Esther Eisenberg1, Richard S Legro2, Michael P Diamond3, Hao Huang4, Louise M O'Brien5,6, Yolanda R Smith5, Christos Coutifaris7, Karl R Hansen8, Nanette Santoro9, Heping Zhang4. 1. Fertility and Infertility Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20817, USA. 2. Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, PA 16802, USA. 3. Department of Obstetrics and Gynecology, Augusta University, Augusta, GA 30912, USA. 4. Department of Biostatistics, Yale University School of Public Health, New Haven, CT 06520, USA. 5. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA. 6. Department of Neurology, University of Michigan, Ann Arbor, MI 48109, United States. 7. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA 19104, USA. 8. Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA. 9. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, CO 80204, USA.
Abstract
CONTEXT: Sleep plays important roles in metabolic and reproductive function, and polycystic ovary syndrome (PCOS) is associated with sleep disturbances, including increased prevalence of obstructive sleep apnea. OBJECTIVE: We sought to evaluate sleep parameters in infertile women with PCOS compared with women with unexplained infertility (UI) and identify risk factors for disturbed sleep. METHODS: At private and academic ambulatory gynecology and infertility practices, we evaluated a prospective cohort of women diagnosed with PCOS or UI from 2 randomized clinical trials. We included 1603 infertile women enrolled in 2 concurrent randomized clinical trials. The main outcome measures were self-reported sleep measures. RESULTS: Sleep duration <6 hours (6.1% vs 2.7%; P < .001), habitual snoring (37.8% vs 19.0%; P < .001), and clinical sleepiness (12.0% vs 8.6%; P < .026) were more common in women with PCOS than those with UI. After adjusting for covariates, PCOS and elevated fasting insulin were associated (P = .010) with clinical symptoms of obstructive sleep apnea (OSA) diagnosis, whereas PCOS, elevated insulin (P = .003), WC >88 cm (P = .003), and current smoking (P = .012) were associated with habitual snoring. Clinical depression score (P < .001) and PCOS diagnosis (P = .002) were associated with perceived daytime sleepiness. Short sleep duration and clinical symptoms of OSA were not associated with conception and live birth rates. CONCLUSION: Infertile women with PCOS more commonly report sleep disturbances than those with UI. Markers of insulin resistance are associated with previous diagnosis of OSA, habitual snoring, and short sleep duration. The presence of clinical symptoms of OSA or short sleep duration does not affect fertility treatment response.
CONTEXT: Sleep plays important roles in metabolic and reproductive function, and polycystic ovary syndrome (PCOS) is associated with sleep disturbances, including increased prevalence of obstructive sleep apnea. OBJECTIVE: We sought to evaluate sleep parameters in infertile women with PCOS compared with women with unexplained infertility (UI) and identify risk factors for disturbed sleep. METHODS: At private and academic ambulatory gynecology and infertility practices, we evaluated a prospective cohort of women diagnosed with PCOS or UI from 2 randomized clinical trials. We included 1603 infertile women enrolled in 2 concurrent randomized clinical trials. The main outcome measures were self-reported sleep measures. RESULTS: Sleep duration <6 hours (6.1% vs 2.7%; P < .001), habitual snoring (37.8% vs 19.0%; P < .001), and clinical sleepiness (12.0% vs 8.6%; P < .026) were more common in women with PCOS than those with UI. After adjusting for covariates, PCOS and elevated fasting insulin were associated (P = .010) with clinical symptoms of obstructive sleep apnea (OSA) diagnosis, whereas PCOS, elevated insulin (P = .003), WC >88 cm (P = .003), and current smoking (P = .012) were associated with habitual snoring. Clinical depression score (P < .001) and PCOS diagnosis (P = .002) were associated with perceived daytime sleepiness. Short sleep duration and clinical symptoms of OSA were not associated with conception and live birth rates. CONCLUSION: Infertile women with PCOS more commonly report sleep disturbances than those with UI. Markers of insulin resistance are associated with previous diagnosis of OSA, habitual snoring, and short sleep duration. The presence of clinical symptoms of OSA or short sleep duration does not affect fertility treatment response.
Authors: Kara A Michels; Pauline Mendola; Karen C Schliep; Edwina H Yeung; Aijun Ye; Galit L Dunietz; Jean Wactawski-Wende; Keewan Kim; Joshua R Freeman; Enrique F Schisterman; Sunni L Mumford Journal: Chronobiol Int Date: 2019-11-28 Impact factor: 2.877
Authors: Michael P Diamond; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter Casson; Gregory M Christman; Joel Ager; Hao Huang; Karl R Hansen; Valerie Baker; Rebecca Usadi; Aimee Seungdamrong; G Wright Bates; R Mitchell Rosen; Daniel Haisenleder; Stephen A Krawetz; Kurt Barnhart; J C Trussell; Dana Ohl; Yufeng Jin; Nanette Santoro; Esther Eisenberg; Heping Zhang Journal: N Engl J Med Date: 2015-09-24 Impact factor: 91.245
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Authors: Michael P Diamond; Richard S Legro; Christos Coutifaris; Ruben Alvero; Randal D Robinson; Peter Casson; Gregory M Christman; Joel Ager; Hao Huang; Karl R Hansen; Valerie Baker; Rebecca Usadi; Aimee Seungdamrong; G Wright Bates; R Mitchell Rosen; Daniel Haisonleder; Stephen A Krawetz; Kurt Barnhart; J C Trussell; Yufeng Jin; Nanette Santoro; Esther Eisenberg; Heping Zhang Journal: Fertil Steril Date: 2015-02-20 Impact factor: 7.329
Authors: Sushmita Pamidi; Lancelot M Pinto; Isabelle Marc; Andrea Benedetti; Kevin Schwartzman; R John Kimoff Journal: Am J Obstet Gynecol Date: 2013-08-02 Impact factor: 8.661