Polycystic Ovary Syndrome and Sleep Disturbance in Postmenopausal Women: Study of Women’s Health Across the Nation

Abstract Context Reproductive age women with polycystic ovarian syndrome (PCOS) are more likely to have sleep apnea and experience sleep disturbances. Since sleep disturbances are known to worsen with age and to impact multiple health outcomes, the sleep experience of postmenopausal women with PCOS is of interest. Objective Determine if postmenopausal women with PCOS have persistently worse subjective and objective measures of sleep disturbance. Design Longitudinal and cross-sectional analyses. Setting Study of Women's Health Across the Nation (SWAN). Participants Women with a history of signs/symptoms of PCOS compared to those without. Interventions None Main Outcome Measures Longitudinal changes in self-reported sleep disturbances (trouble falling asleep, waking up several times at night and waking up earlier than planned), from baseline to 15th SWAN follow-up visit. Actigraphic assessed and self-reported measures at Visit 15 (20-22 years from start of study). Results 83 women with PCOS were compared to 1977 women without PCOS. Longitudinal trends in self-reported sleep disturbance prevalence in women with PCOS plateaued whereas those without PCOS increased through post-menopause. In adjusted longitudinal analyses, women with PCOS who were naturally postmenopausal were significantly less likely to report sleep disturbances compared to those without PCOS. At Visit 15, sleep measures assessed via actigraphy and self-report did not differ between those with PCOS and those without. Conclusions Longitudinal patterns of sleep disturbances differ between those with and without PCOS. In women with PCOS the prevalence of sleep disturbance remained relatively stable into postmenopause rather than increasing.