Abstract
Background:
Polycystic ovary syndrome (PCOS) is associated with a higher prevalence of sleep disturbances and obesity. Treatment of PCOS includes modifying lifestyle behaviours associated with weight management. However, poor sleep in the non-PCOS population has been associated with poorer lifestyle behaviours.
Objective:
To investigate whether sleep disturbance confounds or modifies the association between lifestyle factors and PCOS.
Design & Setting:
This study was a cross-sectional analysis from the Australian Longitudinal Study on Women’s Health cohort aged 31-36 years in 2009 were analysed (n=6067, n=464 PCOS, n=5603 non-PCOS).
Main outcome measures:
Self-reported data were collected on PCOS, anthropometry, validated modified version of the Active Australia Physical Activity survey, validated food frequency questionnaire and sleep disturbances through latent class analysis.
Results:
Women with PCOS had greater adverse sleep symptoms including severe tiredness (p=0.001), difficulty sleeping (p<0.001) and restless sleep (p<0.001), compared to women without PCOS. Women with PCOS also had higher energy consumption (6911±2453 vs 6654±2215kJ, p=0.017), fibre intake (19.8±7.8 vs 18.9±6.9g, p=0.012) and diet quality (dietary guidelines index (DGI)) (88.1±11.6 vs 86.7±11.1, p=0.008), lower glycaemic index (50.2±4.0 vs 50.7±3.9, p=0.021) and increased sedentary behaviour (6.3±2.8 vs 5.9±2.8 hours, p=0.009). There was a significant interaction between PCOS and sleep disturbances for DGI (p=0.035), therefore only for women who had adequate sleep was PCOS associated with a higher DGI. For women with poorer sleep, there was no association between PCOS and DGI.
Conclusion:
The association between PCOS and improved diet quality may only be maintained if women can obtain enough good quality sleep.
Sleep disturbances in a community-based sample of women with polycystic ovary syndrome
