Pathogenesis and Consequences of Disordered Sleep in PCOS

Sam, Susan; Ehrmann, David A.

doi:10.1177/1179558119871269

Cited by 36 publications

(30 citation statements)

References 54 publications

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“…This is why sleep disorders in patients with PCOS are twice as common as in ordinary people [ 80 ]. Hyperandrogenism, IR, and low estrogen and progesterone levels with PCOS have all been suggested to cause OSA in PCOS patients [ 81 ]. IR is associated with irregular sleep breathing [ 3 ].…”

Section: Resultsmentioning

confidence: 99%

Investigation of common risk factors between polycystic ovary syndrome and Alzheimer’s disease: a narrative review

et al. 2021

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Background The most common endocrine and metabolic disorders in premenopausal women is polycystic ovary syndrome (PCOS), characterized by hyperandrogenism, chronic anovulation, and/or ultrasound evidence of small ovarian cysts. Obesity and insulin resistance are also the main factors influencing the clinical manifestations of this syndrome. Alzheimer’s disease (AD) is the most typical progressive neurodegenerative disorder of the brain, and recent studies suggest a relationship between endocrinal dysregulation and neuronal loss during AD pathology. Aim This study aimed to evaluate the common risk factors for Alzheimer’s and PCOS based on previous studies. Knowing the common risk factors and eliminating them may prevent neurodegenerative Alzheimer’s disease in the future. Method In this narrative review, international databases, including Google Scholar, Scopus, PubMed, and the Web of Science, were searched to retrieve the relevant studies. The relevant studies’ summaries were categorized to discuss the possible pathways that may explain the association between Alzheimer’s and PCOS signs/symptoms and complications. Results According to our research, the factors involved in Alzheimer’s and PCOS disorders may share some common risk factors. In patients with PCOS, increased LH to FSH ratio, decreased vitamin D, insulin resistance, and obesity are some of the most important factors that may increase the risk of Alzheimer’s disease.

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Section: Resultsmentioning

confidence: 99%

Investigation of common risk factors between polycystic ovary syndrome and Alzheimer’s disease: a narrative review

et al. 2021

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“…Other reported risk factors for decreased sleep quality during the COVID-19 pandemic are changes to sleep patterns ( 62 ), worries about health ( 68 ), financial consequences ( 69 ), social interactions ( 70 ), reduced physical activity ( 63 ), and gender with women being reportedly 56% more likely than men to experience sleep disruption during this pandemic ( 71 ). As such, it is plausible that such factors further contribute to a potential multifactorial effect upon an already “at risk” population ( 72 ), which clearly exacerbates sleep disruption and may result in reduced QoL. Indeed, the results of the present study support this notion, since women with PCOS who reported negative sleep effects during the COVID-19 pandemic also exhibited reduced QoL (as measured by the PCOSQOL) compared to those without any, or with positive effects on sleep.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disruption and Depression, Stress and Anxiety Levels in Women With Polycystic Ovary Syndrome (PCOS) During the Lockdown Measures for COVID-19 in the UK

Kite

Atkinson

McGregor

et al. 2021

Front. Glob. Womens Health

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Background: Lockdown measures have been enforced globally in response to the COVID-19 pandemic. Given the comorbidity burden in women with polycystic ovary syndrome (PCOS), these lockdown measures may have a particularly negative impact on sleep health, quality of life (QoL), and depression/stress levels in this population. The aim of this study was to explore whether such potential problems were present in women with PCOS during the COVID-19 lockdown in the UK.Methods: UK women with PCOS were recruited through social media into a cross-sectional study during the COVID-19 lockdown. The study survey was delivered online, and included demographic and COVID-19 relevant questions, as well as validated questionnaires/scales, namely the Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale (DASS-21), and PCOSQOL questionnaire.Results: Three hundred and thirty-three women with PCOS [median age: 30.0 (9.0) years] were recruited. Participants were dichotomized based on responses regarding the impact of COVID-19 restrictions on their sleep [negative (N = 242) vs. no/positive (N = 91) impact]. No differences were noted between groups regarding age, time since PCOS diagnosis, body mass index, or number of comorbidities. Based on the ISI, 44.2% of participants reporting a negative impact on sleep exhibited at least moderately severe clinical insomnia. Compared to those who reported no/positive effect on sleep, the participants reporting a negative impact on sleep also reported poorer QoL, based on the total PCOSQOL score, with a greater impact of PCOS and poorer mood in the corresponding PCOSQOL domains. Based on the DASS-21, the latter also had statistically higher depression and stress levels compared to the former. Finally, for this cohort significant inverse correlations were noted between the ISI and PCOSQOL scores (total and domain scores), whilst the DASS-21 and ISI scores were positively correlated (all p-values <0.001).Conclusion: The majority of recruited UK women with PCOS reported that the COVID-19 lockdown had a negative impact on their sleep, which was also associated with impaired QoL and higher depression/stress levels. Whilst further research is required, women with PCOS should be considered a vulnerable population that may experience an adverse impact on sleep, QoL and mental health well-being due to lockdown measures during the COVID-19 pandemic.

