A Cohort Study on Factors Affecting Sleep Quality in Women Undergoing Intrauterine Sperm Insemination (IUI) Treatment

Introduction: The stress associated with infertility can impact an individual's sleep status by affecting the hypothalamus and pituitary axis, potentially leading to sleep disorders. On the other hand, sleep disorders can further contribute to the development of depression and anxiety. This study aims to investigate the factors that influence sleep quality in women undergoing intrauterine sperm insemination (IUI) treatment. Methods: This research involved a prospective cohort study conducted on 131 infertile women aged 18-45 years who sought services at the infertility clinic of Bent Al-Hoda Hospital in Bojnurd City and a private clinic between 2020 and 2023. Data were gathered using a demographic questionnaire, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). Participants completed these questionnaires at three different time points: 0, 14, and 30 days in relation to the time of IUI. Data analysis was carried out using repeated-measures analysis of variance and generalized linear models. Results: The average age of the participating women was 29.85 years, with a standard deviation of 5.75. The overall prevalence of sleep quality disorder was 30.5%. Most patients reported mild to moderate disturbances in the delay of falling asleep. While no significant difference was observed in the comparison of average sleep disturbance scores at three different times, an increasing trend in anxiety and depression was noted in the second stage, followed by a decreasing trend in the third stage. In the presence of other variables, anxiety and depression demonstrated a significant relationship with sleep disorder (p < 0.001). Conclusions: Approximately one-third of infertile women were found to be suffering from a sleep quality disorder. The study underscores the significant impact of depression and anxiety on sleep quality disorders among infertile women. As a recommendation, it is advised to address the psychological well-being of infertile patients within infertility treatment clinics.