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Can Pcos Cause Sleep Problems

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The Vicious Cycle Behind Pcos And Sleep Issues And How To Combat The Problem

Hormones can trigger sleep problems for women

Polycystic Ovarian Syndrome, better known as PCOS, is the most common endocrine disorder worldwide, affecting at least 1 in 10 women and people assigned female at birth . It is a complex condition which affects a womans hormone levels and the way the ovaries function, resulting in a wide range of reproductive, metabolic, and psychological symptoms that affect women differently.

Outside of the main tell-tale symptoms, there are several lesser-known symptoms of PCOS including sleep disturbances, which can have huge short-term and long-term complications. Here we dissect this relationship, along with some ways to combat the dual issues.

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The Dangers Of Too Much Sleep

Women with PCOS are at higher risk of oversleeping .

This can also be a warning sign for other underlying health conditions, including sleep disorders such as sleep apnoea or mental health conditions such as depression, both of which people with PCOS are at greater risk of. Oversleeping is associated with other chronic conditions such as type 2 diabetes and cardiovascular disease so it may be helpful to keep a sleep diary and discuss your concerns with your doctor. Do seek help as there are many techniques and lifestyle interventions that can help improve sleep.

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Study Design And Population

Data for this study were obtained from the first wave of data collection for a cohort of women born during 19731975 at a large maternity hospital in Adelaide, South Australia. To be eligible to participate in the cohort, the baby must have survived to discharge and, as an adult, be capable of providing socio-demographic and health information. At around age 30 years, 2046 women were traced, across Australia, and contacted by letter and telephone. Sixty-two women were confirmed to be deceased or severely disabled. Of those remaining eligible, 974 agreed to participate and provided core information, in a personal interview with a research nurse where possible , or via telephone if they were not geographically close to Adelaide and had no plans to visit. The sample analysed here comprises women interviewed in person in Adelaide, who provided core information, completed additional questionnaires and had anthropometric measurements made by a research nurse . After excluding the 32 individuals with missing information on one or more key variables, the sample available for analysis comprised 724 women.

Flow diagram for cohort tracing and participation.

Sleep Disturbances And Disorders And Pcos


Sleep disturbances include altered sleep duration, delay of sleep onset, difficulty in maintaining sleep or awakening early.38 Insomnia is defined as impairment in the ability to initiate or maintain sleep, including extended periods of wakefulness during the night. Chronic insomnia disorder is diagnosed when insomnia occurs at least three nights per week and for at least three months.39 Obstructive sleep apnea is characterized by frequent cessations of breathing during sleep and may occur along with other sleep disturbances.40 Clinically, OSA is diagnosed by detecting the frequency of events that are apneic and hypopneic , as per the apneaâhypopnea index . A diagnosis of OSA is made when AHI is â¥15 or when AHI is â¥5 with symptoms such as daytime sleepiness, loud snoring and witnessed breathing interruptions.41

Sleep disturbances and disorders have repercussions for daytime mood, cognition and psychomotor functioning,42 which acutely affect well-being and daily activities, and can inhibit performance in roles such as that of parent or employee.43,44 Aspects of cognition that appear most affected are attention, executive function and working memory,42,45 with significant implications for productivity.44 Fatigue, attention deficits and psychomotor impairment can affect safety, increasing the risk of workplace and motor vehicle accidents.42 Thus, poor sleep represents a serious health problem.

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Pcos: Definition And Pathogenesis

A diagnosis of PCOS requires that at least two of the three following abnormalities are present: 1. absent or irregular menstrual cycles 2. elevated levels of circulating androgens or clinical manifestations of hyperandrogenism 3. polycystic ovaries on ultrasonography . Thus, polycystic ovaries need not be present in PCOS women, and conversely, the presence of polycystic ovaries alone does not establish a diagnosis of PCOS. PCOS typically manifests at the time of puberty with menstrual irregularity, hirsutism, and obesity .

Sleep Duration Exercise Shift Work And Polycystic Ovarian Syndrome

  • Affiliation Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, Singapore, 119228, Singapore

  • Affiliation Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, Singapore, 119228, Singapore

  • Affiliation Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, Singapore, 119228, Singapore

  • Affiliations Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, Singapore, 119228, Singapore, Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, H3G1Y6, Canada

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Common Polycystic Ovary Syndrome Signs And Symptoms

To be diagnosed with polycystic ovary syndrome, a doctor will look for a few criteria: irregular periods, excess androgen, and polycystic ovaries. Other symptoms that may be experienced with PCOS include:

  • Weight gain
  • Fatigue
  • Unwanted hair growth : hair growth may appear on the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism is a result of excess androgen.
  • Thinning of hair on the head
  • Infertility
  • Headache
  • Sleep problems

PCOS can also cause many symptoms related to a womans menstrual cycle, leading to pain during menstruation or ovarian pain. Periods may become irregular, absent, heavy, or very light. PCOS can negative impact fertility, either making it difficult to get pregnant or resulting in complete infertility.

