The mental health of Chinese women with polycystic ovary syndrome is related to sleep disorders, not disease status

Abstract

Background: Mental health disorders are highly prevalent in polycystic ovary syndrome (PCOS) cases. The etiology for anxiety/depression in women with PCOS still remains unclear, due to conflicting results.Aim: To examine whether an association exists between the mental health of Chinese women with PCOS and various indicators such as their disease characteristics, biochemistry results and sleep status.Methods: During July 2018 and January 2020, our study included a total of 433 women diagnosed with PCOS at Chongqing Hospital of Traditional Chinese Medicine. Sleep-related variables were evaluated by the Pittsburgh Sleep Quality Index (PSQI), anxiety and depression values were quantified by the Hospital Anxiety and Depression Scale (HADS), and biochemistry results were collected from the medical records of the patients.Results: 26.6% patients resulted as positive anxiety and 23.6% as positive depression. We found significant associations between anxiety/depression status and sleep conditions of PCOS patients. More specifically, anxiety significantly associated with sleep quality OR (95%CI) = 1.611 (1.147–2.261), sleep disturbance 2.326 (1.468–3.685) and daytime dysfunction 1.457 (1.122–1.891). Similarly, depression significantly associated with sleep quality 1.467 (1.043–2.063), sleep disturbance 1.624 (1.030–2.561) and daytime dysfunction 1.406 (1.077–1.836). There was no association detected between mental health and disease characteristics, as well as reproductive and metabolic indicators in PCOS.Limitation: Cross-sectional nature of the data prevents causal associations, selection bias of a hospital-based population.Conclusions: Sleep-related disorders might be involved in the etiology and development of the anxiety/depression observed in PCOS cases. We propose that management of sleep disorders should be an integral part of the disease management of women with PCOS.