How PCOS impacts our sleep and recovery

It may not seem like it, but your body is hard at work while you sleep to prepare you for the following day. Sleep is critical for helping your mind and body recover and recharge and has been linked to memory consolidation (1). Without quality rest you may experience brain fog and an inability to focus, but lack of sleep goes even deeper than that - especially if you have PCOS. 

Sleep is significant for managing stress levels and vice versa. And, keeping your stress under control is a key part of keeping PCOS symptoms and inflammation at bay. However, people with PCOS often experience hormone imbalances relating to cortisol and melatonin. 

Since both of these hormones are responsible for the sleep-wake cycle, these imbalances can cause sleep disorders such as insomnia and sleep apnea and subsequently contribute to additional stress, thus catalyzing a viscous cycle (2).In this article, we will provide an overview of the relationship between PCOS and sleep. Keep reading to understand:

• Why is sleep important?
• What are the common sleep disorders associated with PCOS? 
• How could my PCOS be impacting my insomnia or sleep apnea?
• What are remedies for sleep disturbances associated with PCOS?

The importance of sleep 

At some point or another, we have all faced the consequences of not getting adequate sleep. It is never a pleasant experience!

Without sufficient sleep, you may find that you are more likely to feel tired, irritable, and slow. You probably experience a general feeling of grogginess and all you can think about is going back to sleep. 

These feelings all typically go away once you obtain some quality rest, but what happens when you have long-term sleep disturbances? Not only will your day-to-day energy levels be affected, but also your overall health. 

While you sleep, several vital biological processes happen in your body. Below are a few areas that have been linked to sleep (1).

• Muscle repair and growth
• Emotional well-being
• Memory consolidation
• Support insulin function
• Immune support
• Heart health

Chronic sleep disruptions can impact several different areas of your health, so be sure to discuss any concerns you may have if you are experiencing abnormal sleep disturbances.

The relationship between sleep and recovery

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Sleep can help the body to return to baseline, especially after exercise. Movement is helpful for people with PCOS in particular because it has been shown to improve insulin resistance and overall symptoms (3). If you are into endurance training, weightlifting, or other high intensity exercise, sleep is crucial for recovery because aerobic fitness can put too much stress on your body and worsen symptoms if you overdo it. 

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Allowing your body to recover by taking rest days and getting proper sleep can improve both your performance and symptoms, so be sure you are optimizing your rest days just as much as your training.

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Read more about PCOS and cardio here.

How PCOS may be impacting your sleep

As mentioned earlier, people with PCOS may be more prone to develop a sleep disorder. Sleep disorders can persist over a long period and this can drastically worsen symptoms. Let’s go over the most common sleep disorders associated with PCOS.

Insomnia

Insomnia is defined as the inability to get enough sleep. People with insomnia may find it challenging to fall asleep or stay asleep. Insomnia can cause irritation, low energy levels, and mood changes.

In a study published in the Diabetes Journal, insulin resistance was common among people with sleep problems (4). And at least 70% of people with PCOS are insulin resistant! 

As a result of insulin resistance, the body constantly attempts to regulate blood glucose levels, which affects the body's fight or flight response. Problems with glucose synthesis can cause you to feel tired yet lead to difficulty falling asleep, complicating PCOS and sleep concerns (5).

While insulin resistance could be the root cause of your insomnia, the lack of sleep it causes for people can lead to further hormone disruption. For example, chronic sleep deprivation can lead to high levels of cortisol, which over time has been linked to increased inflammation and more severe PCOS symptoms. 

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is defined as the stopping of breathing once or numerous times during sleep. Symptoms of sleep apnea include snoring, excessive daytime sleepiness, headaches, and irritability (6). 

People with PCOS are 30 times more likely than those without the condition to suffer from OSA (7). Additionally, sleep apnea may increase symptoms associated with PCOS such as fatigue, difficulty losing weight, hypertension, and insulin resistance (8). 

Sleeping with a continuous positive airway pressure (CPAP) machine can help regulate your breathing. A CPAP machine may also help with metabolic functions associated with PCOS such as insulin resistance, hypertension, and high cholesterol. In addition to a CPAP machine, an oral device that pulls the jaw forward is also a possible treatment (8).

Remedies for sleep disturbances associated with PCOS

There is no one-size-fits-all approach for improving your sleep quality and quantity, but there are several items to consider that many people find to be helpful.

Establishing a sleep routine

In addition to increasing the amount of sleep you get at night, establishing a sleep routine can also improve its quality. Perhaps the most important thing to maximize the quality of your shut-eye is your sleep routine.

