Yes — research shows significant sex and gender differences in both the prevalence and characteristics of nightmares.

🔢 Prevalence

• Women report nightmares more frequently than men across all age groups.

• Meta-analyses show that adult women are about 2–3 times more likely to experience frequent nightmares than men.

• This gender gap emerges in adolescence, around the same time as hormonal and psychosocial changes.

🧠 Possible Explanations

1. Hormonal factors

   • Estrogen and progesterone fluctuations (e.g., during menstruation, pregnancy, perimenopause) may influence REM sleep and emotional dream content.

2. Higher rates of PTSD, anxiety, and depression in women

   • These are strong risk factors for nightmares.

   • PTSD-related nightmares are more prevalent in female survivors of sexual trauma or intimate partner violence.

3. Increased dream recall

   • Women tend to have higher dream recall frequency, which may increase the perception and reporting of nightmares.

4. Cultural and emotional expressiveness

   • Women may be more likely to report nightmares due to differences in social conditioning around emotional expression.

📉 Men and Nightmares

• Men may underreport nightmares or dismiss them due to stigma.

• However, when present, nightmares in men — especially those with combat-related PTSD — are often more severe and more likely to persist long term.

• Men may also be more prone to acting out nightmares physically (e.g., REM Sleep Behavior Disorder in older men).

💬 Clinical Implication

• Don’t overlook nightmares in either gender.

• Be especially vigilant in:

  • Women: perinatal period, trauma survivors, those with anxiety/depression

  • Men: military veterans, substance use comorbidity, underreported symptoms

🧠 Dr. Srinivas Rajkumar T

Consultant Psychiatrist
Apollo Clinics – Velachery & Tambaram, Chennai
📞 Phone: 8595155808
🌐 www.srinivasaiims.com

Nightmares have many faces — and understanding gender-specific patterns helps us tailor more compassionate, effective care.