Skip to main content
Log in

Gender differences in insomnia and the role of paid work and family responsibilities

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

A higher prevalence of insomnia in females has been consistently demonstrated across countries and cultures. The aim of this study was to clarify whether gender differences in insomnia could be explained by gender differences in paid work and family responsibilities.

Methods

Participants were employees at two local governments in Hokkaido, Japan, who underwent annual health checkups from April 2003 to March 2004. All data were obtained via self-administered questionnaires. Insomnia was evaluated by the Athens Insomnia Scale. For work and family characteristics, occupation, working hours, days off, shift work, visual display terminal (VDT) work, occupational stress, marital status, hours spent on household tasks, childcare, and caregiving were chosen. Data from 7,451 participants (5,951 men and 1,500 women) were analyzed. Logistic regression analysis examined how much paid work and family responsibilities explained gender differences in insomnia.

Results

The prevalence of insomnia in female subjects (31.0%) was significantly larger than in males (23.2%), but the gender difference disappeared after adjustment for paid work and family responsibilities. The results of stratified analyses revealed that significant gender differences were found only among workers with comparatively favorable work and family conditions, such as non-shift work, less than 6 h/day of VDT work, exposure to low levels of occupational stress, household tasks for less than 1 h/day, and not living with persons who needed care and support.

Conclusions

These results suggest that gender differences in insomnia are explained, in the main, by gender differences in work and family characteristics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6(2):97–111

    Article  PubMed  Google Scholar 

  2. Broman JE, Lundh LG, Hetta J (1996) Insufficient sleep in the general population. Neurophysiol Clin 26(1):30–39

    Article  PubMed  CAS  Google Scholar 

  3. Doi Y, Minowa M, Okawa M, Uchiyama M (2000) Prevalence of sleep disturbance and hypnotic medication use in relation to sociodemographic factors in the general japanese adult population. J Epidemiol 10(2):79–86

    Article  PubMed  CAS  Google Scholar 

  4. Leger D, Guilleminault C, Dreyfus JP, Delahaye C, Paillard M (2000) Prevalence of insomnia in a survey of 12, 778 adults in france. J Sleep Res 9(1):35–42

    Article  PubMed  CAS  Google Scholar 

  5. Hajak G (2001) Epidemiology of severe insomnia and its consequences in germany. Eur Arch Psychiatry Clin Neurosci 251(2):49–56

    Article  PubMed  CAS  Google Scholar 

  6. Bixler EO, Vgontzas AN, Lin HM, Vela-Bueno A, Kales A (2002) Insomnia in central pennsylvania. J Psychosom Res 53(1):589–592

    Article  PubMed  CAS  Google Scholar 

  7. Li RH, Wing YK, Ho SC, Fong SY (2002) Gender differences in insomnia—a study in the Hong Kong Chinese population. J Psychosom Res 53(1):601–609

    Article  PubMed  CAS  Google Scholar 

  8. Leger D, Massuel MA, Metlaine A (2006) Professional correlates of insomnia. Sleep 29(2):171–178

    PubMed  Google Scholar 

  9. Ozminkowski RJ, Wang S, Walsh JK (2007) The direct and indirect costs of untreated insomnia in adults in the United States. Sleep 30(3):263–273

    PubMed  Google Scholar 

  10. Peretti-Watel P, Legleye S, Baumann M, Choquet M, Falissard B, Chau N (2009) Fatigue, insomnia and nervousness: gender disparities and roles of individual characteristics and lifestyle factors among economically active people. Soc Psychiatry Psychiatr Epidemiol 44(9):703–709

    Article  PubMed  Google Scholar 

  11. Zhang B, Wing YK (2006) Sex differences in insomnia: a meta-analysis. Sleep 29(1):85–93

    PubMed  Google Scholar 

  12. Lindberg E, Janson C, Gislason T, Bjornsson E, Hetta J, Boman G (1997) Sleep disturbances in a young adult population: can gender differences be explained by differences in psychological status? Sleep 20(6):381–387

