A case control study of subjective sleep characteristics and polycystic ovary syndrome

Abstract

Abstract To investigate the subjective sleep characteristics of patients with polycystic ovary syndrome (PCOS) and their association with the syndrome. A case-control study was conducted, enrolling 136 patients with PCOS and 164 non-PCOS controls recruited from the gynecology outpatient department between February and October 2025. Sleep quality was assessed using a simplified questionnaire derived from core items of the Pittsburgh Sleep Quality Index. Multivariate logistic regression analysis was performed to evaluate the association between sleep problems and PCOS, with adjustment for age, body mass index (BMI), and other potential confounders. The PCOS group exhibited significantly higher prevalences of difficulty falling asleep (51.5% vs. 32.3%), non-restorative sleep (51.5% vs. 32.9%), and self-reported poor sleep quality (66.2% vs. 53.7%) compared with the control group (all p  < 0.05). The prevalence of frequent dreaming was significantly higher in the PCOS group than in the control group (39.0% vs. 28.0%, p  = 0.045, chi-square test). However, in the correlation analysis, frequent dreaming was not significantly associated with PCOS status ( p  > 0.05). After adjustment for potential confounders, participants with moderate and high sleep problem scores demonstrated a significantly increased risk of PCOS (moderate group: adjusted odds ratio [aOR] = 1.845, 95% CI: 1.025–3.320; high group: aOR = 2.286, 95% CI: 1.054–4.959). Subjective sleep disturbances are highly prevalent among patients with PCOS, particularly characterized by difficulty falling asleep, non-restorative sleep, and perceived poor sleep quality. The severity of these sleep disturbances is independently associated with an increased risk of PCOS. Subjective sleep assessment should be incorporated into the clinical management of PCOS.