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“…Since insulin resistance is an important etiological feature of PCOS, affected women are at higher risk of developing type 2 diabetes and related metabolic complications [ 38 ]. On the other hand, it has been reported that sleep disturbances are common in PCOS, and some form of them, like obstructive sleep apnoea, in turn, exacerbates insulin resistance [ 39 ]. In accordance with our results, there were studies that have shown treatment with exogenous melatonin had favorable effects on sleep quality, which was assessed by the PSQI, especially in the adults with metabolic disorders [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic and hormonal effects of melatonin and/or magnesium supplementation in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial

et al. 2021

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Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. This study was designed to investigate the effects of melatonin and/or magnesium supplementation on metabolic profile and levels of sex hormones in PCOS women. Methods In an 8-week randomized double-blind placebo-controlled trial, 84 subjects with PCOS aged 18–40 years were randomly assigned based on the random block procedure to take magnesium, melatonin, magnesium plus melatonin, and placebo. Fasting blood samples were obtained at the beginning and end of the study. Results After intervention, the mean Pittsburg Sleep Quality Index score decreased significantly in both co-supplementation and melatonin groups (P < 0.001). Magnesium supplementation in combination with melatonin resulted in a significant greater decrease in testosterone concentrations compared with the placebo (P < 0.05). Co-supplementation of magnesium-melatonin had significantly reduced serum insulin levels (geometric means difference: − 1.11 (mIU/mL) (percent change: − 15.99)), homeostasis model of assessment-insulin resistance (HOMA-IR) (− 0.28 (− 18.66)), serum cholesterol (mean difference: − 16.08 (mg/dl) [95% CI − 24.24, − 7.92]), low-density lipoprotein cholesterol (LDL-C) − 18.96 (mg/dl) [− 28.73, − 9.20]) and testosterone levels (− 0.09 (ng/ml) (− 25.00)), as compared to the baseline values (P < 0.05). An increase in serum high-density lipoprotein cholesterol (HDL-C) levels was also observed following the administration of the melatonin alone (2.76 (mg/dl) [0.57, 4.95]) or in combination with magnesium (2.19 (mg/dl) [0.61, 3.77]) (P < 0.05). Conclusions Co-supplementation with magnesium and melatonin had beneficial effects on sleep quality and total testosterone. Additionally, melatonin supplementation alone was found to be associated with a significant reduction in PSQI score. Moreover, combined melatonin and magnesium supplementation was more effective in improving serum levels of cholesterol, LDL-C, HDL-C and insulin, and HOMA-IR. Trial registration: Iranian Registry of Clinical Trial. http://www.irct.ir: IRCT20191130045556N1, January 2020.

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Pathogenesis and Consequences of Disordered Sleep in PCOS

Cited by 36 publications

References 54 publications

Investigation of common risk factors between polycystic ovary syndrome and Alzheimer’s disease: a narrative review

Investigation of common risk factors between polycystic ovary syndrome and Alzheimer’s disease: a narrative review

Sleep Disruption and Depression, Stress and Anxiety Levels in Women With Polycystic Ovary Syndrome (PCOS) During the Lockdown Measures for COVID-19 in the UK

Metabolic and hormonal effects of melatonin and/or magnesium supplementation in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial

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