Psychiatric Annals

Guest Editorial Free

Disorders of Sleep in Women and Children

Safia S. Khan, MD; Imran S. Khawaja, MBBS, FAASM

A ruffled mind makes a restless pillow.

A third of our lives is spent sleeping, recharging, and energizing for the forthcoming day. Each of us will spend about 27 years of our lifetime sleeping. 1 This fact alone explains why neuroanatomists and neurophysiologists have been studying sleep for more than a century.1

More than 50 million Americans suffer from over 80 different sleep disorders, and another 20 to 30 million suffer intermittent sleep problems each year.2 At least 25 million Americans (1 in 5 adults) suffer from sleep apnea, a serious sleep and breathing condition linked to hypertension, cognitive impairment, heart disease, and stroke.2 Chronic insomnia affects at least 10% of Americans.2 Experts consider insomnia as a risk factor for depression and anxiety, with a bidirectional relationship between insomnia and psychiatric disorders.

Restless legs syndrome, a neurological disorder, affects about 5% of the population older than age 65 years.2 In addition, the odds of being sleep deprived have increased significantly over the past 30 years as the lines between work and home have become blurred and digital technology has firmly become part of our lifestyles.2 In this issue of Psychiatric Annals on disorders of sleep in women and children, we discuss sleep disorders, particularly in women, highlighting stressful life events like pregnancy, childbirth, and menopause.

In the first article, “Restless Legs Syndrome in Women with Comorbid Psychiatric Disease,” Drs. Abha Patel and Safia S. Khan discuss the prevalence, diagnosis, and treatment of restless legs syndrome. In the second article, “Disorders of Sleep in Women: Insomnia,” Drs. Khan and Imran S. Khawaja highlight the definition, symptoms, etiology, and treatment for insomnia among women during the different phases of hormonal changes through the lifespan. The third article, “Obstructive Sleep Apnea in Pregnancy,” by Drs. Sarah Rizvi, Mahdi Awwad, Numan Choudhry, and Khan emphasizes the importance of early diagnosis and treatment of obstructive sleep apnea in the time-critical period of pregnancy. Psychiatrists often miss the diagnosis of obstructive sleep apnea in women; treating sleep apnea during pregnancy has an overall beneficial effect on sleep and mental health. The last article, “Hypersomnolence in Children and Adolescents: Causes, Assessment, and Management,” by Drs. Kriti D. Gandhi, Meghna P. Mansukhani, and Bhanu Prakash Kolla discusses hypersomnolence, the causes and etiology being only slightly different among this age group compared to adults. Delayed sleep-phase syndrome in adolescents is often misdiagnosed as insomnia and can respond to certain pharmacological and behavioral interventions.

These articles provide key facts and management strategies for four of the most common types of sleep disorders encountered in clinical practice. We hope that readers will find these articles useful in clinical practice, enhancing outcomes of acute and chronic medical disorders by improving the sleep outcomes of their patients.


  1. Ohayon MM. Epidemiological overview of sleep disorders in the general population. Sleep Med Res. 2011;2(1):1–9. doi:10.17241/smr.2011.2.1.1 [CrossRef]
  2. American Sleep Apna Association. Accessed November 6, 2019.

Safia S. Khan, MD
Imran S. Khawaja, MBBS, FAASM

Safia S. Khan, MD, is an Assistant Professor, Sleep Medicine and Family Medicine, and the Director, Didactics Sleep Medicine Fellowship, University of Texas (UT) Southwestern Medical Center. Imran S. Khawaja, MBBS, FAASM, is a Clinical Professor, Department of Psychiatry and Neurology, UT Southwestern Medical Center; and the Chief Executive Officer, MD TruCare PA.

Address correspondence Safia S. Khan, MD, Sleep Medicine and Family Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390; email:

Grant: Safia S. Khan received a grant (FP00012281) for obesity and obstructive sleep apnea in pregnancy research from the National Institutes of Health National Heart, Lung and Blood Institute.

Disclosure: The authors have no relevant financial relationships to disclose.


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