Can social factors explain sex differences in insomnia? Findings from a national survey in Taiwan.

STUDY OBJECTIVE To examine sociological explanations for the higher level of insomnia in women, including social roles and socioeconomic status (SES). DESIGN Cross sectional survey research SETTING Taiwanese 2001 "social trend survey" PARTICIPANTS A nationally representative sample of 39,588 citizens aged 15 years or older living in Taiwan. MAIN RESULTS On average, women scored 1.25 points higher than men on the insomnia inventory (p<0.001) but after controlling for social roles, the sex discrepancy in insomnia decreased slightly. SES did not, however, explain women's higher levels of insomnia. Subscale analysis showed an association between the role of homemaker and increased night time sleep disturbance and decreased daytime sequelae of poor sleep while higher educational attainment was related only to more severe daytime sequelae. CONCLUSION The sex discrepancy in insomnia narrowed slightly after taking social role factors into consideration but was not explained by SES. The persistent sex gap in insomnia warrants further investigation.