Introduction

Modern life can sometimes move so quickly that you hardly have time to stop and relax; this can make it very challenging to consistently get a good night's sleep. Just like diet and exercise, sleep is crucial for maintaining good health. Although getting enough sleep enhances your health, mood, and cognitive function, some medical conditions can impair the quality of your sleep.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a complicated endocrine disorder that affects women's reproductive, metabolic, and psychological health.

The three main characteristics of PCOS: 

• Irregular periods—this means that your ovaries do not release eggs consistently (ovulation).
• Excess androgens - high levels of "male" hormones in your body, which can manifest as physical symptoms such as excess facial or body hair.
• Polycystic ovaries - your ovaries swell and develop numerous fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not have cysts if you have PCOS). 

The exact cause of polycystic ovary syndrome (PCOS) is unknown, but abnormal hormone levels are thought to be involved.

As a prevalent complex disorder, PCOS appears to be inherited. There are probably several genes at play, each with a small to moderate impact on the risk of developing a disease.¹

Symptoms

If you have PCOS, your symptoms will likely appear in your late teens or early twenties.

Common symptoms of PCOS:

• Periods that are inconsistent or nonexistent.
• Difficulty conceiving due to irregular or absent ovulation.
• Hirsutism, or excessive hair growth, is most commonly seen on the face, chest, back, or buttocks.
• Gaining weight.
• Hair loss and thinning on the head.
• Acne or oily skin.

Additionally, PCOS is linked to a higher risk of later-life health issues like type 2 diabetes and high cholesterol.¹

Lack of sleep and PCOS are linked

According to research, women with PCOS are more likely to have poor sleep quality or chronic daytime sleepiness. These could be signs of OSA (obstructive sleep apnea). If you feel tired or unrefreshed after waking up after a full night's sleep, it could be due to OSA. During the day, you may feel tired, have difficulty concentrating, or even fall asleep unintentionally. This is due to your body waking up frequently during the night, and untreated sleep apnea may exacerbate other symptoms of PCOS. Researchers believe that treating OSA may improve the health and quality of life of people with PCOS by lowering the risk of health problems like type 2 diabetes, obesity, and cardiovascular disease.²

Sleep problems are a common side effect of PCOS

Because PCOS is characterised by metabolic disturbances, and the endocrine system regulates the sleep-wake cycle, it is likely that PCOS interferes with sleep, or that there is a more complex interrelationship.

• Melatonin - is a hormone that your brain produces in response to darkness. It aids in regulating your circadian rhythms (24-hour internal clock).
• Cortisol - is also a hormone that regulates sleep and wakefulness. 

Melatonin levels rise at night and fall during the day, communicating light-dark information. Cortisol also has a circadian pattern, gradually increasing during sleep and in the morning.

PCOS can disrupt these two hormones, causing sleep disruption.³

Poor sleep can flare up symptoms of PCOS

We have already discussed the importance of sleep, but how can it worsen the symptoms caused by PCOS? 

When we do not get enough sleep, it causes an accumulation of damage to proteins and DNA, leading to cellular stress.⁴ Cellular stress is linked to cytokines release (small proteins that are important in controlling the growth and activity of other immune system cells and blood cells). Some cytokines make diseases worse; these cytokines are known as proinflammatory cytokines. This results in a pro-inflammatory state, which generally means promoting inflammation.⁵ Poor sleep quality is associated with an increased risk of obesity, acne flare-ups and insulin resistance.⁶

Ways to improve sleep when struggling with PCOS

Sleep is essential for overall health and wellness, but it is especially important for women with PCOS. Sleep is crucial in assisting in managing PCOS symptoms. You can sleep better by concentrating on good sleep hygiene (habits). Here are some essential behaviours to take into account: ⁷

• Avoid drinking alcohol in the evenings.
• Avoid eating large meals or snacks in the late evening.
• Create a calming bedtime routine that includes activities like taking a bubble bath or reading a book.
• Ensure that your bedroom is completely dark before you turn it in.
• When you get into bed, turn off all electronic devices.
• Consider consuming warm milk or chamomile tea before bed.3
• Maintain consistency. Put yourself to bed at the same time every night and get up at the same time every morning, even on weekends.
• Get some physical activity. Physical activity during the day can assist you in falling asleep more easily at night.⁸

If you're having trouble sleeping, make an appointment with your healthcare provider. Visit a doctor prepared with a list of your symptoms and the number of hours you've been sleeping. A sleep study may be ordered by your physician to help identify any sleep problems.

Conclusion

Restful sleep is essential for your health, especially if you have PCOS. Healthy sleep patterns can benefit mental health, immune health, and blood sugar levels and may even make it easier to follow a healthy, balanced diet. Improving sleep quality can help women with PCOS manage their symptoms, so we suggest looking into ways to sleep better.