Evaluation of sleep quality and daytime dysfunction using the Pittsburgh Sleep Quality Index in women with Polycystic Ovary Syndrome: a cross-sectional study
Evaluation of sleep quality and daytime dysfunction in women with Polycystic Ovary Syndrome
DOI:
https://doi.org/10.52442/jrmi.v12i3.1042Keywords:
Daytime Dysfunction, Pittsburgh Sleep Quality Index, Polycystic Ovary Syndrome, Sleep Quality, Sleep Wake DisordersAbstract
Introduction: Polycystic Ovary Syndrome (PCOS) is frequently associated with sleep disturbances, including insomnia, fatigue, and poor overall sleep quality. However, component-wise evaluation using validated instruments remains underexplored in South Asian populations.
Objective(s): To evaluate and compare sleep quality among women with PCOS and healthy controls using the Pittsburgh Sleep Quality Index (PSQI).
Methodology: This cross-sectional study recruited 62 women with PCOS and 31 age- and BMI-matched healthy controls from a tertiary care hospital in Islamabad, Pakistan. Sleep quality was assessed using the PSQI, which evaluates seven domains of sleep. Independent sample t-tests were applied for group comparisons, with statistical significance set at p < 0.05.
Results: The mean global PSQI scores were 6.14 ± 2.85 for PCOS patients and 5.92 ± 2.78 for controls, showing no significant difference (p=0.705). Among the seven components, only daytime dysfunction was significantly higher in the PCOS group (1.56 ± 0.89 vs. 0.94 ± 0.76, p=0.003). Other components, including sleep latency, duration, disturbances, and medication use, showed no significant differences (p > 0.05).
Conclusion: Overall sleep quality did not differ significantly between groups. However, elevated daytime dysfunction in women with PCOS suggests subtle impairments with functional consequences. Incorporating targeted sleep assessments into PCOS management may enhance clinical outcomes.
References
Azziz R, Carmina E, Chen Z, Dunaif A, Laven JSE, Legro RS, et al. Polycystic ovary syndrome. Nature reviews Disease primers. 2016;2(1):1-18. DOI: 10.1038/nrdp.2016.57
Rotterdam E. ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.DOI: 10.1016/j.fertnstert.2003.10.004
Allen LA, Shrikrishnapalasuriyar N, Rees DA. Long‐term health outcomes in young women with polycystic ovary syndrome: a narrative review. Clin Endocrinol. 2022 Aug;97(2):187-98. DOI: 10.1111/cen.14609.
Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33(9):1602-18.DOI: 10.1093/humrep/dey256
Tasali E, Van Cauter E, Ehrmann DA. Relationships between sleep disordered breathing and glucose metabolism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(1):36-42. DOI: 10.1210/jc.2005-1947
Moran LJ, March WA, Whitrow MJ, Giles LC, Davies MJ, Moore VM. Sleep disturbances in a community-based sample of women with polycystic ovary syndrome. Hum Reprod. 2015;30(2):466-72. DOI: 10.1093/humrep/deu318
Vgontzas AN, Legro RS, Bixler EO, Grayev A, Kales A, Chrousos GP. Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab. 2001;86(2):517-20. DOI: 10.1210/jcem.86.2.7199
Fernandez RC, Moore VM, Van Ryswyk EM, Varcoe TJ, Rodgers RJ, March WA, et al. Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nat Sci Sleep. 2018:45-64. DOI: 10.2147/NSS.S127475
Nandalike K, Strauss T, Agarwal C, Coupey SM, Sin S, Rajpathak S, et al. Screening for sleep-disordered breathing and excessive daytime sleepiness in adolescent girls with polycystic ovarian syndrome. J pediatr. 2011;159(4):591-6. DOI: 10.1016/j.jpeds.2011.04.029
Heydari T, Ramdass PV. Circadian rhythm disruption and polycystic ovary syndrome: a systematic review and meta-analysis. AJOG global reports. 2025 May 1;5(2):100479.
Sam S, Ehrmann DA. Pathogenesis and consequences of disordered sleep in PCOS. Clin Med Insights Reprod Health. 2019 Aug;13:1179558119871269. DOI: 10.1177/1179558119871269
Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May 1;28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4.
Kahal H, Tahrani AA, Kyrou I, Dimitriadis GK, Kimani PK, Barber TM, et al. The relationship between obstructive sleep apnoea and quality of life in women with polycystic ovary syndrome: a cross-sectional study. Ther Adv Endocrinol Metab. 2020;11:2042018820906689. DOI: 10.1177/2042018820906689
Wang C, Huang T, Song W, Zhu J, Liu Y, Chen X, et al. A meta-analysis of the relationship between polycystic ovary syndrome and sleep disturbances risk. Front Physiol. 2022;13:957112.DOI: 10.3389/fphys.2022.957112
Kahal H, Kyrou I, Uthman OA, Brown A, Johnson S, Wall PDH, et al. The prevalence of obstructive sleep apnoea in women with polycystic ovary syndrome: a systematic review and meta-analysis. Sleep Breath. 2020;24(1):339-50. DOI: 10.1007/s11325-019-01965-w
Zhuang X, Zhang S, Fu R, Cai C, Yin J, Shi W, Cen J, Ji X. A case control study of subjective sleep characteristics and polycystic ovary syndrome. Sci Rep. 2026 Apr 29;16: 15053. DOI: 10.1038/s41598-026-50477-3
Li H, Liu M, Zhang C. Women with polycystic ovary syndrome (PCOS) have reduced melatonin concentrations in their follicles and have mild sleep disturbances. BMC Women's Health. 2022;22(1):79. DOI: 10.1186/s12905-022-01674-5
Zhang J, Ye J, Tao X, Lu W, Chen X, Liu C. Sleep disturbances, sleep quality, and cardiovascular risk factors in women with polycystic ovary syndrome: Systematic review and meta-analysis. Front Endocrinol. 2022;13:971604. DOI: 10.3389/fendo.2022.971604
Walker MP. The role of sleep in cognition and emotion. Ann N Y Acad Sci. 2009;1156(1):168-97. DOI: 10.1111/j.1749-6632.2009.04416.x
Medic G, Wille M, Hemels MEH. Short-and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017:151-61. DOI: 10.2147/NSS.S134864
Schrempft S, Baysson H, Chessa A, Lorthe E, Zaballa M-E, Stringhini S, et al. Associations between bedtime media use and sleep outcomes in an adult population-based cohort. Sleep Med. 2024;121:226-35. DOI: 10.1016/j.sleep.2024.02.006
Weaver RG, White JW, Finnegan O, Yang H, Zhong Z, Kiely K, et al. Predicting Sleep and Sleep Stage in Children Using Actigraphy and Heartrate via a Long Short‐Term Memory Deep Learning Algorithm: A Performance Evaluation. J Sleep Res. 2026;35(1):e70149.DOI: 10.1111/jsr.70149
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of Rehman Medical Institute

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
