Sleep disturbances in a community-based sample of women with polycystic ovary syndrome

Moran, Lisa; March, Wendy A.; Whitrow, Melissa J.; Giles, Lynne C.; Davies, Michael J.; Moore, Vivienne

doi:10.1093/humrep/deu318

Cited by 77 publications

(74 citation statements)

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“…Recent findings suggest that there are circadian rhythm and sleep disturbances in women with diagnosed PCOS [20, 21]. We also observed that women with less than 6 hours of sleep had a 1.7-fold increased risk of having long menstrual cycles (more than 35 days) typical of PCOS, although this association did not reach statistical significance.…”

Section: Discussionmentioning

confidence: 50%

Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study

et al. 2016

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ContextFew studies have examined the associations between sleep duration, shiftwork, and exercise to the infrequent menstruation, hyperandrogenism, and ovarian morphological changes observed in women with polycystic ovarian syndrome (PCOS).ObjectiveTo examine whether lifestyle factors, including short sleep duration, insufficient exercise, and shiftwork, alone or in combination, are associated with the reproductive and metabolic abnormalities typical of PCOS in a healthy population.Study Design, Size, DurationProspective cross-sectional study of 231 women, including healthcare workers recruited for an annual health screen, healthy referral patients from the Women’s Clinic and volunteers from the university community at the National University Hospital, Singapore, from 2011 to 2015.Main Outcome MeasuresThe women completed a questionnaire, including their menstrual cycle length, sleep length, frequency of exercise and shift work. Hyperandrogenism (hirsutism score, testosterone, sex hormone binding globulin (SHBG)), ovarian morphology and function (anthral follicle count, ovarian volume, anti-mullerian hormone (AMH)), and metabolic measures (body mass index (BMI), waist hip ratio (WHR), blood pressure, fasting glucose, fasting insulin and fasting lipids) were examined through anthropometric measurements, transvaginal ultrasound scans, and blood tests.ResultsNo significant associations were observed between shift work, exercise or sleep duration and the androgenic and ovarian measures that define PCOS. However, women reporting fewer than 6 hours of sleep were more likely to report abnormal (short or long) menstrual cycle lengths (OR = 2.1; 95% CI, 1.1 to 4.2). Women who reported fewer than 6 hours of sleep had increased fasting insulin levels (difference in means = 2.13; 95% CI, 0.27 to 3.99 mU/L) and higher odds of insulin resistance (OR = 2.58; CI, 1.16 to 5.76). Lack of regular exercise was associated with higher mean fasting insulin (difference in means = 2.3 mU/L; 95% CI, 0.5 to 4.1) and HOMA-IR (difference in means = 0.49; 95% CI, 0.09 to 0.90) levels.ConclusionsWomen with insufficient sleep are at increased risk of menstrual disturbances and insulin resistance, but do not have the hyperandrogenism and polycystic ovarian morphology typical of PCOS.Wider Implications of the FindingsImproved sleep duration may help reduce the risks of diabetes or infertility. Shift work, exercise or sleep duration appear not to impact the androgenic and ovarian measures that define PCOS.

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Section: Discussionmentioning

confidence: 50%

Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study

et al. 2016

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“…Similar proportion of women complained of difficulty falling asleep in study and control group was observed, however more than two fifth of PCOS patients reported unintended early awakening, whereas it was observed only in a few percent of healthy women. The phenomenon was related to Moran et al (2015), but there are some other available data that indicate comorbidity of depressive and anxiety disorders with sleep disorders in women with PCOS [8]. Sleep disorders, as it occurs, might be the one of predictors of depression in women suffering from PCOS [24].…”

Section: Discussionmentioning

confidence: 99%

“…Sleep disturbances in patients suffering from PCOS are described in adult women, but they can be also observed even in adolescent patients [22]. Moran et al (2015) have tried to reveal, that other forms of sleep disorders than OSA are also common in women suffering from PCOS. For this purpose they made investigation of sleep disturbances in a community-based sample of women with and without PCOS.…”

