Abstract
Background: Lockdown measures have been enforced globally in response to the COVID-19 pandemic. Given the comorbidity burden in women with polycystic ovary syndrome (PCOS), these lockdown measures may have a particularly negative impact on sleep health, quality of life (QoL), and depression/stress levels in this population. The aim of this study was to explore whether such potential problems were present in women with PCOS during the COVID-19 lockdown in the UK.Methods: UK women with PCOS were recruited through social media into a cross-sectional study during the COVID-19 lockdown. The study survey was delivered online, and included demographic and COVID-19 relevant questions, as well as validated questionnaires/scales, namely the Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale (DASS-21), and PCOSQOL questionnaire.Results: Three hundred and thirty-three women with PCOS [median age: 30.0 (9.0) years] were recruited. Participants were dichotomized based on responses regarding the impact of COVID-19 restrictions on their sleep [negative (N = 242) vs. no/positive (N = 91) impact]. No differences were noted between groups regarding age, time since PCOS diagnosis, body mass index, or number of comorbidities. Based on the ISI, 44.2% of participants reporting a negative impact on sleep exhibited at least moderately severe clinical insomnia. Compared to those who reported no/positive effect on sleep, the participants reporting a negative impact on sleep also reported poorer QoL, based on the total PCOSQOL score, with a greater impact of PCOS and poorer mood in the corresponding PCOSQOL domains. Based on the DASS-21, the latter also had statistically higher depression and stress levels compared to the former. Finally, for this cohort significant inverse correlations were noted between the ISI and PCOSQOL scores (total and domain scores), whilst the DASS-21 and ISI scores were positively correlated (all p-values <0.001).Conclusion: The majority of recruited UK women with PCOS reported that the COVID-19 lockdown had a negative impact on their sleep, which was also associated with impaired QoL and higher depression/stress levels. Whilst further research is required, women with PCOS should be considered a vulnerable population that may experience an adverse impact on sleep, QoL and mental health well-being due to lockdown measures during the COVID-19 pandemic.
Highlights
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), usually manifests as a respiratory tract infection with mild symptomatology [1,2,3]
We found that the DASS-21 variables were the greatest predictors of Insomnia Severity Index (ISI) score, accounting for the largest proportion of variance in the dependent variable [Stress: Wald χ 2: 87.23, OR: 1.23 (1.18, 1.29), R2N: 0.05, p < 0.0001; Anxiety: Wald χ 2: 64.06, OR: 1.19 (1.14, 1.25), R2N: 0.03, p < 0.0001; Depression: Wald χ2: 55.5, OR: 1.15 (1.11, 1.20), R2N: 0.03, p < 0.0001]
The present study offers a novel insight regarding the selfreported sleep quality of women with polycystic ovary syndrome (PCOS) during the COVID19 pandemic lockdown, and how this is associated with quality of life (QoL) and depression, anxiety, and stress levels in this population
Summary
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), usually manifests as a respiratory tract infection with mild symptomatology (asymptomatic in many cases) [1,2,3]. COVID-19 can lead to severe manifestations in a proportion of high-risk individuals with respiratory and/or extra-pulmonary symptoms/complications requiring hospitalization [1,2,3] As the latter may require intensive care unit (ICU) support and may even be fatal, the COVID-19 pandemic has resulted in enforcement of varying degrees of nationwide lockdown, quarantine and self-isolation measures in many countries worldwide [4, 5]. These measures aim to reduce SARS-CoV-2 transmission in the general population, and the risk of severe COVID-19 in vulnerable groups (e.g., older individuals and patients with certain respiratory and cardio-metabolic diseases) [6,7,8,9,10,11,12]. The aim of this study was to explore whether such potential problems were present in women with PCOS during the COVID-19 lockdown in the UK
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