Sleep Aberrations in Polycystic Ovarian Syndrome: An Observational Study of 38 Women
Keywords:
Sleep deprivation, Polycystic Ovarian Syndrome (PCOS), Insulin resistance
Abstract
Introduction and Aim: Polycystic Ovarian Syndrome (PCOS), one of the non-communicable diseases is reaching an epidemic proportion in India. Sleep insufficiency is known to contribute to obesity and the associated non-communicable diseases like type two diabetes mellitus, cardio-vascular diseases and cancer. Therefore, the aim of the present study was to assess the sleep patterns in patients with PCOS.
Material and Methods: Thirty-eight women with PCOS (diagnosed as per Rotterdam criteria) attending a specialty clinic in Mumbai were evaluated for their sleep patterns specifically for its duration, latency, fragmentation and alignment with diurnal rhythm.
Results: The age group of the women varied from 17 to 40 years with a mean age of 25 yrs. Twenty-eight of 38 women were overweight (42.1%) and obese (31.6%). Hyperinsulinemia, (fasting and/or two hours post glucose) were observed in 14 (36.8%) patients. Majority of PCOS patients had sleep insufficiency (57.9% slept less than 7 hours a day); of these 12 women slept for 6 to 7 hours while 7 women slept for only 5 to 6 hours a day and 4 women slept less than 5 hours a day. Sleep latency was observed in 8 women and sleep fragmentation in 5 of them. Sleep misalignment with diurnal rhythm was observed in 14 patients.
Conclusion: The present study reports high degree of sleep insufficiency among subjects with PCOS.
Conflict of Interest: None declared
Source of funding: None declared
References
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32. Spiegel K, Knutson K, Leproult R, Tasali E, Van Cauter E. Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes. J ApplPhysiol. 2005;99(5):2008–19.
33. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010; 33(2):414–20.
34. Donga E, Dijk MV, Dijk JGV, Biermasz NR, Lammers GJ, et al. A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects. J Clin Endocrinol Metab. 2010;95(6):2963- 2968.
Indian J Endocrinol Metab. 2014; 18(3): 317–324.
2. Gill H, Tiwari P, Dabadghao P. Prevalence of polycystic ovary syndrome in young women from North India: A Community-based study. Indian J Endocrinol Metab. 2012;16
(2):S389-92.
3. Joseph N, Reddy AG, Joy D, Patel V, Santhosh P, Das S, Reddy SK.Study on the proportion and determinants of polycystic ovarian syndrome among health sciences students in South
India. J Nat Sci Biol Med. 2016; 7(2):166-72.
4. Ganie MA, Kalra S. Polycystic ovary syndrome - A metabolic malady, the mother of all lifestyle disorders in women - Can Indian health budget tackle it in future? Indian Journal of Endocrinology And Metabolism. 2011; 15(4): 239–241.
5. Vaidya R. Editorial- Sleep Debt Epidemic of 21st Century. The Indian Practitioner. 2016; 69(6):30-31
6. Shringi MS, Vaidya RA, Vaidya AB et al. Insulin Resistance in Polycystic Ovarian Syndrome (PCOS)- A study of 90 patients. Ind. J. of Endocrinology & Metabolism. 2003; 1:19-23
7. Moghetti P. Insulin Resistance and Polycystic Ovary Syndrome. Curr Pharm Des. 2016; 22(36):5526-5534.
8. Zhang D, Yang X, Li J, Yu J, Wu X. Effect of hyperinsulinaemia and insulin resistance on endocrine, metabolic and fertility outcomes in women with polycystic ovary syndrome
undergoing ovulation induction. Clin Endocrinol (Oxf). 2019; doi: 10.1111/cen.14050. [Epub ahead of print]
9. Spiegel K, Tasali E, Leproult R, Cauter EV. Effects of poor and short sleep on glucose metabolism and obesity risk. Nat Rev Endocrinol. 2009;5(5):253–261.
10. Dutil C, Chaput JP. Inadequate sleep as a contributor to type 2 diabetes in children and adolescents. Nutrition and Diabetes. 2017; 7: e266.
11. Schwartsburd P. Cancer-Induced Reprogramming of Host Glucose Metabolism: “Vicious Cycle” Supporting Cancer Progression. Frontiers in Oncology. 2019; 9:218. doi:10.3389/ fonc.2019.00218
12. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group, authors. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. FertilSteril. 2004; 81:19-25.
13. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health.2015;1(1):40-43.