Some general tips that you can talk about with your coach include:

• Limit screen time: If possible, try to avoid screens for at least 30 - 60 minutes before bed. The more time you put away your cell phone, laptop, and TV, the better! 
• Consider blue light glasses: Blue light glasses can help filter out blue light from electronic screens, which has been shown to be particularly aggravating from a vision as well as sleep perspective. These can be particularly helpful in the morning and before bed, but many people see a difference from wearing them through the course of the day. 
• Aim for morning sunlight: Getting morning sun exposure within a few minutes of waking can help regulate your circadian rhythm. Bonus points if you can get outside at several points throughout the day! 
• Give yourself time to digest after dinner: Many people are aware it is not good to eat right before bed. While having a large meal and going to sleep right afterward probably won’t make you feel too good, some people with blood sugar regulation issues do find that a small snack with protein before bed can help balance their blood sugar levels. TL; DR: Be sure to eat enough at dinner either way, and talk with your coach about whether trying to give your body more time to digest would make sense for you. 
• Be mindful of caffeine intake: Even if you do not feel like your afternoon cup of coffee gives you jitters, it may be taking a toll on your sleep. Try to stick to caffeinated beverages just in the morning.
• Optimize your sleep environment: The “best” sleep environment is said to be quiet, cool, and dark. If this does not reflect your room, consider investing in a white noise machine or blackout shades. Many people also find that decluttering their bedroom can be helpful, as can leaving any non sleep or sex activities for outside the bedroom (i.e., no eating, TikTok scrolling, working, or watching TV from bed). 
• Be consistent: Establishing a regular-wake sleep schedule, such as waking up and going to bed at the same time every day, can be helpful for helping your body get into a better sleep schedule. 
• Practice breathing exercises: If your mind races at night, try guided breathing techniques or meditation to shift your focus on something else.

Herbal teas 

With sleep disturbances, you may benefit from herbal chamomile tea. Chamomile tea is often suggested for those experiencing stress, anxiety, and difficulty sleeping. Chamomile contains apigenin, an antioxidant that promotes relaxation and sleep (9).

In addition to chamomile tea, other herbal options such as lavender tea have also shown positive outcomes in people experiencing sleep disturbances such as insomnia. Just make sure to stay away from caffeine! 

Essential oils

Essential oils are naturally found in plants. Their calming and healing properties make them popular. Consider adding essential oils to your nighttime routine if you have trouble falling asleep or staying asleep.

Lavender, chamomile, eucalyptus, and jasmine are some essential oils that may aid sleep. You can apply them directly to the skin or inhale them through a diffuser.

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Note: While we are excited to help you improve your PCOS symptoms at Pollie and find sleep strategies that work for you, we do not specialize in sleep health. Discuss your concerns with your doctor if you have problems with your sleep or feel tired during the day.

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References

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1. Division of Sleep Medicine at Harvard Medical School. (2007, December 18). Sleep, learning, and memory. Sleep, Learning, and Memory . Retrieved April 28, 2022, from https://healthysleep.med.harvard.edu/healthy/matters/benefits-of-sleep/learning-memory#:~:text=Research%20suggests%20that%20sleep%20helps,essential%20for%20learning%20new%20information. 
2. 2. Kim, T. W., Jeong, J. H., & Hong, S. C. (2015). The impact of sleep and circadian disturbance on hormones and metabolism. International journal of endocrinology, 2015, 591729. https://doi.org/10.1155/2015/591729
3. 3. Hutchison SK, Stepto NK, Harrison CL, Moran LJ, Strauss BJ, Teede HJ. (2011, January). Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome. National Library of Medicine. Retrieved March 16, 2022, from https://pubmed.ncbi.nlm.nih.gov/20926534/
4. 4. Mesarwi, O., Polak, J., Jun, J., & Polotsky, V. Y. (2013). Sleep disorders and the development of insulin resistance and obesity. Endocrinology and metabolism clinics of North America, 42(3), 617–634. https://doi.org/10.1016/j.ecl.2013.05.001
5. 5. Fernandez, R. C., Moore, V. M., Van Ryswyk, E. M., Varcoe, T. J., Rodgers, R. J., March, W. A., Moran, L. J., Avery, J. C., McEvoy, R. D., & Davies, M. J. (2018). Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and science of sleep, 10, 45–64. https://doi.org/10.2147/NSS.S127475
6. Mayo Foundation for Medical Education and Research. (2021, July 27). Obstructive sleep apnea. Mayo Clinic. Retrieved April 28, 2022, from https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090#:~:text=Obstructive%20sleep%20apnea%20occurs%20when,breathing%20is%20momentarily%20cut%20off. 
7. Tasali, E., Van Cauter, E., & Ehrmann, D. A. (2008). Polycystic Ovary Syndrome and Obstructive Sleep Apnea. Sleep medicine clinics, 3(1), 37–46. https://doi.org/10.1016/j.jsmc.2007.11.001
8. University of Pennsylvania. (n.d.). PCOS and sleep apnea. Penn Medicine. Retrieved April 28, 2022, from https://www.pennmedicine.org/updates/blogs/fertility-blog/2014/may/pcos-and-sleep-apnea#:~:text=There%20is%20also%20a%20small,blood%20pressure%20and%20high%20cholesterol. 
9. Elliott, B. (2017, August 18). 5 ways Chamomile Tea Benefits Your Health. Healthline. Retrieved April 28, 2022, from https://www.healthline.com/nutrition/5-benefits-of-chamomile-tea#:~:text=Chamomile%20has%20some%20unique%20properties,sleep%20(%201%20%2C%202%20). 

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