Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies

Renae Fernandez, Vivienne Moore, Emer Van Ryswyk, Tamara J Varoce, Raymond J Rodgers, Wendy March, Lisa Moran, Jodie Avery, R. McEvoy, Michael J Davies

    Research output: Contribution to journalArticlepeer-review

    15 Citations (Scopus)

    Abstract

    Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances and disorders including obstructive sleep apnea and excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without the syndrome. Evidence from the few available population-based studies is supportive. Women with PCOS tend to be overweight/obese, but this only partly accounts for their sleep problems as associations are generally upheld after adjustment for body mass index; sleep problems also occur in women with PCOS of normal weight. There are several, possibly bidirectional, pathways through which PCOS is associated with sleep disturbances. The pathophysiology of PCOS involves hyperandrogenemia, a form of insulin resistance unique to affected women, and possible changes in cortisol and melatonin secretion, arguably reflecting altered hypothalamic–pituitary–adrenal function. Psychological and behavioral pathways are also likely to play a role, as anxiety and depression, smoking, alcohol use and lack of physical activity are also common among women with PCOS, partly in response to the distressing symptoms they experience. The specific impact of sleep disturbances on the health of women with PCOS is not yet clear; however, both PCOS and sleep disturbances are associated with deterioration in cardiometabolic health in the longer term and increased risk of type 2 diabetes. Both immediate quality of life and longer-term health of women with PCOS are likely to benefit from diagnosis and management of sleep disorders as part of interdisciplinary health care.

    Original languageEnglish
    Pages (from-to)45-64
    Number of pages20
    JournalNature and Science of Sleep
    Volume10
    Issue number10
    DOIs
    Publication statusPublished - 2018

    Keywords

    • Cardiometabolic health
    • Hypothalamic-pituitary-adrenal
    • Polycystic ovary syndrome
    • Sleep
    • Sleep disturbance

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