Sleep disturbances in PCOS as indicators of metabolic dysfunction

sleep disturbances

Women with Polycystic Ovary Syndrome (PCOS) often experience sleep disturbances. Sleep patterns can be disturbed by hormonal abnormalities, insulin resistance, and obesity connected to PCOS. Increased testosterone levels may promote insomnia, but irregular menstrual cycles may disrupt sleep patterns. Additionally, mental problems and obstructive sleep apnea are frequent comorbidities.

What are the types of sleep disturbances that are caused due to PCOS?

While sleep disturbances are not a primary sign of PCOS, hormonal imbalances and associated diseases might lead to sleep problems. Here are some examples of sleep disturbances associated with PCOS:

  1. Insomnia: Due to hormonal fluctuations, stress, anxiety, and other conditions related with PCOS, women may have difficulties sleeping or staying asleep.
  2. Sleep Apnea: PCOS is frequently linked to an increased risk of sleep apnea, a condition characterized by pauses in breathing while sleeping. Sleep apnea can be caused by hormonal imbalances, obesity (common in PCOS), and insulin resistance.
  3. Restless Legs Syndrome (RLS): RLS is a syndrome characterized by an insatiable desire to move one’s legs, which is frequently accompanied by unpleasant feelings. RLS symptoms may be exacerbated by PCOS-related hormonal imbalances and metabolic disorders.
  4. Shift work sleep disorder: Women with PCOS who work irregular, or night shifts may encounter changes in their circadian rhythms, making it difficult to keep a regular sleep schedule.
  5. Mood disorders: PCOS has been linked to mood disorders like depression and anxiety. These conditions have the potential to alter sleep patterns and quality.
  6. Excessive daytime drowsiness: PCOS-related hormonal imbalances and sleep disruptions can cause excessive daytime drowsiness and weariness.sleep disturbances

How does PCOS causes sleep disturbances?

PCOS can lead to sleep disturbances through various mechanisms:

  1. Hormonal Imbalances: Insulin resistance and high levels of androgens (male hormones) characterize PCOS. The normal sleep-wake cycle may be thrown off by these abnormalities, which may impact sleep-regulating hormones like melatonin and cortisol.
  2. Insulin Resistance: Obesity and metabolic syndrome can be exacerbated by insulin resistance, which is common in PCOS. Sleep apnea, a problem where breathing repeatedly stops and starts while you sleep, causes poor sleep quality, and is associated with both disorders.
  3. Obesity: Many PCOS-afflicted women battle with weight gain and obesity, both of which increase the chance of developing sleep apnea and other breathing issues associated with sleep. Narrowed airways brought on by being overweight can interfere with breathing as you sleep.
  4. Irregular Menstrual Cycles: Menstrual irregularities in PCOS can be brought on by hormonal imbalances. Circadian rhythms and the body’s natural sleeping habits may be disturbed by these oscillations.
  5. Stress and Anxiety: Because PCOS affects fertility, attractiveness, and general well-being, it can be emotionally upsetting. Anxiety and stress can have a negative impact on the quantity and quality of sleep.
  6. Effects of Androgen: PCOS symptoms including hirsutism (excessive hair growth) and acne may be exacerbated by elevated androgen levels. These physiological symptoms could cause problems with body image, which would impair sleep.
  7. Inflammation: Low-grade inflammation and PCOS are related. By altering neurotransmitters and the body’s reaction to signals that cause sleep, chronic inflammation can interfere with sleep.

How to treat sleep disturbances caused by PCOS?

Sleep disturbances in PCOS women are treated with a combination of lifestyle adjustments, medication therapies, and addressing the underlying hormonal abnormalities. Here are a few ideas:

Lifestyle modifications:

  1. Regular sleep schedule: Maintain a consistent sleep routine by going to bed and getting up at the same times every day.
  2. Healthy diet: Adopt a balanced diet to manage insulin resistance and improve general health.
  3. Physical activity: Regular physical activity can enhance insulin sensitivity and aid with weight management.
  4. Stress management: To alleviate tension and anxiety, use relaxation techniques such as deep breathing, meditation, or yoga.

Sleep hygiene:

  1. Bedtime routine: Create a relaxing nighttime ritual to communicate to your body that it’s time to unwind.
  2. Screen time: Limit screen time (phones, computers, TVs) before night since blue light can affect melatonin production.sleep disturbances
  3. Sleep environment: Create a comfortable and dark sleeping environment favorable to peaceful sleep.

Counselling therapy:

  1. Cognitive Behavioral Therapy for Insomnia (CBT-I): This organized therapy can address negative sleep-related cognitive patterns and behaviors.

Consultation with Medical Personnel:

  1. Endocrinologist: An endocrinologist can assist in the management of hormonal imbalances caused by PCOS.
  2. Consultation with a sleep specialist: If sleep disruptions are severe, meeting with a sleep specialist might result in more personalized treatment strategies.

Treatment of PCOS in order to treat the sleep disturbances:

Treating the underlying PCOS may help improve some of the sleep disruptions caused by hormone imbalances and other PCOS-related issues. Aspects of PCOS treatment that may help with sleep difficulties include a 5 pillar strategy which aids in treating PCOS naturally.

The 5 pillar strategy to reverse PCOS naturally: 

  1. Eat Right: Embrace living, water-rich, whole, plant-based foods that nurture our genetic potential. By opting for local and seasonal choices, we honor nature’s wisdom. Eliminating packaged and processed foods liberates us from epigenetic imprints, elevating our hormonal health.
  1. Move More: Embark on a journey of holistic lifestyle changes, where staying active transcends mere exercise. Embracing constant movement throughout the day optimizes epigenetic expression, igniting hormonal balance. Engage in pleasurable physical activities, dance, or even mindful walks to unlock the power of epigenetic triggers.
  1. Breathe Aware: As we deepen our understanding of Pranayama, the science of breath, we access a profound gateway to support gland function and harmonize hormones. Harnessing the breath’s epigenetic influence, we transcend the ordinary and elevate our hormonal well-being.sleep disturbances
  1. Sleep Better: Unlock the secrets of deep sleep, a transformative practice for healing and regeneration. With the art of Yog Nidra, we embrace epigenetic potential, unearthing hormonal harmony in the realm of dreams. Rejuvenate your entire being through this exquisite dance with the epigenetic clock.
  1. Mind Free: Journey into the realm of emotions, thoughts, and stress resilience, where journaling, gratitude, and emotional practices become our guiding compass. Embracing epigenetic intelligence, we shift our narrative from stress to serenity, empowering our hormonal landscape.


In conclusion treating the sleep disturbances caused by PCOS without treating the PCOS can help in temporary relief only as in such treatment we are treating only the symptom (i.e., the sleep disturbance) but not the root cause of the problem (i.e., PCOS). Hence treating PCOS is advised in order to prevent sleep disturbances and many other problems that arise due to PCOS.