Sleep Characteristics Among Women With and Without PCOS

Clinical studies indicate that sleep disorders, including obstructive sleep apnea (OSA) and excessive daytime sleepiness, occur more frequently among women with PCOS compared to comparison groups without the syndrome. The presence of OSA in PCOS is associated with worsening of metabolic parameters. There is some evidence that obesity directly contributes to OSA among women with PCOS, although, it does not fully account for findings from community-and clinic-based studies. Questionnaires are used as screening for sleep disorders. The objective was to verify the quality of sleep, the prevalence of OSA and daytime sleepness among women with PCOS compared to control group. The sample size calculation was based on estimates bad quality of sleep among women with PCOS in 80% and among control women in 45% (1). The sample with 58 women, 29 each group, had a power of 80%, with a significance level of 0.05. This is a cross sectional study with 29 patients with PCOS and 31 controls from Gynecology Endocrinology Ambulatory of São Vicente de Paulo Hospital, Passo Fundo, RS, Brazil, who consulted between January 2017 and March 2020. Women with PCOS by Rotterdam criteria and controls were under 40 years old and no pregnant. Controls women had regular cycles, no history of PCOS or hirsutism and had normal ovaries on transvaginal ultrasound. Age, BMI, blood pressure (BP), waist circumference (WC) were measured. It was applied the validated questionnaires of Pittsburgh Sleep Quality Index, to classify in good and bad sleep quality; Epworth Sleepiness Scale for daytime sleepiness and Berlim Questionnaire for evaluate sleep apnea risk. The mean of age was 30.6 ± 5.9, PCOS 29.1± 6.7 versus 32.3±4.7, p=0.06. The group of PCOS women was heavier (BMI 32.4±6.1versus 28.0 ± 5.3, p=0.04) and presented higher WC (101.3±16.1 versus 91.6 ±14cm, p=0.03). The mean of BP was similar between the groups. The prevalence of bad sleep quality was 53.6% for women with PCOS and 63.1% for controls (p=0.29). The daytime sleepiness was present in 14,5% of the women with PCOS and 35.7% of controls (p=0,061) and the sleep apnea risk was 32.1% for women with PCOS and 21.4% for controls (p=0.27). The association of risk of OSA was verified with robust multivariate Poisson. The prevalence ratio (PR) of BMI ≥ 30 was 1.820 (CI 1.281-2.587) p<0.001, BMI ≥ 25 1.549 (IC 1.067- 2.250) p=0.02, adjusted for age, WC and PCOS diagnosis. In conclusion, there was no difference in prevalence of quality of sleep, OSA risk or daytime sleepiness between women with PCOS and controls. The risk of OSA was higher in obese women independently of age, abdominal circumference and PCOS diagnosis. Reference: (1) Fernandez et al., Nature and Science of Sleep 2018; 10: 45–64.