Sleep disturbances are common findings in women with Polyendocrine Metabolic Ovarian Syndrome (PMOS), though mechanisms remain unclear. This observational case-control study aimed to identify pathological key factors that play a role in determining sleep disturbances in the context of PMOS. One hundred and twelve women with PMOS and 112 healthy women matched for age and body mass index (BMI 18-39.9 kg/m²; age 18-39 years) were included in the analysis. Participants underwent anthropometry, body composition analysis (assessed by bioimpedentiometry), fasting biochemical tests, seven-day food records, and assessment of adherence to the Mediterranean diet (MedDiet) (through the PREDIMED questionnaire). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Women with PMOS had higher PSQI scores (p = 0.002) and a higher prevalence of poor sleepers than controls (p < 0.001). Among women with PMOS, poor sleepers showed higher absolute and percentage fat mass (both p < 0.001), lower fat-free mass both in percentage (p < 0.001) and absolute values (p = 0.006), and lower phase angle (p = 0.035) compared to good sleepers. They also exhibited worse insulin resistance (p < 0.001), inflammatory (p < 0.001), and androgen profiles (p < 0.001) despite similar BMI. Poor sleepers consumed more total (p = 0.001) and saturated fat (p < 0.001) and less fiber (p = 0.004) and had lower PREDIMED scores (p < 0.001) than good sleepers. Regression analyses identified fat mass as the strongest body composition predictor of sleep quality (p < 0.001), saturated fat intake as the strongest dietary predictor (p < 0.001), and adherence to the MedDiet as the strongest overall determinant (p < 0.001). Poor sleep quality in women with PMOS is associated with a cluster of unfavorable body composition, metabolic, inflammatory, and dietary characteristics. However, when considering their relative contribution, body fat mass and dietary factors, particularly adherence to the MedDiet, emerged as the most relevant determinants of sleep quality. These findings suggest that sleep disturbances in PMOS are not solely driven by metabolic impairment but are closely linked to modifiable lifestyle factors, highlighting dietary quality and adiposity as potential targets for intervention.
Verde et al. (Sat,) studied this question.