Abstract Background Sleep disorders and depression are prevalent conditions that can affect reproductive health. However, the complex interplay between these factors and infertility remains poorly understood, particularly the potential mediating role of sleep disorders in the association between depression and infertility. Methods We analyzed data from 2068 female participants in the National Health and Nutrition Examination Survey (NHANES), including 244 women with self‐reported infertility. Multivariable regression analyses examined associations between depression, sleep disorders, and infertility. Subgroup analyses were conducted to identify effect modifications, and mediation analysis was performed to assess whether sleep disorders mediate the association between depression and infertility. Results The infertility group had significantly higher prevalence of sleep disorders compared to the non‐infertility group (33.78% vs. 24.12%, P = 0.034). In subgroup analyses, sleep disorders were significantly associated with infertility among participants without depression (odds ratio OR 1.94, 95% confidence interval CI 1.16–3.23, P = 0.012), those with obesity (OR 1.99, 95% CI 1.05–3.79, P = 0.037), never smokers (OR 1.84, 95% CI 1.11–3.04, P = 0.018), and individuals with impaired fasting glucose (OR 4.75, 95% CI 1.16–19.48, P = 0.032). Depression was significantly associated with infertility among participants aged <35 years (OR 1.83, 95% CI 1.05–3.20, P = 0.035). Most importantly, mediation analysis revealed that sleep disorders significantly mediated the association between depression and infertility, accounting for 67.6% of the total effect (coefficient = 0.01839, 95% CI: 0.00634–0.03589, P < 0.001). Conclusion Our findings suggest that sleep disorders might play a critical mediating role in the relationship between depression and infertility. This highlights the importance of addressing sleep health in reproductive‐aged women, particularly those with depression, as a potential strategy for improving fertility outcomes.
Zhang et al. (Tue,) studied this question.