Sleep

Circadian rhythms are the cycles that tell the body when to sleep, wake, and eat—the biological and psychological processes that oscillate in predictable patterns each day.

Circadian rhythms are governed by a group of neurons called the suprachiasmatic nucleus, located in a region of the brain called the hypothalamus. This master clock translates cues from the environment into directives for the body. For example, receptors in the eyes detect darkness and pass that signal along to the suprachiasmatic nucleus, which then stimulates the production of melatonin, the hormone that causes sleepiness.

Sleep is a critical component to one’s physical and emotional health and well-being. Among both women and men, it is well established that sleep disorders, particularly insomnia, contribute to, or are associated with, several health conditions, including cardiovascular disease, hypertension, glucose dysregulation, depression, and anxiety disorders. There appears to be a relationship between sleep disturbance and reproductive health.

Sleep disturbance includes:

• Sleep fragmentation
• sleep continuity disturbance
• short or long sleep duration
• circadian dysrhythmia
• and/or hypoxia.

It is possible that anxiety related to fertility, including several attempts, repeated disappointments, uncomfortable physical procedures, relationship constraints, and unfulfilled life values can produce high levels of psychosocial distress, which can cause sleep disturbances. It is also possible that sleep disturbances in people otherwise healthy can lead to fertility problems.

Female Fertility

• Study involved women doing shift work, identified, adverse reproductive health outcomes: menstrual irregularities, dysmenorrhea, increased time to, and reduced rates for, conception, increased miscarriages, lower birth weights.
• Women who suffer from insomnia are four times more likely to struggle with fertility.
• In a study, women with infertility were more likely to experience sleep disturbance (34%)
• Women with diminished ovarian reserve were found to be 30 times more likely to have disturbed sleep.
• 35% of women receiving intrauterine insemination reported disturbances in their sleep.
• Two key studies demonstrate the association between sleep disordered breathing and PCOS. One seminal study showed that premenopausal women with PCOS were 30 times more likely to suffer from sleep disorder breathing. Another key study similarly showed obstructive sleep apnea was prevalent in 44% of obese women with PCOS.
• Obstructive sleep apnoea is believed to contribute to the metabolic abnormalities (insulin resistance and decreased glucose tolerance) in women with PCOS.

• Getting enough sleep has beneficial effect on reproductive hormone secretion. It might be helpful to fertility and IVF outcomes. However, excessive sleep disturbs circadian rhythms and hormone cycles.
• We found a significant association between FSH levels and sleep duration. Women who routinely slept six hours or less a night have 20% less FSH than women who got a full 8 hours.
• A study categorized women as short sleepers (four to six hours a night), moderate sleepers (seven to eight hours), and long sleepers (nine to 11 hours). The results indicated that moderate sleepers had the highest rate of pregnancy (53%). Instead, pregnancy rates among the short sleepers (46%) and long sleepers (43%) were significantly lower.
• sleep deprivation during pregnancy increases the risk of preterm delivery and postpartum depression.
• Pregnant women who do work night shifts or irregular shifts double their odds of miscarriage.
• Pregnant women who work long hours (100+ per week) during their first trimester and experience sleep deprivation, as a result, are twice as likely to have a preterm delivery (10% vs 5%).
• Pregnant women who sleep less than six hours per night experience nine more hours of labor on average than well-rested women (29 hours versus 20 hours).
• Pregnant women who sleep less than six hours per night are four-and-a-half times more likely to have a cesarean birth.

Male Fertility

• Short and long sleep durations and late bedtime were associated with impaired sperm health in the study cohort.
• Short sleep duration in men was associated with reduced fecundability.
• Men who slept less than 6 or more than 9 hours a night had a 42 percent reduced probability of conception in any given month.

What You Can Do

• Wake up and go to sleep at the same time every day (and exposing oneself to sunlight and darkness at those times supports steady melatonin production).
• Create a bedtime routine, with calming activities.
• Avoid caffeine or heavy meals 2 hours before bedtime.
• Avoid screens and artificial light in the evening.
• Make sure the bedroom temperature is comfortable.
• Listening to sleep meditation can be helpful.
• Rest for 7 to 8 hours of uninterrupted sleep.