Association of Sleep Characteristics and Night Shift Work with Polycystic Ovary Syndrome: A Cross-Sectional Study

Abstract Background: The association between polycystic ovary syndrome (PCOS) and circadian rhythm has been established, but to date, investigations that describe the sleep-wake behavior of PCOS in China are limited. Here, we examined the association of sleep characteristics and night shift work with the risk of PCOS in Chinese women, and investigated their relationship to infertility in PCOS. Methods: From March 21, 2021, to April 31, 2021, a total of 3 927 Chinese women with or without PCOS were recruited online. All participants completed the WeChat-based electronic questionnaires. Sleep characteristics were measured by the Pittsburgh Sleep Quality Index.Results: A total of 2 871 women were extracted for final analysis. Sleep duration (OR, 0.857; 95% CI, 0.763-0.963), sleep midpoint (OR, 1.142; 95% CI, 1.049-1.244), sleep disturbance (OR,1.320; 95% CI, 0.957-1.146), daytime dysfunction (OR, 1.136; 95% CI, 1.030-1.253) and night shift work (OR, 1.628; 95% CI, 1.264-2.097) were associated with higher risk of PCOS. After adjusting for confounders including age, body mass index, smoking status, coffee and tea drinking status, sleep disturbance (OR, 1.314; 95% CI, 1.111-1.555), daytime dysfunction (OR, 1.143; 95% CI, 1.034-1.264) and night shift work (OR, 1.800; 95% CI, 1.388-2.333) remained associated. In addition, sleep disturbance (OR, 1.887; 95% CI, 1.400-2.542) and subjective sleep quality (OR, 1.299; 95% CI, 1.037-1.627) were related to infertility in women with PCOS, and sleep disturbance (OR, 1.750; 95% CI, 1.281-2.390) remained significant after adjusting for confounders.Conclusions: These results suggest that sleep disturbance, daytime dysfunction and night shift work were significantly associated with PCOS. Screening for sleep disturbance and providing appropriate treatment could be potential strategies to manage PCOS and its long-term complications.