Relationship between sleep disorders and female infertility among US reproductive-aged women

Sleep disorders are a risk factor for a wide variety of dysfunctions of endocrine, metabolic, cardiovascular, and neurological diseases. However, the risk of sleep disorders to female infertility has not been thoroughly explored. Our study aimed to examine whether or not sleep disorders increase the risk of female infertility.

Cross-sectional data on sleep disorders and fertility history were obtained from the National Health and Nutrition Examination Survey 2013-2018. Women aged 20 to 40 years old were enrolled in our study. Weighted multivariable logistic regression models and stratified analysis by age, smokers, and patient health questionnaire-9 (PHQ-9) score were conducted to estimate the effect of sleep disorders on female infertility.

Among 1820 reproductive-age females, 248 individuals had infertility and 430 individuals had sleep disorders. Two weighted logistic regression models found that sleep disorders were an independent risk factor for infertility. After adjusting for the covariates (age, race/ethnicity, marital status, education level, poverty income ratio, body mass index (BMI), waist circumference, PHQ-9 score, smokers, drinkers, and sleeping hours), the risk of infertility was 2.14-fold higher in individuals with sleep disorders than in those without. The further stratified analysis demonstrated that the relationship between sleep disorders and infertility was maintained and that the risk was higher particularly in infertile women aged 40-44 years, with PHQ-9 score greater than 10, and smokers.

A strong association was found between sleep disorders and female infertility, and the association remained after adjusting for other confounding factors.