PCOS & Sleep Disturbances Part I:
Types, Causes & Health Implications
Posted by Allie on 18th March 2016
Sleep is essential to wellbeing and believed to enable our bodies perform restorative and rejuvenating processes. However, there is some evidence that women with PCOS can experience difficulties sleeping, which may have longer term health implications.
What types of sleep disturbances are associated with PCOS?
Obstructive sleep apnoea (OSA): When you sleep, your throat muscles relax. However, in some people, the muscles and tissues in the throat relax and collapse, causing a total blockage of the airway. If the airway blocks for 10 seconds or more, it is called apnoea. Signs of OSA include loud snoring, noisy/laboured breathing, and repeated interrupted breathing, such as gasping.
OSA appears to be common in women with PCOS who are obese (5). Obese women with PCOS have also been found to have higher risks and rates of OSA than those within a normal weight range and women without PCOS (1). You can learn more about OSA on the NHS Choices website.
Daytime sleepiness: Obese women with PCOS have been found more likely to experience drowsiness during the day than women without PCOS (1).
Difficulties falling asleep or maintaining sleep i.e. increased waking for no reason and not being able to get back to sleep quickly. An Australian study found that 35% of their participants with PCOS had difficulties falling asleep compared with 20% of women without the condition (3).
Increased irritability or mood issues have been reported by women with PCOS due to sleep disturbances (3).
What are the causes of sleep disturbances in PCOS?
The definitive causes of disturbed sleep in PCOS are not yet known. The high prevalence of OSA in PCOS was thought to be due to elevated testosterone levels associated with the condition and obesity. However, it appears that these factors alone are not fully responsible for the risks and rates of OSA in PCOS (2). Some data indicates that BMI, insulin resistance and glucose tolerance are risk factors (1), and obese women with PCOS have an increased risk of sleep disordered breathing and daytime sleepiness. Non-obese women with PCOS have been found not to be at increased risk of disordered sleep.
One study has found that there appears to be a correlation between clinical depression and sleep disturbances in PCOS (3). For example, emotional or psychological issues can affect sleep and, conversely, sleep problems may impact an individual’s emotional wellbeing.
What are the health implications of sleep disturbances for women with PCOS?
OSA in the general population, if left untreated, is linked to an increased risk of type II diabetes, cardiovascular disease and high blood pressure. Sleep disturbances could also lead to reduced quality of life, emotional or psychological issues. Sleep issues may exacerbate insulin resistance (4), which many women with PCOS suffer from.
Note that referenced or mentioned authors, websites and organisations are not affiliated with, nor endorsing, the content published on Positive PCOS.
1: Conway, G. et al. 2014. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. European Journal of Endocrinology. 171:1-29
2: Nitsche, K. & D. Ehrmann. 2010. Obstructive sleep apnea and metabolic dysfunction in polycystic ovary syndrome. Best Practice & Research Clinical Endocrinology & Metabolism. 24 (5): 717–730
3: Moran, L.J. et al. 2015. Sleep disturbances in a community based sample of women with polycystic ovary syndrome. Human Reproduction. 30 (2): 466–472
4: Tasali, E. et al. 2008. Impact of obstructive sleep apnea on insulin resistance and glucose tolerance in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 93 (10): 3878–3884
5: Kahal, H. et al. 2017. Obstructive sleep apnoea and polycystic ovary syndrome: a comprehensive review of clinical interactions and underlying pathophysiology. Clinical Endocrinology. 87 (4): 313-319