14. Shrivastava D, Jung S, Saadat M, Sirohi R, Crewson K. How to interpret the results of a sleep study. Journal of community hospital internal medicine perspectives, 2014;4(5):24983.
15. World Health Organization (WHO). International Association for the Study of Obesity (IASO) and International Obesity Task Force (IOTF). The Asia-Pacific Perspective: Redefining Obesity and its Treatment. Geneva: World Health Organization. 2000; 378-420.
16. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation. 2002; 106(25):3143-421.
17. Lim AJ, Huang Z, Chua SE, Kramer MS, Yong EL. Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study. PloS One. 2016; 11(11): e0167048.
18. Helvaci N, Karabulut E, Demir AU, Yildiz BO. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocrine connection. 2017; 6(7): 437–445.
19. Tasali E, Van Cauter E, Ehrmann DA. Polycystic Ovary Syndrome and Obstructive Sleep Apnea. Sleep medicine clinics. 2008; 3(1): 37–46.
20. Hachul H, Polesel DN, Tock L, Carneiro G, Pereira A Z, et al. Sleep disorders in polycystic ovary syndrome: influence of obesity and hyperandrogenism. Revista da AssociaçãoMédicaBrasileira. 2019; 65(3): 375-383.
21. Kaur G, Singh A. Sleep Hygiene, Sleep Quality and Excessive Daytime Sleepiness among Indian College Students. J Sleep Med Disord. 2017;4(1):1076.
22. Ghugre PS, Pandya A, Shobha G, Pathak M, Gadit S, Udipi SA. Physical Activity, Sleep and Anthropometric Profile of Young Adult Females from Mumbai City. International
Journal of Health Sciences & Research. 2018;8(1):194-202.
23. Vaidya RA, Udipi SA, Gandhi F et al. Are Indian School Children Sleep- Deprived? An Investigation into Sleep Patterns of Two Schools in Mumbai city – (Manuscript under preparation).
24. Desai SR, Vaidya RA, Udipi SA, et al. Determinants of sleep deprivation amongst secondary school children and adolescents from western suburbs of Mumbai (unpublished data).
25. Leger D, Beck F, Richard JB, Godeau E. Total Sleep Time Severely Drops during Adolescence. PLoS ONE. 2012;7(10):e45204.
26. Singh R, Suri JC, Sharma R, Suri T, Adhikari T. Sleep Pattern of Adolescents in a School in Delhi, India: Impact on their Mood and Academic Performance. Indian J Pediatr. 2018; 85(10):841-848.
27. Cedernaes J, Schiöth HB, Benedict C. Determinants of Shortened, Disrupted, and Mistimed Sleep and Associated Metabolic Health Consequences in Healthy Humans. Diabetes. 2015; 64:1073–1080
28. Knutson K L, Spiegel K, Penev P, Van Cauter E. The metabolic consequences of sleep deprivation. Sleep medicine reviews, 2007;11(3):163–178.
29. Cooper CB, Neufeld EV, Dolezal BA et al. Sleep deprivation and obesity in adults: a brief narrative review. BMJ Open Sport & Exercise Medicine. 2018;4:e000392.
30. Ajjan R, Orme SM (eds.), Endocrinology and Diabetes: Case Studies, Questions and Commentaries, 99 DOI 10.1007/978- 1-4471-2789-5_13, © Springer-Verlag London 2015. Available
at: http://www.anateb.net/file/9606/9781447127888.pdf# page=107
31. Ionescu CA, Popescu I, Banacu M, Dimitriu M. Lifestyle Changes and Weight Loss: Effects in PCOS 2018. Open access peer-reviewed chapter. Available at: https://www. intechopen.com/books/debatable-topics-in-pcos-patients/ lifestyle-changes-and-weight-loss-effects-in-pcos
32. Spiegel K, Knutson K, Leproult R, Tasali E, Van Cauter E. Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes. J ApplPhysiol. 2005;99(5):2008–19.
33. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010; 33(2):414–20.
34. Donga E, Dijk MV, Dijk JGV, Biermasz NR, Lammers GJ, et al. A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects. J Clin Endocrinol Metab. 2010;95(6):2963- 2968.
Published
2019-09-23
How to Cite
Rama Vaidya, Nayana Rege, Sharvari Desai, Hiteshi Dhami, Shubhada Agashe, Sadananda Talwalkar, Shobha Udipi, Ashok Vaidya. (2019). Sleep Aberrations in Polycystic Ovarian Syndrome: An Observational Study of 38 Women. The Indian Practitioner, 72(9), 25-29. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/810
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Original Article
