Polycystic ovary syndrome (PCOS) is a common disorder that affects 18-20% of women in the US. The defining characteristics of PCOS are hyperandrogenism, chronic anovulation, ovarian polycystic morphology. In lay terms, that means infrequent menstruation, weight gain, acne, abnormal hair growth and fertility problems. 

While multiple comorbidities are associated with PCOS, namely: diabetes, liver disease, and cardiovascular disease, obesity is a common risk factor for PCOS and sleep apnea.

According to recent research, women with PCOS are twice as likely to develop sleep apnea which helps explain why they report feeling tired, moody and often depressed. Alterations in sex steroids (i.e. high androgen and low estrogen levels) and increased visceral adiposity in PCOS could potentially contribute to the increased prevalence of OSA (obstructive sleep apnea).

The bottom line: Get treated for sleep apnea, reduce weight gain and mitigate some of the effects of PCOS. 

Here’s some topline clinical research:

 

Polycystic Ovary Syndrome Is Associated with Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance

OSA was much more prevalent in premenopausal women with PCOS than in normal controls (ratio, 30:1). This difference remained significant, even when we corrected for BMI differences between the two groups. Eighty percent of PCOS patients reported daytime sleepiness, in contrast with 25% of normal controls. JCEM

Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study

Women with PCOS are at increased risk of developing OSA compared to control women irrespective of obesity. Considering the significant metabolic morbidity associated with OSA, clinicians should have a low threshold to test for OSA in women with PCOS. Whether OSA treatment has an impact on PCOS symptoms and outcomes needs to be examined. European Journal of Endocrinology

Polycystic Ovary Syndrome and Obstructive Sleep Apnea

Recent evidence is that sleep disturbances also appear to be an important feature in PCOS and that OSA is considerably more common than expected in women with PCOS. However, the high prevalence of OSA is under recognized among clinicians who manage PCOS patients. Limited evidence summarized in this review suggests that the androgen excess, subnormal estrogen levels and visceral adiposity could be involved in the increased risk of OSA in PCOS, and that there may be a strong association between the severity of OSA and glucose intolerance and insulin resistance.  ncbi.nlm.nih.gov

PCOS and Sleep Apnea

“Women with PCOS are at risk for other, related life-long conditions and symptoms including diabetes, high cholesterol, hypertension,” says Anuja Dokras, MD, PhD, director of the Penn Polycystic Ovary Syndrome Center. “They are also at risk for sleep apnea.”  Penn Medicine