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Women's Health
pcos and sleep issues

Women with PCOS (polycystic ovarian syndrome) may struggle with getting good quality sleep. Sleep plays a critical role in not only managing some symptoms of PCOS, but also your overall health.  In this article, we share information about PCOS and sleep issues. Then, we provide five helpful strategies to get a better night’s sleep with PCOS.

About PCOS and Sleep Issues

PCOS is marked by a hormonal imbalance which can create certain problems in the body. These problems include weight gain, fatigue, unwanted hair growth, mood changes, and sleep problems. In one study PCOS patients were 30 times more likely to suffer from disordered breathing during sleep than the controls. Many women with PCOS also often complain of excessive daytime sleepiness (EDS) even without a diagnosis of disordered breathing.

Experts believe that women with PCOS may be at higher risk for sleep disturbance due to insulin resistance. Women with PCOS tend to overproduce insulin. Insulin is a hormone that allows our cells to use glucose (sugar) to produce energy. When this occurs, the cells lose their ability to respond normally to insulin, and this can ultimately lead to type 2 diabetes.

Poor quality sleep with PCOS

Since women with PCOS may not get good quality sleep, this can lead to EDS.  Women with EDS complain of reduced productivity with tasks, making more mistakes and having lapses in judgment or wakefulness. They also report feeling less able to participate in activities and less joy when participating fully.

One of the reasons why some women with PCOS get poor quality sleep is obstructive sleep apnea (OSA). OSA is a disorder causing repeated brief interruptions in breathing during sleep because the muscles in the throat are not able to properly keep the airway open. Besides the symptoms of EDS, those with OSA also are more likely to have a number of metabolic complications. These complications include high blood pressure, non-alcoholic fatty liver disease, lower glucose tolerance, weight gain and difficulty losing weight.

Restful sleep is vital for your well-being, especially with PCOS

Sleep deprivation leads to not only fatigue but also mood changes, increased hunger, decreases in insulin sensitivity and carb cravings. Those who do not get enough sleep are more prone to overeating which can lead to weight gain.

Improving sleep quality and reducing OSA can help women with PCOS manage weight and mood.

healthy living with pcos

Sleep Strategies For Women With PCOS

No matter what the reason is for your sleep disturbance, it is important to explore ways that you can get better quality sleep so that you can improve your health.

1.  Check out online resources for help.

There are a variety of great resources online to help with your PCOS and sleep issues. Check out this blog article for guidelines on how much sleep you need and strategies for getting better, more restful sleep. These include sleeping in a cool, dark room, limiting screen time before bedtime, avoiding caffeine after your morning coffee, and much more. Also, check out the blog at PCOS Nutrition for more sleep tips.

2. Seek treatment from a health professional.

If you think you have OSA, see your physician and bring a list of your symptoms and the number of hours you have been sleeping. Your physician may then send you for a sleep study which will determine if you have OSA and if so, the severity. The sleep study involves an overnight stay at a clinic where they will examine your sleep state, eye movements, respiratory efforts, muscle activity, heart rate, and blood oxygen levels.

You may be recommended to use a continuous positive airway pressure device or CPAP. The CPAP is highly effective at treating OSA and be sure to follow your doctor’s advice when using it.

For some women, an underlying condition such as obesity, depression or medication can cause EDS, and if you have tried these tips but you’re not feeling well rested, see your healthcare professional.

3.  Improve your “sleep hygiene.” 

EDS can be due to poor sleep habits, reduced opportunity for adequate sleep and an irregular sleep schedule. By improving sleep hygiene you can significantly improve the quality of your sleep. Some suggestions for how to naturally improve your sleep hygiene include:

  • Limit alcohol, food, and drink close to bedtime
  • Avoid caffeine after your morning cup of coffee
  • Sleep in a cool, dark room
  • Limit screen time at bedtime

4. Participate in regular exercise.

Those who exercise regularly tend to have a more restful sleep. Exercise reduces daytime sleepiness and disordered breathing symptoms associated with OSA.

Most healthcare experts recommend moderate intensity level exercise, which is an intensity effort of 5 to 6 on a scale of 0 to 10.

The National Heart Lung and Blood Institute recommends getting started with activities that you like to do and find ways to make them a part of your routine. Including friends and family and tracking your progress with a fitness app can be great motivators to getting moving and staying moving.

5. Try taking a melatonin supplement.

Melatonin is one of the hormones that can be out of balance in women with PCOS, and this hormone is connected to sleep. Optimally, the production and release of melatonin are related to the time of day; in the evening, melatonin levels rise, and in the morning, melatonin levels fall. In women with PCOS, melatonin blood levels may be higher which may, in turn, correlate to higher testosterone levels. This hormonal imbalance can contribute to sleep disruption, which can further disrupt hormone levels and symptoms of PCOS.

Melatonin is an antioxidant which can help protect cells against oxidative stress, and it may help reduce inflammatory markers in people with type 2 diabetes. Women with PCOS are at an increased risk of developing type 2 diabetes.

A pilot study showed that taking a melatonin supplement improves menstrual regularity and decreases testosterone levels in women with PCOS.  Melatonin may also improve egg quality among women going through fertility treatment.

Discuss taking melatonin with your healthcare provider. Melatonin can interact with certain medications, and not all women with PCOS will benefit from taking a supplement. If you do take melatonin, look for a high-quality supplement, and be sure to take it 30-60 minutes before bedtime.


Poor sleep can affect your work, relationships, and your motivation for activities. You can get relaxing sleep with PCOS by following the five strategies outlined in this article.

Track your hours of sleep and symptoms, and this information can help you and your healthcare professional determine a strategy of care. If you think you have OSA, seek treatment and follow your physician’s advice.

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