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Sleep and female reproduction

Willis, Sydney Kaye; Hatch, Elizabeth Elliott; Wise, Lauren Anne

Current Opinion in Obstetrics and Gynecology: August 2019 - Volume 31 - Issue 4 - p 222–227
doi: 10.1097/GCO.0000000000000554

Purpose of review Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction.

Recent findings There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited. Recent studies provide suggestive evidence that sleep disorders are associated with increased menstrual irregularity, subfertility/infertility, and poor pregnancy and birth outcomes. Mechanisms underlying these associations are likely to be multifactorial and complex. In addition to genetics, circadian disruption may impact reproductive outcomes through dysregulation of the hypothalamic-pituitary-adrenal axis, insulin resistance, oxidative stress, and systemic inflammation. Recommendations for future studies include: use of prospective study designs; assessment of populations not already experiencing reproductive disorders; more detailed and accurate assessments of sleep such as validated self-reported measures or objective sleep measures (e.g. actigraphy); comprehensive assessment of potential confounders and mediators; and elucidation of biologic mechanisms.

Summary There is a growing body of literature showing evidence that sleep disturbances influence female reproduction, although further epidemiologic research is needed.

Department of Epidemiology, Boston University School of Public Health, Boston, USA

Correspondence to Sydney Kaye Willis, MSPH, Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA. Tel: +1 617 358 3425; e-mail:

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