title: Sleep disturbances in a community-based sample of women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Is there an excess of sleep disturbances in women with polycystic ovary syndrome (PCOS) in a community-based sample?
  
  
  CONCLUSIONS
  Sleep disturbances are almost twice as common in women with PCOS compared with women of similar age without PCOS, with the association slightly accounted for by body weight and, to a greater extent, by depressive symptoms.
  
  
  BACKGROUND
  There is an excess of sleep-disordered breathing in clinical samples of women with PCOS, after accounting for their profile of body weight. Poor sleep patterns increase insulin resistance and thus may exacerbate PCOS symptoms and longer-term risk of metabolic disease.
  
  
  METHODS
  A cross-sectional study of 724 women, comprising 74% of a cohort study established retrospectively when women were around age 30 years.
  
  
  METHODS
  Comparisons were made between 87 women with PCOS, diagnosed using the Rotterdam criteria, and 637 women without this diagnosis in Adelaide, South Australia. Differences in sleep disturbances, assessed using a modified version of the Jenkins questionnaire, were investigated using ordered logistic regression.
  
  
  RESULTS
  Sleep disturbances were twice as common in women with PCOS compared with those without. Specifically, PCOS was associated with increasing occurrence of difficulty falling asleep (odds ratio (OR) 1.94, 95% confidence interval (CI) 1.28-2.95); this association was attenuated but still statistically significant after accounting for BMI and depressive symptoms. Increasing occurrence of difficulty maintaining sleep (OR 1.92 95% CI 1.12-3.31) was mediated by obesity and depressive symptoms, together. Other factors did not change these findings.
  
  
  CONCLUSIONS
  The cross-sectional nature of the study means that the direction of associations between PCOS and sleep disturbances is unclear, although bi-directionality for the mediators is likely based on data in the wider literature.
  
  
  CONCLUSIONS
  Our results indicate that assessment and management of both sleep and mental health problems in women with PCOS should be undertaken. Longitudinal data would be valuable to see how poor sleep affects longer-term health profiles.
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia lisa.moran@adelaide.edu.au.
authors.forename: L J
authors.initials: LJ
authors.lastname: Moran
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: W A
authors.initials: WA
authors.lastname: March
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Whitrow
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia.
authors.forename: L C
authors.initials: LC
authors.lastname: Giles
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: The Robinson Research Institute, University of Adelaide, Adelaide, Australia School of Population Health, University of Adelaide, Adelaide, Australia The Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, Australia.
authors.forename: V M
authors.initials: VM
authors.lastname: Moore
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D050177:Overweight / Q000150:complications / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D012892:Sleep Deprivation / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D013021:South Australia / Q000453:epidemiology
keywords: depression; obesity; polycystic ovary syndrome; sleep disturbances