Sleep Habits of Women with Infertility.

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 to women with unexplained infertility (UI) and identify risk factors for disturbed sleep.

DESIGN: Prospective cohort of women diagnosed with PCOS or UI from two randomized clinical trials.

SETTING: Private and academic ambulatory gynecology and infertility practices.

PARTICIPANTS: 1603 infertile women enrolled in two concurrent randomized clinical trials.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): 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<0.026) were more common in women with PCOS than those with UI. After adjusting for covariates, PCOS and elevated fasting insulin were associated (p=0.010) with clinical symptoms of obstructive sleep apnea (OSA) diagnosis, whereas PCOS, elevated insulin (p=0.003), waist circumference >88 cm (p=0.003), and current smoking (p=0.012) were associated with habitual snoring. Clinical depression score (p<0.001) and PCOS diagnosis (p=0.002) were associated with perceived daytime sleepiness. Short sleep duration and clinical symptoms of OSA were not associated with conception and live birth rates.

CONCLUSIONS: 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. Presence of clinical symptoms of OSA or short sleep duration does not affect fertility treatment response.