Consistently getting a bad night's sleep may lead to an unsatisfactory sex life for many older women. In fact, women who slept poorly were nearly twice as likely to report issues such as lack of sexual interest or pleasure than women who got plenty of sleep.
Poor sleep was measured by the Pittsburgh Sleep Quality Index, which asks questions about ability to fall and stay asleep, use of sleep medication, daytime drowsiness and more.
In contrast, the study also found that good sleep quality was linked with having more sexual activity, a result that "doesn't surprise anyone, right?" said senior author Dr Stephanie Faubion, who directs the Mayo Clinic Centre for Women's Health.
"If you put a platter of sleep and a platter of sex in front of a tired woman, she's going to pick sleep every time," said Faubion, who is also the medical director for the North American Menopause Society.
These results, she added, should be a wake-up call for physicians to begin asking their patients about their sleep and their sexual functioning.
"In an ideal world, every woman should be asked by her primary care provider about her sexual function. Is that happening? No, it's not happening," Faubion said.
"Sleep may be something easier to ask about, and poor sleep is associated with so many negative outcomes, such as cardiovascular disease," she added. "If she's not sleeping well, that leads you to the next question, because sexual function is probably suffering, too."
CNN reports that in the new study, over 3,400 women who visited Mayo health clinics in Rochester, Minnesota, and Scottsdale, Arizona, completed questionnaires on sleep quality between December 2016 and September 2019. The women, who were an average age of 53, also underwent clinical evaluation for sexual dysfunction and were asked to rate their level of distress about their sex life – a first for a study of this kind, Faubion said.
"You can't call it sexual dysfunction unless a woman is distressed about it," she said. "For example, a woman can have low sexual desire, but it may not bother her. So, we are the first study to my knowledge that has actually looked at not only sexual function but distress related to that."
The research was part of a larger study called DREAMS, or Data Registry on Experiences of Aging, Menopause and Sexuality, which followed nearly 9,000 women for a dozen years.
In addition to poor quality sleep, the new study found women who regularly slept less than five hours a night were also more likely to report sexual problems.
However, the results were not statistically significant once factors such as age, partner status, education, race/ethnicity, body mass index, reproductive stage, depression, anxiety, relationship distress, and use of contraception and other medications were analysed.
Since all of those factors can disrupt sleep, it was important to factor those out in order to label poor sleep as the possible cause, Faubion said.
Associations of sleep and female sexual function
Kling, Juliana M; Kapoor, Ekta; Mara, Kristin; Faubion, Stephanie S
Published in Menopause on 19 April 2021
To evaluate associations between sleep and female sexual function.
A cross-sectional analysis from the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) was performed using questionnaires in women presenting for menopause or sexual health consult at Mayo Clinic from December, 2016 to September, 2019. Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and the Pittsburgh Sleep Quality Index (PSQI) assessed sexual function and sleep parameters, respectively. Associations between sleep quality (PSQI score ≥ 5 poor sleep quality), sleep durations (< 5 h, 5-6 h, 6-7 h, > 7 h) and female sexual dysfunction (FSFI ≤ 26.55 and FSDS-R ≥ 11) were evaluated utilizing a multivariable logistic model adjusting for multiple factors. A secondary analysis evaluated sleep quality by sexual activity and also included sexually inactive women.
A total of 3,433 women were included (mean age 53). Sexually active women (N = 2,487; 72.4%) were included in the primary analysis; 75% had poor sleep quality, and 54% met criteria for female sexual dysfunction. On multivariable analysis, women with poor sleep quality were 1.48 times more likely to report female sexual dysfunction (95% CI 1.21-1.80, P < 0.001). Of women who reported sleeping < 5 hours nightly, 63.3% had female sexual dysfunction, and their Female Sexual Function Index total and domain scores were significantly lower than women sleeping > 7 hours nightly (P = 0.004); however, this was not statistically significant in multivariable analysis. Sexually active women were more likely to report good sleep quality compared with sexually inactive women (25.3% vs 20.5%, P = 0.003).
Poor sleep quality, but not sleep duration, was associated with greater odds of female sexual dysfunction. Good sleep quality was linked to sexual activity. In addition to its myriad effects on health, poor sleep quality is associated with female sexual dysfunction.