Sleep, psychological distress, and clinical pregnancy outcome in women and their partners undergoing in vitro or intracytoplasmic sperm injection fertility treatment.

OBJECTIVES: To explore the prevalence of poor sleep quality in couples undergoing fertility treatment and study possible associations. PARTICIPANTS: 163 women and 132 partners receiving in vitro (IVF) or intracytoplasmic sperm injection (ICSI) fertility treatment. SETTING: Three public Danish fertility clinics. DESIGN AND MEASUREMENTS: Participants completed the Pittsburgh Sleep Quality Index (PSQI) at three time-points as part of a larger RCT. Additional data from patient records and questionnaires were included to evaluate possible associations with treatment protocol type, psychological distress, and pregnancy outcome. RESULTS: Mean PSQI global scores before treatment were 8.1 (standard deviation = 2.3), with 91% of participants having PSQI scores > 5, indicating poor sleep quality. Scores did not differ between women and their partners and did not change during treatment. Statistically significant associations were found between sleep quality and depressive symptoms and state anxiety (p < .001). No difference in PSQI scores was found between protocol types. While there was a trend towards higher clinical pregnancy rates among women with good sleep quality (PSQI ≤ 5 = 72.7%, PSQI 6-10 = 52.6% and PSQI ≥ 11 = 42.3%), the differences did not reach statistical significance (p = .10-.21). CONCLUSIONS: Poor sleep quality is a prevalent problem among couples undergoing fertility treatment and is associated with psychological distress and possibly with pregnancy outcomes. Success rates after fertility treatment remain moderate, and poor sleep quality, a potentially modifiable factor, could be relevant to screen for and treat among couples undergoing fertility treatment. The high prevalence of poor sleep quality calls for further investigation.

Associations of bedtime, sleep duration, and sleep quality with semen quality in males seeking fertility treatment: a preliminary study.

BACKGROUND: Poor sleep has been linked to a number of adverse health outcomes. Recent studies suggest that late bedtimes, short or long sleep durations, and poor sleep quality may impair semen quality. No study has previously explored all three factors in relation to semen quality. RESULTS: One hundred and four men and their partners treated at three fertility clinics in Denmark between 2010 and 2012 completed an online-version of the Pittsburgh Sleep Quality Index (PSQI). The results of the semen analyses conducted at the fertility clinics were self-reported and categorised as normal or reduced.Early bedtime (< 10:30 PM) was more often associated with normal semen quality compared with both regular (10:30 PM-11:29 PM) and late (≥11:30 PM) bedtime (OR: 2.75, 95%CI: 1.1-7.1, p = 0.04 and OR: 3.97, 95%CI: 1.2-13.5, p = 0.03). Conventional sleep duration (7.5-7.99 h) was more often associated with normal semen quality than both short (7.0-7.49 h) and very short (< 7.0 h) sleep duration (OR: 1.36, 95% CI: 1.2-12.9, p = 0.03 and OR: 6.18, 95%CI: 1.6-24.2, p = 0.01). Although poor sleep quality was associated with reduced semen quality in the descriptive statistics (p = 0.04), no differences were found between optimal (PSQI ≤6) and either borderline (PSQI 7-8) or poor (PSQI ≥9) sleep quality (OR: 1.19, 95%CI: 0.4-3.4, p = 0.75 and OR: 2.43, 95%CI: 0.8-7.1, p = 0.11) in multivariate regression models. CONCLUSION: Early bedtimes (< 10:30 PM) and conventional sleep duration (7.5-7.99 h) were associated with self-reported normal semen quality. The role of subjective sleep quality remains uncertain.

CONTEXTE: Un mauvais sommeil a été associé à plusieurs issues néfastes pour la santé. De récentes études suggèrent que les heures de coucher tardives, des durées de sommeil courtes ou longues, et une mauvaise qualité de sommeil altèrent la qualité du sperme. Aucune étude n'a à ce jour exploré les trois facteurs en relation avec la qualité du sperme. RÉSULTATS: Cent quatre hommes et leurs partenaires traités dans trois cliniques de fertilité au Danemark entre 2010 et 2012 ont rempli un questionnaire correspondant à une version en ligne de l'Indice de Qualité du Sommeil de Pittsburg (IQSP). Les résultats des analyses de sperme réalisées dans les cliniques de fertilité ont été autodéclarés et classés comme normaux ou réduits.Une heure de coucher précoce (< 22 h30) était plus souvent associée à une qualité normale du sperme comparativement à la fois à une heure régulière (22 h30-23 h29) et à une heure tardive (≥23 h30) de coucher (OR: 2.75, 95% CI: 1.1­7.1, p = 0.04 et OR: 3.97, 95% CI: 1.2­13.5, p = 0.03). Une durée conventionnelle de sommeil (7.5­7.99 heures) était plus souvent associée à une qualité normale du sperme qu'une courte (7.0­7.49 heures) et qu'une très courte (< 7.0 heures) durée de sommeil (OR: 1.36, 95% CI: 1.2­12.9, p = 0.03 et OR: 6.18, 95% CI: 1.6­24.2, p = 0.01). Bien qu'une mauvaise qualité du sommeil ait été associée à une qualité réduite du sperme dans les statistiques descriptives (p = 0.04), aucune différence n'a été retrouvée entre une qualité du sommeil optimale (IQSP ≤6) et une qualité soit limite (IQSP 7­8) ou soit pauvre (IQSP ≥9) du sommeil (OR: 1.19, 95% CI: 0.4­3.4, p = 0.75 et OR: 2.43, 95% CI: 0.8­7.1, p = 0.11) dans les modèles de régression multivariée. CONCLUSIONS: Des heures de coucher précoces (< 22 h30) et une durée conventionnelle de sommeil (7.5­7.99 heures) ont été associées à une qualité normale autodéclarée du sperme. Un éventuel rôle de la qualité suggestive du sommeil reste incertain.