STOCKHOLM – Researchers at the Karolinska Institute have identified a significant discrepancy between how men and women perceive their sleep quality versus the actual physiological data.
The findings suggest that while women are more likely to report disturbed sleep and seek clinical treatment, men often experience worse objective sleep quality but fail to perceive it.
This gap in perception may lead to a critical health risk, as men may overlook sleep disorders that are linked to early mortality, diabetes, and cardiovascular disease.
Physiological Sleep Discrepancies
The study compared 238 randomly selected women and 238 men, who were matched by age and BMI to ensure consistent results.
Participants were monitored in their own homes using electroencephalography (EEG) to measure brain waves, electromyography (EMG) for muscle tension, and electrooculography (EOG) for eye movements. Sleep was scored using internationally accepted criteria for clinical and research practice under the framework of the International Labour Organization’s guidelines on occupational safety and health, which recognize sleep disruption as a risk factor for work-related accidents and long-term illness.
The objective data revealed that women consistently achieved higher sleep quality than their male counterparts across several key metrics:
- Total Sleep Duration: Women averaged 400 minutes of sleep per night, compared to 382 minutes for men.
- Sleep Efficiency: Women spent more time asleep while in bed and experienced fewer nighttime awakenings.
- Sleep Stages: Women recorded more stage three (deep) sleep and less stage one (superficial) sleep.
Researchers noted that, taken together, these indicators point to a pattern in which women’s sleep is biologically more restorative on average, even as they report feeling less well-rested.
The Perception Paradox
Despite the objective data, the study found that women subjectively reported significantly lower sleep quality than men.
The researchers determined that this paradox is driven by how different genders perceive and remember waking up during the night.
When women wake up, they typically remain awake longer-approximately nine minutes per instance, compared to just under seven minutes for men.
Because it generally takes five minutes of wakefulness for a person to remember the event the following morning, women are more likely to recall their awakenings.
This led to a stark difference in how participants estimated their sleep disturbances:
- Men: Underestimated their number of nighttime awakenings by 72%.
- Women: Underestimated their number of nighttime awakenings by 37%.
The research team found that when men who experienced only short awakenings (around eight minutes) were removed from the data, the gender difference in subjective sleep quality disappeared. That suggests the gender gap is less about fundamental differences in how sleep is biologically experienced, and more about memory, perception, and how those factors shape what patients tell clinicians.
Age-Related Decline in Men
The data further indicated that objective sleep quality deteriorates more rapidly in men as they age, particularly regarding deep sleep.
Among participants aged 30 to 50, the amount of stage three sleep was similar for both genders, at approximately 70 minutes.
However, for those over the age of 65, a significant gap emerged:
- Women (65+): Averaged 80 minutes of stage three sleep per night.
- Men (65+): Averaged 53 minutes of stage three sleep per night.
The researchers adjusted these analyses for variables including smoking, alcohol consumption, and BMI to ensure the results were linked to gender and age rather than lifestyle factors.
As populations age and retirement ages rise across Europe and other high‑income economies, the pattern raises concerns for policymakers about older men’s fitness for work in safety‑critical roles, from transport and logistics to policing and health care. Poor deep sleep has been tied to slower reaction times, impaired judgment, and higher accident risk, all of which carry implications for regulators overseeing working‑time rules and fatigue management.
Clinical and Policy Implications
The institute’s findings suggest that the experience of waking up, rather than the physiological act of sleep itself, heavily influences how rested a person feels.
Because many men are unable to perceive their nighttime awakenings, they may be unaware of sleep problems that impact their overall wellbeing. This mismatch between symptoms and perception can undermine clinical screening, which still relies heavily on patient self‑reporting in many primary care systems.
This lack of awareness may result in men failing to seek medical help for conditions that could otherwise be managed. The results add weight to calls from public health officials for more routine, objective sleep assessments in high‑risk groups, including older men and workers in shift‑based or overnight occupations, as part of national non‑communicable disease strategies under the World Health Organization’s NCD policy framework.
Future research will focus on whether these findings remain consistent over longer study periods and the specific causes behind the accelerated decline of sleep quality in aging men. For health systems, the Karolinska team says the next step is to test whether brief, low‑cost screening tools based on objective sleep measures can be integrated into routine check‑ups-before undetected sleep loss shows up as cardiovascular disease, diabetes, or preventable workplace incidents.
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