    PubMed  CAS  Google Scholar 

  13. Chen YY, Kawachi I, Subramanian SV, Acevedo-Garcia D, Lee YJ (2005) Can social factors explain sex differences in insomnia? Findings from a national survey in Taiwan. J Epidemiol Community Health 59(6):488–494

    Article  PubMed  Google Scholar 

  14. Sekine M, Chandola T, Martikainen P, Marmot M, Kagamimori S (2006) Work and family characteristics as determinants of socioeconomic and sex inequalities in sleep: the Japanese civil servants study. Sleep 29(2):206–216

    PubMed  Google Scholar 

  15. Hale L, Do DP, Basurto-Davila R, Heron M, Finch BK, Dubowitz T, Lurie N, Bird CE (2009) Does mental health history explain gender disparities in insomnia symptoms among young adults? Sleep Med 10(10):1118–1123

    Article  PubMed  Google Scholar 

  16. Manber R, Armitage R (1999) Sex, steroids, and sleep: a review. Sleep 22(5):540–555

    PubMed  CAS  Google Scholar 

  17. Vazquez-Barquero JL, Diez Manrique JF, Munoz J, Menendez Arango JM, Gaite L, Herrera S, Der GJ (1992) Sex differences in mental illness: a community study of the influence of physical health and sociodemographic factors. Soc Psychiatry Psychiatr Epidemiol 27(2):62–68

    Article  PubMed  CAS  Google Scholar 

  18. Piccinelli M, Wilkinson G (2000) Gender differences in depression. Critical review. Br J Psychiatry 177:486–492

    Article  PubMed  CAS  Google Scholar 

  19. Bijl RV, De Graaf R, Ravelli A, Smit F, Vollebergh WA (2002) Gender and age-specific first incidence of DSM-III-R psychiatric disorders in the general population Results from the Netherlands mental health survey and incidence study (nemesis). Soc Psychiatry Psychiatr Epidemiol 37(8):372–379

    Article  PubMed  Google Scholar 

  20. Breslau N, Roth T, Rosenthal L, Andreski P (1996) Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 39(6):411–418

    Article  PubMed  CAS  Google Scholar 

  21. Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ (2007) Comorbidity of chronic insomnia with medical problems. Sleep 30(2):213–218

    PubMed  Google Scholar 

  22. Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W (2008) Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep 31(4):473–480

    PubMed  Google Scholar 

  23. Bird CE, Fremont AM (1991) Gender, time use, and health. J Health Soc Behav 32(2):114–129

    Article  PubMed  CAS  Google Scholar 

  24. Bird CE (1999) Gender, household labor, and psychological distress: the impact of the amount and division of housework. J Health Soc Behav 40(1):32–45

    Article  PubMed  CAS  Google Scholar 

  25. Martikainen P (1995) Women’s employment, marriage, motherhood and mortality: a test of the multiple role and role accumulation hypotheses. Soc Sci Med 40(2):199–212

    Article  PubMed  CAS  Google Scholar 

  26. Bird CE, Rieker PP (1999) Gender matters: an integrated model for understanding men’s and women’s health. Soc Sci Med 48(6):745–755

    Article  PubMed  CAS  Google Scholar 

  27. Chandola T, Martikainen P, Bartley M, Lahelma E, Marmot M, Michikazu S, Nasermoaddeli A, Kagamimori S (2004) Does conflict between home and work explain the effect of multiple roles on mental health? A comparative study of Finland, Japan, and the UK. Int J Epidemiol 33(4):884–893

    Article  PubMed  Google Scholar 

  28. Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens insomnia scale: validation of an instrument based on icd-10 criteria. J Psychosom Res 48(6):555–560

    Article  PubMed  CAS  Google Scholar 

  29. Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2003) The diagnostic validity of the Athens insomnia scale. J Psychosom Res 55(3):263–267

    Article  PubMed  Google Scholar 

  30. Sugisawa A, Uehata T, Pin H, Sekiya E, Chida T, Ishihara S, Yamazaki Y, Sakano J, Abe M, Hasegawa Y et al (1993) Mental health, work environment, and health practices among middle-aged male workers. Sangyo Igaku 35(1):7–18

