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AND THEIR COLLEAGUES make the point that, while a large amount of information about sleep has been obtained over the past 50 years, " …there are numerous areas of considerable ignorance. One of these concerns, the particulari-ties of sleep in women. " 1 The lack of basic research on the effects of sex (i.e., the genetic make-up of the individual, not the act itself) on sleep is of particular concern given our almost total lack of understanding on the importance of women's sleep in health and disease. 1 The findings of Zhang and Wing in a paper in this issue of SLEEP, 2 reporting on a meta-analysis approach to investigate sex differences in the risk of insomnia, supports the clear need to develop a better understanding of how sex influences sleep. The meta-analysis involved 31 published epidemiologic studies and more than 1.25 million subjects. The conclusion: as has been found in most epidemiologic studies, there is an increased risk (a risk ratio of 1.41) for insomnia in females, as compared with males. While it is likely that many cultural, sociologic, socioeconomic , and other environmental factors could underlie some of the sex-based differences in insomnia, the clear evidence that the reproductive-hormone environment can influence various sleep-wake parameters 3 suggests a role, as well as for the genome and other biologic factors on women's sleep in health and disease. Although there are a number of reports indicating that sleep in humans is greatly influenced by sex, 1,3 the mechanisms underlying these differences remain poorly understood. Given the potential importance of sex-specific differences in normal and pathophysi-ologic sleep-wake states, there is a clear need to develop animal models to determine the mechanisms responsible for the effects of sex on sleep. Surprisingly, few studies directly examining the influence of sex on sleep and wakefulness in animal models have been reported. The influence of reproductive neuroendocrine and/or endo-crine processes on sleep could be occurring at a number of developmental and/or age-related steps. In rodents, the sex-hormone environment around the time of birth plays a major role in " organizing " the neural circuitry responsible for generating a variety of sex-influenced behaviors later in life, 6,7 including sex-specific mating behavior, 10 aggression, 11 arousal, 12 and stress responses. 13 Thus, the " activation " of many sex-related behaviors by the ste-roid-hormone environment during later pubertal and adult life is dependent on the " organizational " …

Gender (Sex) and Sleep: Shh…Not in Front of the Children