Beyond counting sheep: Exploring the link between polycystic ovary syndrome and sleep health
Open accessAbstract
Polycystic ovary syndrome (PCOS) is a common hormonal condition with reproductive, metabolic, and psychological sequelae that affects 8 to 13% of reproductive-aged women and 3 to 11% of adolescent girls. Sleep is often compromised in women with PCOS due to increased rates of sleep problems, with the most established problem being obstructive sleep apnea (OSA). OSA is highly prevalent in reproductive-aged adult women with PCOS, but not so in adolescence. The international evidence-based PCOS guideline to improve health outcomes in women with PCOS indicated routine screening to identify and alleviate symptoms of OSA. The guidelines, however, did not weigh other multidimensional constructs of sleep health such as sleep disturbances (e.g., sleep quality and quantity), beyond OSA. This is perhaps due to the lack of research and existing mixed findings in the area of PCOS and sleep health. This narrative review summarizes the current knowledge about OSA and expands further to include the limited knowledge about other sleep problems in PCOS among reproductive-aged women and adolescent girls. We broadly cover the prevalence, risk factors, and mechanisms of sleep problems in PCOS and their relationship with cardiometabolic and psychological health. A brief summary on treatment and intervention strategies for sleep problems in PCOS and future recommendations will be deliberated.
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Sleep disturbances and associated symptoms may drive inflammation, oxidative stress and increased sympathetic excitability, plausibly alter the regulation of gonadotropins and gonadotropin-releasing hormones, thus contributing to the expression of pathophysiological features of PCOS such as hyperandrogenism and insulin resistance in a bidirectional association.
“This indicates that sleep disturbances and associated symptoms may drive the inflammation, oxidative stress and increased sympathetic excitability, plausibly alter the regulation of gonadotropins and gonadotropin-releasing hormones, thus contributing to the expression of pathophysiological features of PCOS such as hyperandrogenism and insulin resistance in a bidirectional association (41).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [41]
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Experimental — accuracy not yet measuredThe inflammatory and oxidative stress responses from recurrent episodes of apnea, coupled with cycles of hypoxia and reoxygenation in those with OSAS can also exacerbate the pathophysiological features underpinning PCOS.
“The inflammatory and oxidative stress responses from recurrent episodes of apnea, coupled with cycles of hypoxia and reoxygenation in those with OSAS can also exacerbate the above pathophysiological features underpinning PCOS (41).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [41]
The “Impact on Cardiometabolic Health” section says OSA increases oxidative stress and that recurrent hypoxia can worsen insulin resistance and other metabolic disturbances, which the paper says can worsen PCOS. It does not describe hypoxia–reoxygenation cycles or attribute an inflammatory response specifically to recurrent apnea; its “Risk Factors and Mechanisms” section instead links inflammatory pathways to central adiposity. (LLM, conf=0.85)
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Flagged first, then by citations
Research works printed but not linked: 2
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Sorted by citations
Polycystic ovary syndrome in obstructive sleep apnea-hypopnea syndrome: an updated meta-analysis
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Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis
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“The in fl ammatory and oxidative stress responses from recurrent episodes of apnea, coupled with cycles of hypoxia and reoxygenation in those with OSAS can also exacerbate the above pathophysiological features underpinning PCOS (41).”
Self-citation
- Authors
- Jafar, N. K. A., Bennett, C. J., Moran, L. J., & Mansfield, D. R.
- Affiliations
- Monash University (AU)
- Monash Health (AU)
- Corresponding author
- Mansfield, Darren R.
- Venue
- Seminars in Reproductive Medicine
- Publisher
- Georg Thieme Verlag KG
- Published
- 2023-03
- Volume
- 41
- Issue
- 01/02
- Pages
- 045-058
- ISSN
- 1526-4564 (ISSN-L)
- 1526-8004
- OpenAlex
- W4389981774
- Cited by
- 12
- References
- 161
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Seminars in Reproductive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Veski
- Australian Government
- National Health and Medical Research Council (1171592)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- polycystic ovary syndrome, sleep health, obstructive sleep apnea, sleep disorders, sleep quality, sleep quantity, women of reproductive age, adolescent girls, cardiometabolic health, mental health, sleep screening, sleep interventions
- MeSH terms
- Adolescent, Adult, Female, Humans, Polycystic Ovary Syndrome, Risk Factors, Sleep, Prevalence, Sleep Apnea, Obstructive
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