Aside from the extensive list of symptoms above, PCOS also increases your risk of insulin resistance, which is a precursor to type 2 diabetes, along with the risk of heart and vascular diseases like stroke, reproductive cancers, miscarriages, infertility, and obesity.

Warning Signs Associated With Pcos And Weight Gain

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There are a few warning signs associated with PCOS and weight gain. If you experience any of the following, its important to contact your healthcare provider:

  • A sudden or gradual increase in weight
  • Thinning hair on your head or excess hair growth on your face, chest, or back
  • Irregular periods or no periods at all
  • Ovarian cysts
  • Acne
  • Darkening of the skin on the neck, breasts, or inner thighs

If youre struggling with your weight, PCOS may be to blame. But before any official diagnosis can be made, youll need to see your healthcare provider for a few tests.

These may include:

  • Blood tests
  • Ultrasound

Once PCOS is confirmed, there are treatments available that can help you lose weight and manage the symptoms of this disorder. But its important to remember that everyones experience with PCOS is different, so what works for one person may not work for another.

Thats why its important to work with your healthcare provider to develop a treatment plan thats right for you. If youre struggling to lose weight on your own, dont hesitate to ask for help. There are plenty of resources available to support you on your journey.

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Why Could Pcos Cause Sleep Problems

There are several possible reasons why PCOS might cause sleep disturbances.

Women with PCOS are at higher risk of Obstructive Sleep Apnoea , a condition where the airway becomes blocked many times during sleep.

PCOS can also lead to weight gain, with women more often being overweight or obese.

Being overweight or obese is associated with sleep disorders such as insomnia as well as OSA in the general population.

There are other features of PCOS that may also lead to sleep disturbances, even in women without OSA.

Hormonal imbalances in women with PCOS can lead to decreased production of the hormone progesterone. Progesterone has been shown to have an important sleep stabilizing effect 5.

Conditions that occur more often with PCOS, such as diabetes 6 and depression 7, can also make daytime sleepiness worse.

Heart Disease And High Blood Pressure

Cardiovascular disease includes a range of different conditions:

  • Coronary artery disease
  • This is a narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart.
  • Coronary artery disease can lead to heart attack, heart failure, or an irregular heartbeat, also called an arrhythmia .6
  • Atherosclerosis , or hardening of the arteries
  • Women with PCOS have high levels of low-density lipoprotein , sometimes called “bad” cholesterol, and low levels of high-density lipoprotein , sometimes called “good” cholesterol. Both problems are linked to atherosclerosis.2
  • High blood pressure
  • Women with PCOS are at increased risk for high blood pressure.7
  • High blood pressure can increase the risk of stroke. During a stroke, the blood vessels that carry blood to the brain are blocked or broken open so that oxygen and other essential factors are not delivered to the brain cells. Stroke can cause serious disability and even death.8
  • Cardiomyopathy
  • With this condition, the heart muscle becomes larger, thick, and hard, making the heart less able to pump blood to the body.9
  • Several factors related to PCOS, including insulin resistance, metabolic syndrome, and obesity, increase a woman’s risk of cardiovascular disease.1

    Heart disease is the leading killer of women in the United States,5 and several studies have found that women with PCOS are at increased risk for cardiovascular disease.10 Doctors should regularly screen PCOS patients for their risk of heart disease.11

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    Mental Health Profiles Of Women With Pcos

    Anxiety and depression are well recognized to be associated with sleep disorders.116â118 A systematic review of nine longitudinal studies found suggestive, though not definitive, evidence of a bidirectional relationship.119 A recent study of young women followed over two weeks found reciprocal dynamics between anhedonic depression and disrupted sleep to be especially potent.120

    Anxiety and depression are elevated in women with PCOS, with consistent evidence presented in several systematic reviews with meta-analysis.121â125 In our community-based sample, among women with PCOS , 50% had symptoms consistent with clinical depression compared with 30% of their peers.48

    In one of the above systematic reviews,125 clinical symptoms, including hirsutism, obesity, and infertility, were shown to contribute to higher emotional distress in women with PCOS, but did not fully account for the disparity. Elevated androgens have been associated with negative affect and depressive symptoms in women with PCOS,78,126 but the relationship between androgens and mood disorders in women remains controversial.124,127 As discussed, women with PCOS may have hyperresponsivity of the HPA axis, which is associated with impaired mental health, including depression.128

    As with anxiety and depression, it is likely that a bidirectional relationship exists between sleep and QoL.131 This may be especially so in people with medical conditions.132

    How Pcos Impacts Our Sleep And Recovery

    PCOS and Insomnia: The Natural Way to Reclaim Your Zzzzzzz

    Did you know PCOS leaves you at a greater risk of sleep disturbances? Learn more about this as well as sleep health tips.

    It may not seem like it, but your body is hard at work while you sleep to prepare you for the following day. Sleep is critical for helping your mind and body recover and recharge and has been linked to memory consolidation . Without quality rest you may experience brain fog and an inability to focus, but lack of sleep goes even deeper than that – especially if you have PCOS.