Section: Discussionmentioning

confidence: 99%

“…The greater occurrence of overweight and obesity in women with PCOS had a minimal role in their difficulty falling asleep, whereas symptoms of clinical depression more strongly mediated this association. Similar correlation concerned the difficulty maintaining sleep [23]. In a study conducted by our team we also dealt with the problem of sleep disturbances in women with PCOS, in a wide range of them without analysis of their etiology.…”

Section: Discussionmentioning

confidence: 99%

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Sleep disturbances in women with polycystic ovary syndrome

Franik

Krysta

Madej

et al. 2016

Gynecological Endocrinology

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Sleep disturbances in women with Polycystic Ovary Syndrome (PCOS) have been reported in recent years. The majority of published studies are related to Obstructive Sleep Apnea (OSA) while not many researches have analyzed any other causes of sleep disturbances. A group of ninety five women with Polycystic Ovary Syndrome were enrolled into the study. Sleep disturbances were assessed using validated questionnaires. On the grounds of Athens Insomnia Scale (AIS) evaluation a clinically significant insomnia was ascertained in 12.6% of women with PCOS, while according to Insomnia Severity Index (ISI) in 10.5%. Clinically significant insomnia according to both AIS and ISI, occurred significantly more often in women with PCOS than in women without PCOS based on the chi-square test. The Mann-Whitney U test revealed statistically significant difference between women with and without PCOS based on total values of ISI. An excessive daytime sleepiness occurred at 7.4% of women with PCOS. Statistically significant dependance between: clinically significant insomnia in both AIS and ISI and excessive daytime sleepiness indicated by Epworth Sleepiness Scale (ESS) was observed. Sleep disorders are common in women with PCOS. Screening assessment of sleep disturbances should be a part of medical diagnostics in women with PCOS.

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“…This increased risk was present in only obese women with PCOS, indicating that BMI was the only independent predictor of OSA risk on Berlin Questionnaire (23). Another study, investigating sleep disturbances using a modified version of Jenkins Sleep Questionnaire in a community-based sample of women with and without PCOS, showed that sleep disturbances were almost twice as common in women with PCOS compared with women of similar age without PCOS and difficulty achieving and maintaining sleep were most problematic (24). Findings about sleep architecture in adults with PCOS are conflicting.…”

Section: Discussionmentioning

confidence: 99%

Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature

Helvacı

Karabulut

Demir

et al. 2017

Endocrine Connections

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Background and ObjectivePolycystic ovary syndrome (PCOS) has been reported to be associated with the development of obstructive sleep apnea (OSA). The objective of this meta-analysis is to assess the relationship between PCOS and OSA.MethodsA literature search was conducted to identify studies linking PCOS with the risk of OSA. Studies in which the presence of OSA was confirmed with overnight polysomnography were included. Random effects models were used to calculate pooled relative risks.ResultsEight studies conducted in adults and five studies conducted in adolescents were identified. The pooled OSA prevalence was 0.22 (95% confidence interval (CI): 0.08–0.40) in PCOS patients. The pooled prevalence of OSA was higher in adults (0.32, 95% CI: 0.13–0.55) than adolescents (0.08, 95% CI: 0.00–0.30). Risk of OSA was significantly increased in adult patients with PCOS (odds ratio (OR) 9.74, 95% CI: 2.76–34.41). Risk of OSA was not significantly increased in adolescents (OR: 4.54, 95% CI:0.56–36.43).ConclusionsThese findings demonstrate a significant association between PCOS and OSA in adult patients. Considering the increased risk for long-term cardiometabolic disorders associated with both PCOS and OSA, it is important to diagnose and treat OSA in patients with PCOS.

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Sleep disturbances in a community-based sample of women with polycystic ovary syndrome

Abstract: Our results indicate that assessment and management of both sleep and mental health problems in women with PCOS should be undertaken. Longitudinal data would be valuable to see how poor sleep affects longer-term health profiles.

Cited by 77 publications

References 38 publications

Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study

Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study

Sleep disturbances in women with polycystic ovary syndrome

Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature

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