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Sleep and Fertility

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Sleeping well could increase your chances of conceiving. Although it’s not the only factor, sleep certainly plays a role in fertility; both male and female reproductive functioning gets better on sufficient sleep as hormones are balanced better and all organs work properly. 

Other factors that play a large role in both male and female fertility are age, weight, mental health (stress, depression, and anxiety can work against you), consuming tobacco, alcohol or illicit drugs, and having a history of sexually transmitted infections.

Fertility is surely complicated and depends on many factors – here we’ll focus on how and why sleep and fertility are connected.

Sleep and fertility in women

Menstrual cycles are in a tight relationship with the circadian rhythm in women. The circadian rhythm is the biological rhythm of the body. A brain center called the suprachiasmatic nucleus is considered to be responsible for the circadian rhythm – it tells the body when to release which hormones and in what amount. The circadian rhythm relies on the day/night rhythm while proper, regular sleep helps it run smoothly.

Menstrual cycles are rhythmical and depend on a proper, rhythmical hormonal secretion. A hectic sleep schedule throws both of those rhythms out of order. Some studies suggest that shift work may disrupt the menstrual cycle. Other studies state that low levels of hormones prolactin and melatonin, in particular, suppress the ovarian function in women who work at night.

Women who sleep longer seem to have higher levels of FSH (follicle-stimulating hormone), whose function is to stimulate the growth of ovarian follicles before the egg release. FSH also helps increase the production of oestradiol (a form of estrogen).

Melatonin – an important component?

Melatonin, the “darkness hormone” typically associated with making us sleepy, was found to vary in level depending on the part of the cycle, hitting the lowest point in the preovulatory phase and the highest in the luteal phase. Although its changes aren’t as drastic as changes in LH, oestradiol, or progesterone, melatonin may be the key to solving some women’s fertility issues.

Women who take melatonin supplements when undergoing in vitro fertilization (IVF) seem to have higher chances of pregnancy. Melatonin works as an antioxidant (it reduces oxidative damage) and protects the egg.

Sleep and fertility in men

Circadian rhythm is important for male fertility, not just female. Hormones like LH and FSH are needed for sperm production and maturity. Testosterone is the most important reproductive hormone for men and it drops a lot in those who are sleep deprived. When young healthy men have short sleep of 5 hours, after a week their testosterone is decreased by 10-15%, reaching the level of someone 20 years older. 

One study revealed that short sleep time results in lower sperm count and lower sperm survival rate. Researchers found an increase in the antisperm antibody production which results in impaired sperm quality.

Men have the most fertility problems are usually the ones who report having trouble sleeping.

Sleep disorders linked to infertility

Any disorder that results in short sleep time, like insomnia; excessive sleep time such as hypersomnia, or fragmented sleep (frequent wakings) like obstructive sleep apnea; ultimately impairs fertility. Circadian rhythm disorders go hand in hand with disrupted hormones, including reproductive hormones.

For both men and women sleep length and quality are tightly connected with fertility and successful conception. Poor sleep typically results in inflammation and inefficient immune system which also negatively correlates with fertility. Many infertile couples complain about insomnia as well as depression and anxiety.

Figure 1. Stress, sleep dysregulation, and circadian dysrhythmia as potential pathways for infertility. Source: Sleep, Sleep Disturbance and Fertility in Women.

The image above shows the relationship between inappropriate/dysregulated sleep, hypothalamic-pituitary-adrenal axis (HPA axis), and circadian rhythm in women. The HPA axis is our main system for stress response. Research suggests that the HPA axis may have a direct effect on female reproductive hormones and an indirect effect on fertility, menstrual cycles, and follicle development.

Circadian dysrhythmia refers to sudden and big changes in daily biological rhythm, such as shift work or simply a lack of sleep schedule (for example, going out and staying up late, sleeping in on weekends, then getting up early for the working week). As female reproductive hormones have a circadian pattern, a messed up schedule reflects on hormonal secretion. The research mentioned above states that over 50% of female shift workers report menstrual changes while working in shifts; they are also at a higher risk of “infertility, spontaneous abortions, pre-term birth, and impaired fetal development”.

Another problem lies in disrupted melatonin which, although not fully investigated, does play a role in successful conception.

In men, infertility is linked to sperm count, movement, and survival rate. Obstructive sleep apnea is a commonly discussed disorder in men; it is associated with erectile dysfunction (in up to 60% of OSA sufferers) and poor sperm quality. OSA is a breathing disorder in which a person stops breathing several times a night; in order to catch breath, they wake up. OSA is successfully treated but the problem is that people are rarely aware of having this disorder – they don’t know they are snoring and don’t remember waking up. Women with OSA tend to suffer from polycystic ovary syndrome.

Improve your sleep

According to Sleep.org, a website by the National Sleep Foundation, those who are trying to conceive should make sure to:

  • Sleep just enough and at the right time – avoid sleeping in and cutting back on sleep alike. Seven to eight hours of sleep seems to be the best for women who are trying to conceive via IVF. Going to bed too late also disrupts hormones, as we discussed above. If you are not sure whether or not you’re getting enough sleep, check our guide to sleep length. Make sure your sleep is as regular as possible by going to bed and waking up at about the same time.
  • Avoid screens; phones, tablets, computers – all of them. The same goes for strong white light. They have a negative impact on your sleep-wake schedule and circadian rhythm by suppressing melatonin. This hormone only gets secreted in a dark environment and it plays a role in protecting eggs in women while low melatonin was found in infertile men. As much as avoiding light at night is important, you should also expose yourself to bright light in the morning and throughout the day. In the dark winter months you can resort to light therapy – using a bright light lamp which imitates sunlight.

Here are more of the important tips for improving your sleep:

  • Reserve your bed for sleep and sex. Your bedroom should be the place that you associate with calmness, sleep, and rest and your bed should be even more so. Avoid using your phone, working, eating, or doing anything that causes you stress in the bed.
  • Exercise. Exercise improves sleep and reduces stress, but it is also linked to better fertility. Get your body moving so that it can serve you properly.
  • Relax. If possible, avoid things that cause stress and make a relaxing routine in the evening. It may include a warm bath, a cup of tea, reading, prayer, or doing a calming hobby. Whatever works for you and helps your mind declutter.

Finally, if you are working on increasing your fertility, sleep alone is not going to help you as avoiding harmful substances and making other lifestyle changes is equally important.

Additional resources

  1. Sleep, Sleep Disturbance and Fertility in Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402098/
  2. Influence of Sleep on Fertility in Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125064/
  3. Sleep Deprivation and Late Bedtime Impair Sperm Health Through Increasing Antisperm Antibody Production: A Prospective Study of 981 Healthy Men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402839/
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