    Sleep is significant for managing stress levels and vice versa. And, keeping your stress under control is a key part of keeping PCOS symptoms and inflammation at bay. However, people with PCOS often experience hormone imbalances relating to cortisol and melatonin.

    Since both of these hormones are responsible for the sleep-wake cycle, these imbalances can cause sleep disorders such as insomnia and sleep apnea and subsequently contribute to additional stress, thus catalyzing a viscous cycle .In this article, we will provide an overview of the relationship between PCOS and sleep. Keep reading to understand:

    • Why is sleep important?
    • What are the common sleep disorders associated with PCOS?
    • How could my PCOS be impacting my insomnia or sleep apnea?
    • What are remedies for sleep disturbances associated with PCOS?

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    Feel Free To Let Us Know What Has Helped You Get A Good Night Sleep And What Difference Its Made For Your Health Happy Zs

    Sam S, Ehrmann DA.Pathogenesis and Consequences of Disordered Sleep in PCOS. Clin Med Insights Reprod Health. 2019 Sep 3 13: 2019.

    Kahal H, Kyrou I, Uthman OA.The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis. Sleep Breath. 2019

    Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nat Sci Sleep. 2018 Feb 1 10:45-64.

    Van Cauter E. Sleep disturbances and insulin resistance. Diabet Med. 2011.

    Tasali E, Chapotot F, Leproult R, Whitmore H, Ehrmann DA.Treatment of obstructive sleep apnea improves cardiometabolic function in young obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2011 Feb 96:365-74.

    Pamidi S, Aronsohn RS, Tasali E. Obstructive sleep apnea: role in the risk and severity of diabetes. Best Pract Res Clin Endocrinol Metab. 2010 Oct 24:703-15.

    Spiegel K, Tasali E, Leproult R, Scherberg N, Van Cauter E. Twenty-four-hour profiles of acylated and total ghrelin: relationship with glucose levels and impact of time of day and sleep. J Clin Endocrinol Metab. 2011 Feb 96:486-93.

    Aronsohn RS, Whitmore H, Van Cauter E, Tasali E. Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med. 2010 Mar 1 181:507-13.

    At Some Point Or Another We Have All Faced The Consequences Of Not Getting Adequate Sleep It Is Never A Pleasant Experience

    Without sufficient sleep, you may find that you are more likely to feel tired, irritable, and slow. You probably experience a general feeling of grogginess and all you can think about is going back to sleep.

    These feelings all typically go away once you obtain some quality rest, but what happens when you have long-term sleep disturbances? Not only will your day-to-day energy levels be affected, but also your overall health.

    While you sleep, several vital biological processes happen in your body. Below are a few areas that have been linked to sleep .

    • Muscle repair and growth
    • Immune support
    • Heart health

    Chronic sleep disruptions can impact several different areas of your health, so be sure to discuss any concerns you may have if you are experiencing abnormal sleep disturbances.

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    How Important Is Sleep

    Experts believe that women with PCOS may not be sleeping as well as they could because of metabolic changes they experience, especially glucose metabolism. Also, women with PCOS may experience hormonal imbalances which can also impact their sleep.

    Bottom line: sleep is essential for women with PCOS and its vital to have some strategies in place to ensure you get good quality sleep.

    What Are The Risks Associated With Pcos

    Sleeping Problems During Pregnancy Reasons & Solutions

    No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

    Many of these conditions can lead to heart disease.

    Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne.

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    Seek Treatment From A Health Professional

    If you have sleep concerns, schedule a visit with your healthcare provider. Come prepared with a list of your symptoms and the number of hours you have been sleeping. Your physician may order a sleep study, which can help identify any sleep problems. The sleep study involves an overnight stay at a clinic where your healthcare team will evaluate your sleep state, eye movements, respiratory efforts, muscle activity, heart rate, and blood oxygen levels.

    Make sure you follow any recommendations provided by your physician.

    Sleep is so important for your overall health and well-being. For many, its the missing piece of the puzzle. If you have sleep concerns, keep these sleep strategies handy and consult with your healthcare provider to help you achieve the restful sleep you deserve.

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    Predictors Of Sleep Apnea In Pcos

    PCOS patients with and without SDB were similar, in terms of age , whereas PCOS women with SDB were heavier . PCOS patients who were recommended treatment for SDB showed significantly higher fasting insulin levels and a lower glucose-to-insulin ratio than those who were not . The difference between the insulin levels remained significant when adjusted for BMI . Plasma free or total testosterone and fasting blood glucose concentrations were not different between the two subgroups of PCOS patients.

    To understand further the relation between the presence of SDB in PCOS patients and potential predictive factors, we used logistic regression analysis to predict PCOS patients requiring treatment for SDB vs. those not requiring treatment for SDB. In this model, we included age, BMI, free and total testosterone, fasting insulin levels, and glucose-to-insulin ratio as potential predictors of the presence of SDB in PCOS women. All predictor variables were initially entered into this analysis as continuous variables. The backward conditional analysis eliminated all variables except insulin and glucose-to-insulin ratio, suggesting that insulin resistance was a stronger predictor than age, BMI, or testosterone.

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