Every year in June, Men’s Health Week occurs in the lead up to Father’s Day. It aims to raise awareness of preventable health issues, especially those that disproportionately affect men. Men are less likely to seek out medical help than women, so another goal of the week is to encourage men to access support where they need it.
In the first part of this article, we share some of the most important risks for Men’s Health, according to charity Men’s Health Forum, and highlight how good sleep patterns could play a role in prevention. In part two, we explore the differences in sleep health between men and women, and signpost where to go for further help.
Part 1: How could good sleep help men to protect their health?
In September 2021, in the wake of the covid pandemic, the Office for National Statistics (ONS) reported the first decline in male life expectancy since the 1980s. Male life expectancy from 2018 to 2020 fell by 7 weeks to 79.0 years , while female life expectancy was 82.9 years; a 0.5 week increase since the previous period from 2015 to 2017.
So which conditions contribute to the male/female mortality gap?
1. Suicide: 75% of deaths from suicide are men; suicide is the highest cause of male death under 50
The reasons for suicide are always complex, but untreated or persistent mental health disorders often have a role to play. Poor sleep is a risk factor for suicidal thoughts and behaviours, independent of anxiety or depression (Harris 2020). Sleep and mental health have a bidirectional relationship. Encouragingly, recent research suggests that treating poor sleepers with cognitive behavioural therapy for insomnia can both reduce suicidal thoughts and reduce the risk of suicidal ideas developing (Kalmbach 2022).
2. Heart disease: men experience 76% of premature deaths from heart disease
You can read a detailed article about the links between poor sleep and heart disease here (LINK). Although there are no long term trials looking at the impact of sleep improvement on heart outcomes, we do know that consistent bedtimes, good quality sleep and routinely getting at least 7 hours of sleep are associated with lower risks of heart disease (Korostovtseva 2021).
3. Cancer: men are 43% more likely to die from cancer
A number of different types of cancer are more common in men, including prostate, bladder and head and neck cancers. While sleep duration is not a significant predictor of cancer, the disruption to sleep-wake cycles caused by shift work has been identified as a probable carcinogen. The risks are highest for those who work nights frequently and for long periods of time. Night shift workers typically get an hour less sleep than day workers. Health outcomes for shift workers can be improved by managing other pillars of health, such as healthy nutrition, regular exercise and managing stress.
4. Type 2 Diabetes: Men are 26% more likely to have type 2 diabetes
Diabetes is a condition where there is too much glucose, or sugar, in the blood. Type 2 diabetes is known as a ‘lifestyle’ disease since lifestyle choices can heavily influence the risks and management of the condition. You can read more about the science linking diabetes and sleep here (LINK) Both lack of sleep and poor quality sleep can interfere with insulin sensitivity, increase inflammation, increase hunger hormones and make us more susceptible to unhealthy food choices. Protecting time for sleep could therefore make it easier to both prevent and manage diabetes.
5. Harmful alcohol consumption: men account for 66% of alcohol-related deaths
Many poor sleepers turn to alcohol believing that it helps them to fall asleep. In fact, alcohol makes sleep more fragmented, delays the body clock so that we find it harder to wake up, and suppresses REM sleep, which can lead to some pretty intense dreams. Alcohol dependence and insomnia seem to have a two-way relationship; insomnia increases the odds that someone will reach for alcohol in a bid to switch off, and heavy alcohol use increases the risks of insomnia (He 2019).
Fortunately, talking therapy for insomnia is still effective at improving sleep in those with an alcohol misuse disorder, but it’s not yet clear whether this can also impact on alcohol consumption (Hertenstein 2022 ).
Part 2: How is men’s sleep health different?
Sleep problems can affect all genders and ages, but certain sleep disorders are more common in men. Here we have a quickfire round of questions about male sleep health.
1. How does men’s sleep compare with women’s?
Studies suggest that on average, men sleep for 10-20 minutes less, and fall asleep 20 minutes later than women. It’s not clear why these differences exist, but men’s body clocks may run at a slightly slower rate than women’s. The overall recommendation to adults get at least 7 hours sleep is the same for both men and women. You can find out more about the differences between sleep in men and women here.
2. Why do men get erections in the morning?
Nocturnal penile erections occur during REM, or Rapid Eye Movement sleep. We have more REM sleep in the second part of the night. During REM sleep, the balance of activity in our autonomic nervous system, which controls automatic processes such as breathing and blood pressure, shifts from the sympathetic (‘fight or flight’) to the parasympathetic (‘rest and digest’). This shift to parasympathetic activity is thought to be a trigger for the blood vessels in the penis to expand, allowing more trapped blood volume and a temporarily enlarged and more rigid penis.
Sleep erections, or ‘nocturnal penile tumescence’ are unconscious and automatic. Levels of testosterone are highest in the morning, which may help bolster erections at waking. One theory is that a full bladder stimulates nerves that go to the spine which causes a spinal reflex which generates an erection, which is why the erection goes away after emptying one’s bladder.
Women can also experience changes in their sexual organs during REM sleep, with pulses of blood flow occurring in the vagina, an engorged clitoris, and increased vaginal sensitivity.
3. Why are men more likely to snore than women?
Snoring occurs when air is forced through a narrowing in our airways as we breathe, causing a vibration of air and soft tissue. This usually happens when the tissues in the back of the mouth and tongue fall back into an area called the oropharynx, above the larynx (voice box). Men are more likely to snore because of differences in anatomy. Men tend to have a larger oropharynx and a lower larynx, and this extra length and space allows more potential for the airways to narrow or collapse during sleep. Men also tend to carry more weighty tissue in their necks and upper chests, which can add more pressure on the airways as we lie down.
4. Which sleep disorders are more common in men?
Sleep apnoea is thought to be at least twice as common in men than women. In contrast, insomnia is more common in women, affecting roughly 1 in 4 women, and 1 in 6 men.
An unusual sleep disorder which is more common in men over the age of 50 is REM Sleep Behaviour Disorder (RBD). This occurs when you act out vivid dreams during REM sleep. Normally our main muscle groups are completely relaxed during REM sleep, but in RBD, people can become active and aggressive - shouting, kicking, punching and swearing, for example.
It is usually easy to wake someone from an RBD episode, and they will typically remember the experience as a vivid dream. This is in contrast to sleep walking or sleep talking, which happen during deep sleep, and usually the sleeper cannot remember anything afterwards.
RBD can be a serious risk for bed partners, and may be a sign of another health condition, so speak to your GP if you recognise the symptoms. RBD episodes may only happen very infrequently when they start, but will typically become more common over time without treatment. Alcohol, or alcohol withdrawal, sleep deprivation and certain medications make RBD episodes more likely.
For more advice and information about sleep, and 10 tips to sleep really well - for men and women - please see our ‘ Back to Basics’ article.