14 Reasons Why Sleep is Important for PCOS

I find that most of my patients with PCOS spend a great deal of energy focusing on their diet and exercise regimen, but tend to neglect one of the most important aspects of health when it comes to PCOS – sleep. What percentage of the time do you wake up feeling totally well-rested? Probably not very often. Studies show that 40% of us get less than 6 hours or less of sleep a night!  And women with PCOS have an even greater risk for sleep problems. Not only does inadequate sleep make it difficult to focus on what you have to do for the day, but it can make you want to eat everything in sight!

The majority of my patients with PCOS report increased hunger and carb cravings when they are tired. There are real physiological reasons for this which I’ll discuss below. But fatigue and increased hunger are just the tip of the iceberg when it comes to inadequate sleep. Sleep deprivation can affect almost every part of your body ranging from your brain, muscles, immune system and even skin. And if that’s not enough, inadequate sleep can increase risk of heart disease, diabetes and obesity as well as cause inflammation and worsen insulin resistance.This is the last thing a woman with PCOS wants. Read on to learn why sleep is important and what you can do to get your zzzz’s.

PCOS and sleep problems

Women with PCOS tend to have more sleep problems than those without PCOS. There is a greater prevalence of obstructive sleep apnea (OSA) in PCOS patients, possibly due to the mechanisms associated with the obesity caused by PCOS-induced metabolic abnormalities.  As per Dr. Walter Futterweit, overweight women with PCOS with elevated androgens are 4 times more likely to have OSA than healthy women.  Second, regardless of OSA, studies have shown that the sleep disorders in patients with PCOS might be related to raised nighttime urinary melatonin levels, which are associated with lower sleep quality.  Other preliminary hypotheses for sleep disorder among PCOS patients include the impact of insulin resistance and hyperandrogenemia.  Reference

14 Reasons why sleep is important for PCOS

1. Mood changes … and not for the good!  Adequate sleep helps regulate mood and emotion regulation. You can be more reactive to stress than usual when you don’t get enough sleep. Several studies have confirmed that depression and anxiety are the most common comorbidities in patients with PCOS . This study indicated that PCOS might be a risk factor for subsequent depressive and anxiety disorders. Reference
2. Weight gain. The trends of chronic sleep restriction have paralleled those of obesity in recent years, suggesting epidemiological links between the two. In 1942 we got an average of 7.9 hrs sleep a night compared to 2013 with 6.8 hrs sleep a night. Leptin (satiety hormone) is decreased in sleep deprivation – while ghrelin (hunger hormone) is increased. Sleep deprived people eat more calories. Studies have shown that women eat 329 more calories and men eat 263 more calories the day after sleeping only 4 hours. To make matters worse, inadequate sleep will decrease motivation to exercise
3. Increased insulin resistance and risk of diabetes. Sleep restriction has been shown in many studies to increase insulin resistance, which is the last thing a woman with PCOS wants. And as we know, insulin resistance can be precursor to diabetes. Sleep extension improves insulin sensitivity. Read my previous post on 25 ways to decrease insulin resistance naturally. 
4. Inflammation. Sleep deprivation increases inflammatory cytokines TNF, IL-1 and IL-6. These cytokines disturb sleep. The increased levels of inflammatory markers can increase GI diseases such as Inflammatory Bowel Disease, colorectal cancer, gastro-esophageal reflux and liver disease have changed cytokine profiles. Sleep disruption can increase the severity of these GI disturbances.
5. Increased blood pressure. Inadequate sleep has been shown to increase risk of hypertension, a component of the metabolic syndrome. Hypertension is a well-known risk  factor for cardiovascular disease.
6. Increased risk of heart disease. Sleeping fewer than six hours a night can increase your risk of developing high blood pressure or worsen high blood pressure if you already have it. It can increase inflammatory markers including white blood cells, IL-6 and CRP. Over time, skimping on sleep can increase your odds of developing cardiovascular disease. Reference Read my previous post on heart healthy diet and lifestyle tips.
7. Carb cravings. This is one of the most common complaints I hear from my patients with PCOS. Hyperinsulinemia is likely the cause. Sleep deprivation definitely exacerbates this!

   These are other effects of inadequate sleep, not specific to PCOS, but important nonetheless:

8. Your mind doesn’t function optimally. Sleep is critical for the formation and consolidation of memories as well as your ability to retrieve them when awake. It becomes more difficult to focus on a task or learn something new. Your creativity is compromised as well as your ability to make decisions – which affects overall work performance.
9. Decreased reaction time. Sleeping only 5 hours a night can have a similar effect on judgement and motor reaction time as if you are legally drunk. This can be hazardous when driving or operating machinery. Lets hope your Via driver got a good nights sleep…
10. Change in mental health. Sleep affects our “emotional intelligence” – that is our ability to perceive and respond to others emotional state as well as our own. So make sure your significant other gets adequate sleep! Inadequate sleep can also increase anxiety and even suicidal thoughts
11. Decreased muscle repair and growth. Sleep provides an opportunity for rejuvenation. Many of the critical restorative functions in the body—like tissue repair and muscle growth—occur mostly or only during sleep. Inadequate sleep will also impede your progress if you are weight training to build muscle mass
12. Decreased immunity. Do you feel like you get sick every time you get run down? This isn’t surprising! When you’re tired and even moderately sleep-deprived, your immune function is compromised. This can leave you vulnerable to catching colds, the flu, and other infectious illnesses—and make it harder to recover from infections and heal from wounds.
13. Less relief from chronic pain. During REM sleep, muscles are relaxed, which can help relieve tension and reduce symptoms of certain types of chronic pain. Just like you couldn’t mentally focus for 24-hours straight at your day job, your body needs a break to chill out so it can conquer the next day with gusto.
14. Wrinkled saggy skin. So this one is little superficial and not specifically geared towards PCOS … but no one wants wrinkled skin!  Consistently skimping on sleep can lead to premature wrinkling and sagging of your skin, partly because cortisol (a stress hormone that’s released when you’re sleep-deprived) can break down collagen, which keeps your skin smooth.

Bottom line

Sleep plays a crucial role in helping you control your symptoms of PCOS and overall health. Stay tuned for an upcoming blog post on how to get more sleep!

Question for my readers – do you get enough sleep? If you don’t, how do you feel the next day? I’d love your comments!