    Article  PubMed  CAS  Google Scholar 

  31. Tsutsumi A, Kayaba K, Tsutsumi K, Igarashi M (2001) Association between job strain and prevalence of hypertension: a cross sectional analysis in a Japanese working population with a wide range of occupations: the Jichi medical school cohort study. Occup Environ Med 58(6):367–373

    Article  PubMed  CAS  Google Scholar 

  32. Tsutsumi A, Kayaba K, Nagami M, Miki A, Kawano Y, Ohya Y, Odagiri Y, Shimomitsu T (2002) The effort–reward imbalance model: experience in Japanese working population. J Occup Health 44:398–407

    Article  Google Scholar 

  33. Fahlen G, Knutsson A, Peter R, Akerstedt T, Nordin M, Alfredsson L, Westerholm P (2006) Effort–reward imbalance, sleep disturbances and fatigue. Int Arch Occup Environ Health 79(5):371–378

    Article  PubMed  Google Scholar 

  34. Doi Y, Minowa M, Tango T (2003) Impact and correlates of poor sleep quality in Japanese white-collar employees. Sleep 26(4):467–471

    PubMed  Google Scholar 

  35. Soldatos CR, Allaert FA, Ohta T, Dikeos DG (2005) How do individuals sleep around the world? Results from a single-day survey in ten countries. Sleep Med 6(1):5–13

    Article  PubMed  Google Scholar 

  36. Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G (2002) Sleep disturbances, work stress and work hours: a cross-sectional study. J Psychosom Res 53(3):741–748

    Article  PubMed  CAS  Google Scholar 

  37. Ribet C, Derriennic F (1999) Age, working conditions, and sleep disorders: a longitudinal analysis in the French cohort e.S.T.E.V. Sleep 22(4):491–504

    PubMed  CAS  Google Scholar 

  38. Martikainen P, Lahelma E, Marmot M, Sekine M, Nishi N, Kagamimori S (2004) A comparison of socioeconomic differences in physical functioning and perceived health among male and female employees in Britain, Finland and Japan. Soc Sci Med 59(6):1287–1295

    Article  PubMed  Google Scholar 

  39. Akerstedt T (2003) Shift work and disturbed sleep/wakefulness. Occup Med (Lond) 53(2):89–94

    Article  Google Scholar 

  40. Tachibana H, Izumi T, Honda S, Horiguchi I, Manabe E, Takemoto T (1996) A study of the impact of occupational and domestic factors on insomnia among industrial workers of a manufacturing company in japan. Occup Med (Lond) 46(3):221–227

    CAS  Google Scholar 

  41. Tachibana H, Izumi T, Honda S, Takemoto TI (1998) The prevalence and pattern of insomnia in Japanese industrial workers: relationship between psychosocial stress and type of insomnia. Psychiatry Clin Neurosci 52(4):397–402

    Article  PubMed  CAS  Google Scholar 

  42. Nakazawa T, Okubo Y, Suwazono Y, Kobayashi E, Komine S, Kato N, Nogawa K (2002) Association between duration of daily VDT use and subjective symptoms. Am J Ind Med 42(5):421–426

    Article  PubMed  Google Scholar 

  43. Yoshioka E, Saijo Y, Fukui T, Kawaharada M, Kishi R (2008) Association between duration of daily visual display terminal work and insomnia among local government clerks in japan. Am J Ind Med 51(2):148–156

    Article  PubMed  Google Scholar 

  44. Kudielka BM, Von Kanel R, Gander M-L, Fischer JE (2004) Effort-reward imbalance, overcommitment and sleep in a working population. Work Stress 18(2):167–178

    Article  Google Scholar 

  45. Ota A, Masue T, Yasuda N, Tsutsumi A, Mino Y, Ohara H (2005) Association between psychosocial job characteristics and insomnia: an investigation using two relevant job stress models—the demand-control-support (DCS) model and the effort–reward imbalance (ERI) model. Sleep Med 6(4):353–358

