Abstract
ContextFew studies have examined the associations between sleep duration, shiftwork, and exercise to the infrequent menstruation, hyperandrogenism, and ovarian morphological changes observed in women with polycystic ovarian syndrome (PCOS).ObjectiveTo examine whether lifestyle factors, including short sleep duration, insufficient exercise, and shiftwork, alone or in combination, are associated with the reproductive and metabolic abnormalities typical of PCOS in a healthy population.Study Design, Size, DurationProspective cross-sectional study of 231 women, including healthcare workers recruited for an annual health screen, healthy referral patients from the Women’s Clinic and volunteers from the university community at the National University Hospital, Singapore, from 2011 to 2015.Main Outcome MeasuresThe women completed a questionnaire, including their menstrual cycle length, sleep length, frequency of exercise and shift work. Hyperandrogenism (hirsutism score, testosterone, sex hormone binding globulin (SHBG)), ovarian morphology and function (anthral follicle count, ovarian volume, anti-mullerian hormone (AMH)), and metabolic measures (body mass index (BMI), waist hip ratio (WHR), blood pressure, fasting glucose, fasting insulin and fasting lipids) were examined through anthropometric measurements, transvaginal ultrasound scans, and blood tests.ResultsNo significant associations were observed between shift work, exercise or sleep duration and the androgenic and ovarian measures that define PCOS. However, women reporting fewer than 6 hours of sleep were more likely to report abnormal (short or long) menstrual cycle lengths (OR = 2.1; 95% CI, 1.1 to 4.2). Women who reported fewer than 6 hours of sleep had increased fasting insulin levels (difference in means = 2.13; 95% CI, 0.27 to 3.99 mU/L) and higher odds of insulin resistance (OR = 2.58; CI, 1.16 to 5.76). Lack of regular exercise was associated with higher mean fasting insulin (difference in means = 2.3 mU/L; 95% CI, 0.5 to 4.1) and HOMA-IR (difference in means = 0.49; 95% CI, 0.09 to 0.90) levels.ConclusionsWomen with insufficient sleep are at increased risk of menstrual disturbances and insulin resistance, but do not have the hyperandrogenism and polycystic ovarian morphology typical of PCOS.Wider Implications of the FindingsImproved sleep duration may help reduce the risks of diabetes or infertility. Shift work, exercise or sleep duration appear not to impact the androgenic and ovarian measures that define PCOS.
Highlights
The typical phenotype of polycystic ovarian syndrome (PCOS) is characterized by the presence of infrequent menstruation (>35 days for cycle length, or less than 8 cycles a year), hyperandrogenism, and polycystic ovarian morphology (PCOM) on ultrasound assessment
No significant associations were observed between shift work, exercise or sleep duration and the androgenic and ovarian measures that define PCOS
Women who reported fewer than 6 hours of sleep had increased fasting insulin levels and higher odds of insulin resistance (OR = 2.58; CI, 1.16 to 5.76)
Summary
The typical phenotype of polycystic ovarian syndrome (PCOS) is characterized by the presence of infrequent menstruation (>35 days for cycle length, or less than 8 cycles a year), hyperandrogenism (manifesting as hirsutism and/or elevated serum androgens), and polycystic ovarian morphology (PCOM) on ultrasound assessment. At least three sub-phenotypes are generally recognized—oligomenorrhea and hyperandrogenism; PCOM and oligomenorrhea; PCOM and hyperandrogenism [2]. It is unclear whether these sub-phenotypes have distinct etiologies, or are merely precursors to the complete phenotype comprising of all three abnormalities. Insulin resistance can be the result of lifestyle factors such as shiftwork, insufficient sleep or lack of exercise [6]. Lifestyle factors associated with insulin resistance can be interrelated, as shiftwork can lead to reduced time available for sleep and exercise [6]. The question arises as to whether these lifestyle factors, acting alone or in combination, can lead to changes in menstrual cycle length, clinical or biochemical hyperandrogenism and abnormal ovarian morphology, thereby resulting in the sub-phenotypes of PCOS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
