to treatment for women as opposed to men. However, over the past 20 years much has been written in an effort to reduce the gender gap not only with respect to diagnosis and treatment of obstructive sleep apnea, but also to address sleep issues specific to women's health care. Moreover, in 1994 the National Institutes of Health (NIH) revised its granting guidelines, requiring that clinical trial subject selection not only include sufficient numbers of each sex, but that outcomes be analyzed with due attention to gender. There is no doubt that these guidelines had the desired effect of gender equality in research related to sleep medicine as well as in other disciplines.
Sleep Disorders in Women: A Guide to Practical Management, 2nd Edition serves to reinforce the NIH guidelines by reviewing and summarizing the latest literature, providing the reader with efficient, comprehensive and practical information on the management of sleep disorders in women. The text provides an excellent overview of sleep issues in women as well as detailed information specific to women of varying ages: adolescents, women of child bearing age, and perimenopausal and postmenopausal women. In addition to coverage of sleep throughout the lifespan, well-written chapters address topics especially pertinent to women such as restless legs syndrome and pharmacological treatments of insomnia, and disorders that occur exclusively in women, such as polycystic ovary syndrome and sleep disturbances associated with pregnancy. Among our favorite segments of the book are the chapters concerning pregnancy. Here the authors do a splendid job bringing the reader an up-to-date understanding of gestational restless legs syndrome, insomnia during pregnancy, and sleep disordered breathing that may complicate pregnancy. Importantly, the latter topic includes information on the respiratory changes during pregnancy as well as the potential risks of untreated OSA in pregnancy.
Many of the chapters excel in highlighting the latest literature on subjects such as delayed sleep phase in adolescents and other potential sleep disorders affecting women throughout their lifespan. The book concludes with a discussion of the very important topic of menopausal transition and sleep. The authors expertly cover the relationship between menopause and OSA, and their discussion of insomnia during this period of life includes coverage of hormonal therapy, medications, and excellent suggestions for conservative treatment. Finally, the text is particularly well organized and indexed, allowing the reader to find information of interest quickly and efficiently.
Sleep Disorders in Women provides an overview of where we've been, where we are, and where we need to go in terms of a gender specific understanding of sleep medicine. This volume is reasonably priced, well-written, and contains a plethora of high quality, up-to-date information. It should serve as an excellent reference for any dedicated sleep specialist.
The authors have indicated no financial conflicts of interest.
Ralls FM; Abrams SK. Sleep disorders in women: a guide to practical management, 2nd edition. J Clin Sleep Med 2013;9(10):1103.