    Article  PubMed  Google Scholar 

  46. Utsugi M, Saijo Y, Yoshioka E, Horikawa N, Sato T, Gong Y, Kishi R (2005) Relationships of occupational stress to insomnia and short sleep in Japanese workers. Sleep 28(6):728–735

    PubMed  Google Scholar 

  47. Knudsen HK, Ducharme LJ, Roman PM (2007) Job stress and poor sleep quality: data from an American sample of full-time workers. Soc Sci Med 64(10):1997–2007

    Article  PubMed  Google Scholar 

  48. Ota A, Masue T, Yasuda N, Tsutsumi A, Mino Y, Ohara H, Ono Y (2009) Psychosocial job characteristics and insomnia: a prospective cohort study using the demand-control-support (DCS) and effort–reward imbalance (ERI) job stress models. Sleep Med 10:1112–1117

    Google Scholar 

  49. Marmot M, Siegrist J, Theorell T, Feeney A (1999) Health and the psychosocial environment at work. In: Marmot MG, Wilkinson RG (eds) Social determinants of health. Oxford University Press, Oxford, pp 97–130

    Google Scholar 

  50. Peter R, Siegrist J, Hallqvist J, Reuterwall C, Theorell T (2002) Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the sheep study. J Epidemiol Commun Health 56(4):294–300

    Article  CAS  Google Scholar 

  51. Calnan M, Wadsworth E, May M, Smith A, Wainwright D (2004) Job strain, effort–reward imbalance, and stress at work: competing or complementary models? Scand J Public Health 32(2):84–93

    Article  PubMed  Google Scholar 

  52. Schulz R, O’Brien AT, Bookwala J, Fleissner K (1995) Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist 35(6):771–791

    Article  PubMed  CAS  Google Scholar 

  53. Doi Y, Ogata K (2000) Psychiatric distress and related risk factors of family caregivers who care for the demented elderly at home. Nippon Koshu Eisei Zasshi 47(1):32–46

    PubMed  CAS  Google Scholar 

  54. Cannuscio CC, Jones C, Kawachi I, Colditz GA, Berkman L, Rimm E (2002) Reverberations of family illness: a longitudinal assessment of informal caregiving and mental health status in the nurses’ health study. Am J Public Health 92(8):1305–1311

    Article  PubMed  Google Scholar 

  55. Ho SC, Chan A, Woo J, Chong P, Sham A (2009) Impact of caregiving on health and quality of life: a comparative population-based study of caregivers for elderly persons and noncaregivers. J Gerontol A Biol Sci Med Sci 64(8):873–879

    Article  PubMed  Google Scholar 

  56. Mills PJ, Ancoli-Israel S, von Kanel R, Mausbach BT, Aschbacher K, Patterson TL, Ziegler MG, Dimsdale JE, Grant I (2009) Effects of gender and dementia severity on Alzheimer’s disease caregivers’ sleep and biomarkers of coagulation and inflammation. Brain Behav Immun 23(5):605–610

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Mr. Manabu Shojiguchi, Mr. Hiyoruki Arizuka, Ms. Toyoko Enomoto, Mr. Takanori Mogi, Mr. Naoto Sasaki, Mr. Takeshi Tsuda, Ms. Tomoko Arihara, Mr. Chizuko Sato, Dr. Takehito Nakabayashi, Mr. Masahiro Odajima, and Ms. Tomoko Hinoda for their excellent assistance with data collection and thank Ms. Akemi Onodera, Ms. Maki Fukushima, and Ms. Aki Yasuike for their assistance with data checking.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eiji Yoshioka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoshioka, E., Saijo, Y., Kita, T. et al. Gender differences in insomnia and the role of paid work and family responsibilities. Soc Psychiatry Psychiatr Epidemiol 47, 651–662 (2012). https://doi.org/10.1007/s00127-011-0370-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-011-0370-z

Keywords

Navigation