Sleep and Fertility
Sleep impacts every aspect of our health and well-being including our cognitive, mental health and physical health. It bolsters our immunity, affects heart function, metabolism, weight, appetite, blood sugar levels and importantly, regulates all the different hormones and hormonal functions (including the reproductive) in our body.
When people are trying to conceive, there is a focus on getting bodies and minds into an optimal state of health. As there isn’t one area of our health that isn’t compromised when we don’t get the sleep we need, it’s a piece of the fertility puzzle that shouldn’t be overlooked.
While there is a significant lack of research on the impact of sleep disorders on reproduction, there is growing evidence that indicates sleep may be essential to reproductive function in a number of direct and indirect ways.
The bi-directional nature of sleep
The impact of hormones:
In general, whenever we chronically disrupt sleep in quantity and quality, we disturb hormonal balance. For women who are trying to conceive, it’s especially important for estrogen and progesterone levels to be balanced. Disrupted estrogen levels, for example, can cause fluctuations in body temperature, melatonin secretions, cortisol release and the quantity of REM sleep, all which can impact sleep. Short sleep duration is associated with irregular menstrual cycles, which may impact ovulation and reproductive health.
Poor sleep can also affect melatonin levels, which may influence reproductive health for both men and women as this hormone helps protect your eggs. Hormonal imbalance can lead to a decrease in libido for both men and women. Over time, this could disrupt your relationship with your partner and lead to fewer opportunities for pregnancy to occur.
The impact of stress:
Anxiety, depression, and sleep disturbances are common complaints for women undergoing IVF. Fertility can be a stressful time. Stress can impact sleep and poor sleep can elevate and dysregulate stress hormones, like cortisol.
The impact of healing and restoration:
THE most important time for healing, boosting immunity, new cell growth, muscle recovery and tissue repair is during deep sleep.
Missing sleep may lead to:
reduced immunity
more frequent infections
increases in illnesses
spikes in appetite
higher calorie consumption
weight gain
increasing your risk for diseases and conditions that may affect your fertility (eg. diabetes, cardiovascular disease and obesity)
Immune system health is considered an important component for reproductive health and the above conditions have been linked to poorer pregnancy outcomes.
Conceiving is Complex
Fertility is complex and the human body is complicated. In some cases, it’s clear what may be causing infertility and in other cases, it may not be so clear cut. It would be irresponsible to make a blanket claim that poor sleep causes infertility but what we do know is that poor sleep can lead to certain factors that may put you more at risk for having certain conditions which in turn may interfere with fertility and issues conceiving.
Women with low quality sleep have lower rates of fertility than those getting adequate rest. A recent study showed that OSA is more commonly seen in infertile women and increases the odds that a woman will be infertile. Rising rates of infertility over the last several decades parallel the increasing prevalence of sleep deprivation and disruption. But there are also other factors at play, and due to the lack of research, one cannot draw straight conclusions.
A More Balanced Approach to Fertility
People are often told to engage in physical activity and healthy nutritional practices but importantly, sleep should be viewed as a significant modifiable target to improve reproductive health and outcomes. Researchers are just starting to note the importance of including sleep education and healthy sleep protocols into fertility practices. Physicians should consider screening and identifying women with compromised sleep quality and could plan a more in-depth assessment and/or refer out to a sleep coach or specialist where applicable. Improving sleep may concomitantly improve psychological well-being, physical health and fertility outcomes.
Tips to Optimize Sleep During the Fertility Process:
Manage stress during the day and wind down at night
Unaddressed stress and anxiety during the day can creep up in the night and keep you awake. Journaling, talking to a loved one, mindfulness or breath work can be effective stress reduction techniques to try out. Create a protective bubble around your nights, leaving the 30-60 min before bed to unwind from tech, thoughts and anything activating by implementing a relaxing, repetitive wind down routine.
Manage light exposure
Get bright light as soon as you can after you wake up and again around lunchtime. Outdoor light is best. And remove your sunnies! As the sun goes down, keep lights dim at home and aim to reduce any blue light exposure approximately 30-60 min before bed.
Manage sleep schedules
Try and keep consistent bed and wake times 7 days a week. Start by anchoring your wake time and if you’re not sleepy at bedtime, don’t force it. Consider leaving the bedroom to do a relaxing activity (eg. listening to relaxing music or a sleep story, adult colouring book, reading a book) until you feel sleepy and then return to your bed.
REFERENCES:
Gabriela Caetano, Inès Bozinovic, Charlotte Dupont, Damien Léger, Rachel Lévy, Nathalie Sermondade. Impact of sleep on female and male reproductive functions: a systematic review. Fertility and Sterility. 2021; 115 (3): 715-731. https://doi.org/10.1016/j.fertnstert.2020.08.1429.
Gaurie Palnitkar, Craig L. Phillips, Camilla M. Hoyos, Anthony J. Marren, Mark C. Bowman, Brendon J. Yee. Linking sleep disturbance to idiopathic male infertility. Sleep Medicine Reviews. 2018; Volume 42: 149-159. https://doi.org/10.1016/j.smrv.2018.07.006.
Giorgia Spaggiari, Marilina Romeo, Livio Casarini, Antonio R.M. Granata, Manuela Simoni, Daniele Santi. Human fertility and sleep disturbances: A narrative review. Sleep Medicine. 2022; 98:13-25. https://doi.org/10.1016/j.sleep.2022.06.009.
Lateef OM, Akintubosun MO. Sleep and Reproductive Health. J Circadian Rhythms. 2020 Mar 23;18:1. doi: 10.5334/jcr.190. PMID: 32256630; PMCID: PMC7101004.
Olcese J.M. Melatonin and Female Reproduction: An Expanding Universe. Front. Endocrinol. (Lausanne) 2020;11:85. doi: 10.3389/fendo.2020.00085.
Sun T.C., Li H.Y., Li X.Y., Yu K., Deng S.L., Tian L. Protective effects of melatonin on male fertility preservation and reproductive system. Cryobiology. 2020;95:1–8. doi: 10.1016/j.cryobiol.2020.01.018.
Willis SK, Hatch EE, Wise LA. Sleep and female reproduction. Curr Opin Obstet Gynecol. 2019 Aug;31(4):222-227. doi: 10.1097/GCO.0000000000000554. PMID: 31082843.
