Women With PCOS Less Likely to Experience Disturbed Sleep After Menopause

The prevalence of sleep disturbance was lower after menopause among women with polycystic ovary syndrome (PCOS) compared with those without PCOS. These findings were published in the Journal of Clinical Endocrinology and Metabolism.

At reproductive ages, women with PCOS are more likely to report sleep disturbance, obstructive sleep apnea, shorter sleep duration, and daytime sleepiness than women without PCOS.

To assess how sleep patterns change with menopause in PCOS, investigators sourced data from the Study of Women’s Health Across the Nation (SWAN), which was initiated in 1996 at 7 sites in in the United States (US). Women were evaluated for changes in self-reported sleep outcomes from baseline to follow-up visit 15 on the basis of PCOS status. Actigraphically assessed sleep outcomes at visit 15 were also compared between women with and without PCOS.

The women with data at baseline (n=3299) and visit 15 (n=2060), of whom 4.1% and 4.0% had PCOS, 47.0% and 48.9% were White, and 0.0% and 90.9% were in natural post-menopause, respectively, had median (IQR) ages of 46.0 (44.0-48.0) and 65.5 (63.4-67.6) years and BMI of 26.5 (22.9-32.2) and 28.0 (23.9-33.3) kg/m².

Given the limited data on the effects of PCOS on this phase of a woman’s reproductive life cycle, this study addresses an important gap in knowledge and suggests that sleep issues may not continue to worsen through the menopause transition in women with PCOS.

The women with PCOS at visit 15 had a higher BMI (P =.002) and more were White (P =.008), had a comorbidity score of at least 2 (P =.014), and currently smoked (P =.010) than women without PCOS.

Women with PCOS were not at higher risk for disturbed sleep during premenopause, early perimenopause, or late perimenopause than those without PCOS.

In natural post-menopause, however, women with vs without PCOS were less likely to report:

• Waking earlier than planned (adjusted odds ratio [aOR], 0.56; 95% CI, 0.37-0.85);
• Having any sleep problem (aOR, 0.57; 95% CI, 0.41-0.80);
• Waking several times in the night (aOR, 0.62; 95% CI, 0.44-0.89); and,
• Trouble falling asleep (aOR, 0.63; 95% CI, 0.41-0.97)

Conversely, the women with PCOS who underwent hysterectomy or bilateral salpingo-oophorectomy were more likely to report trouble falling asleep (aOR, 3.40; 95% CI, 1.67-6.93) and waking earlier than intended (aOR, 2.80; 95% CI, 1.30-6.04) relative to those without PCOS.

More women with PCOS reported that they stopped breathing during sleep than women without PCOS (19.7% vs 11.5%; odds ratio [OR], 1.88; 95% CI, 1.03-3.45; P =.040), respectively, but this difference was attenuated after adjustment for cofounders (aOR, 1.55; 95% CI, 0.78-3.11; P =.215).

No significant trends in actigraphy outcomes were observed at visit 15.

The major limitation of this study was the collection of actigraphy outcomes at only visit 15 and their exclusion from longitudinal analyses.

The study authors concluded, “Given the limited data on the effects of PCOS on this phase of a woman’s reproductive life cycle, this study addresses an important gap in knowledge and suggests that sleep issues may not continue to worsen through the menopause transition in women with PCOS.”

Disclosure: A study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Endocrinology Advisor