Table 1 Sleep disturbance and infertility among reproductive-age females
From: Sleep disturbances and female infertility: a systematic review
Year | Authors | Study object | Study type | Study population | Age (Mean ± SD) | Fertility characteristics | Sleep measurements | Sleep characteristics | Other clinical features | Other evaluations | Results |
|---|---|---|---|---|---|---|---|---|---|---|---|
2023 | Freeman [41] | Females attempting pregnancy with history of 1–2 pregnancy loss | Prospective cohort study | n = 1220 | 18–40 | Time to pregnancy (TTP) | Self-reported sleep characteristics | • Sleep duration (< 6, 6-<7, 7-<8, 8-<9, ≥ 9) • Sleep midpoint (2:44, 3:36, 4:30) • Social jetlag • Shift work | n/a | n/a | Sleep duration, later sleep midpoints, social jetlag and night shift were not associated with reduced fecundability. In sensitivity analyses, sleep duration ≥ 9 hours was associated with low fecundability. |
2023 | Özçelik [30] | Females with infertility | Cross-sectional study | • n = 110 infertility • n = 117 fertility | 18–40 | Infertility or not | • Morningness-Eveningness Questionnaire (MEQ) • Pittsburgh Sleep Quality Index (PSQI) | • Sleep chronotype (MEQ 16–41, evening type; 42–58 intermediate type; 59–86 morning type) • Sleep quality (PSQI > 5 poor sleep quality) | n/a | n/a | Significantly worse sleep quality, and more evening chronotype were found in the patients with infertility. |
2023 | Zhao [40] | Females attempting pregnancy (from NHANES) | Cross-sectional study | n = 1820 (n = 248 infertility, n = 1572 fertility) | 20–40 | Infertility or not | Sleep interview and self-report sleep duration | • Sleep disorder (question about trouble sleeping or sleep disorder) • Sleep duration (≤ 6, 7–8, > 8) | Depress | The Patient Health Questionnaire (PHQ-9) | The risk of infertility was 2.14-fold higher in individuals with sleep disorders than in those without. |
2022 | Liang [39] | Females attempting pregnancy (from NHANES) | Cross-sectional study | n = 2175 (n = 212 infertility, n = 1963 fertility) | 18–44 | Self-reported infertility | Self-reported sleep characteristics | • Sleep duration • Sleep behavior (bedtime, waketime) | n/a | n/a | Sleep-wake behavior was significantly associated with infertility and participants with early-bed/early-rise behavior had the lowest risk. |
2020 | Shi [38] | Females and males in reproductive-age (from NHIS, CHNS) | Cross-sectional study | • n = 9137 females from NHIS • n = 2687 females and male mates from CHNS | • Mean 34 (range 27–41) from NHIS • Mean 38 (range 32–42) from CHNS | Self-reported pregnancy status | Sleep questionnaire | Sleep duration • NHIS (≤ 5, 6, 7, 8, ≥ 9) • CHNS (≤ 6, 7, 8, 9, ≥ 10) | n/a | n/a | A U-shaped association between female sleep duration and conception probability was observed, 7 h/day was associated with a lower probability of conception when compared to either longer or shorter sleep duration times in both NHIS and CHNS populations. |
2019 | Willis [36] | Females attempting pregnancy (from PRESTO) | Prospective cohort study | n = 6,873 | 21–45 | Time to pregnancy (TTP) | Sleep questionnaire | • Sleep duration (< 6, 6, 7, 8, ≥ 9) • Sleep quality (MDI, have you had trouble sleeping at night?) • Shift work | Depress, stress and anxiety | • Perceived stress scale (PSS-10), • Major Depression Inventory (MDI) | Trouble sleeping at night and shorter sleep duration were associated with modestly reduced fecundability, the results were slightly stronger among women with higher depressive symptoms and perceived stress levels. Little association was seen between shift work and fecundability. |
2018 | Wang [37] | Females with infertility (from NHIRD) | Retrospective cohort study | n = 16,718 NASD, n = 33,436 control | 35.45 ± 6.62 (NASD), 35.26 ± 6.60 (control) | ICD-9-CM diagnosed infertility | ICD-9-CM diagnosed non-apnea sleep disorder | n/a | n/a | n/a | NASD patients had a 3.718-fold risk of female infertility compared with the control cohort and the younger age group patients were more likely to become infertile which may be due to high level of stress. |