Human fertility and sleep disturbances: A narrative review

Sleep quality, perceived stress and associated factors in women undergoing IVF treatment: short-term longitudinal study

BACKGROUND

Despite limited studies in the literature, it is hypothesised that lifestyle factors are modifiable habits that have an impact on couples' fertility health. However, the relationship between sleep quality and infertility is an area that needs to be clarified.

OBJECTIVE

To determine sleep quality and associated factors in women receiving in vitro fertilisation treatment and to evaluate the changes in sleep over the treatment cycle.

METHODS

This is a longitudinal descriptive study conducted on 158 women in two infertility centres in Izmir, Turkey. Data were collected using the Personal Introduction Form, Pittsburgh Sleep Quality Index, Visual Analogue Stress Scale, and Physical Symptoms List. Data were collected during three different treatment periods: beginning of the in vitro fertilisation trial, oocyte pick-up day and the postembryo transfer period.

RESULTS

The sleep quality score of women progressively decreased as treatment progressed (p < .001). A strong positive correlation was determined between stress and sleep quality (p < .001). Additionally, advanced age, low education level, shift work, prolonged treatment and economic distress were associated with poorer sleep quality (p < .001). In addition, breast fullness, abdominal distension, and pain (p < .001) observed until the oocyte pick-up day, as well as nausea and fatigue during the postembryo transfer period (p < .001), were identified as physical symptoms affecting sleep quality.

CONCLUSION

This article provides information on sleep quality during in vitro fertilisation and guides healthcare professionals to encourage and improve women's sleep quality.

The mediating and moderating effects of resilience on the relationship between sleep quality and psychological distress in Chinese women with infertility

BACKGROUND

Research has widely indicated that the psychological distress experienced by infertile patients during fertility treatments may have a negative effect on the results of assisted reproduction. Although numerous studies have shown that psychological resilience and sleep quality are important influencing factors for psychological distress, the mediating mechanisms of psychological resilience in the relationship between sleep quality and psychological distress for Chinese women in particular remain unclear. Therefore, the current study investigates the association between sleep quality, resilience, and psychological distress in Chinese women with infertility and examines the mediating and moderating roles of resilience on the relationship between sleep quality and psychological distress.

METHODS

In this cross-sectional study, a total of 595 women with infertility who were undergoing IVF-ET were recruited at the Reproductive Medicine, Shandong University, from April to November 2019. Participants were instructed to complete four questionnaires, including a questionnaire about socio-demographic and clinical-related information, the Pittsburgh Sleep Quality Index (PSQI), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and the Kessler-10 (K10). Pearson's correlation analysis was conducted preliminarily to describe the relationships between sleep quality, resilience, and psychological distress. A mediation model and a moderated model were constructed and analyzed using the PROCESS macro for SPSS. The Johnson-Neyman (J-N) technique was then used to identify the regions of significance across the levels of moderator values.

RESULTS

Patients in the sample had a high prevalence of psychological distress (48.6%, K10 scores > 22), and mediation analysis indicated that resilience played a partially mediating role in the relationship between sleep quality and psychological distress (indict effect = 0.072, P < 0.001). Moderation analysis indicated that resilience also moderated the association between sleep quality and psychological distress.

CONCLUSIONS

Resilience may play a key role in the relationship between sleep quality and psychological distress. Our findings imply that resilience training may therefore be an effective component of psychological distress intervention in women with infertility.

Antibiotic exposure associated with nighttime sleep duration and daytime sleepiness in newlyweds

Few studies have explored the relationship between antibiotic exposure and sleep in newlyweds. We applied the actor-partner interdependence moderation model to estimate the relationships of antibiotic exposure with nighttime sleep duration (weekday, weekend, and average sleep durations) and daytime sleepiness in newlyweds. We found that 99.0% of the 2698 enrolled individuals were exposed to at least one antibiotic. Among the newlyweds, exposure to florfenicol (β, - 0.077; 95% confidence interval [CI], - 0.143, - 0.011), exposure to chloramphenicols (- 0.086 [- 0.160, - 0.011]), and exposure to veterinary antibiotics (VAs) (- 0.106 [- 0.201, - 0.010]) were negatively associated with weekday sleep duration. Florfenicol, chloramphenicols, and VAs were also inversely related to average sleep duration in the newlyweds. Ciprofloxacin and cyadox exposure was significantly associated with an increase of 0.264 (0.030, 0.497) and (0.375 [0.088, 0.663]) Epworth Sleepiness Scale (ESS) scores in the newlyweds, respectively. Gender moderated the actor-partner effects of erythromycin and tetracyclines on the newlyweds' weekday sleep duration and ESS scores. Overall, exposure to florfenicol, chloramphenicols, and VAs shortened weekday and average sleep durations of newlyweds. Exposure to ciprofloxacin and cyadox promoted daytime sleepiness. Gender moderated the actor-partner effects of specific antibiotics on the weekday sleep duration and ESS scores of the newlyweds.

Microbiota Composition and Probiotics Supplementations on Sleep Quality-A Systematic Review and Meta-Analysis

The gut microbiota (GM) plays a crucial role in human health. The bidirectional interaction between GM and the central nervous system may occur via the microbiota-gut-brain axis, possibly regulating the sleep/wake cycle. Recent reports highlight associations between intestinal dysbiosis and sleep disorders, suggesting that probiotics could ameliorate this condition. However, data are poor and inconsistent. The aim of this quantitative metanalytic study is to assess the GM composition in sleep disturbances and evaluate probiotics' effectiveness for managing sleep disorders. A systematic review was carried out until July 2022 in online databases, limiting the literature research to human studies and English language articles. No significant GM diversity between patients with sleep disturbances versus healthy controls was found, revealed by α-diversity, while β-diversity is missing due to lack of proper reporting. However, probiotics supplementation significantly reduced the self-assessed parameter of sleep quality and disturbances Pittsburgh Sleep Quality Index (PSQI) score compared with the placebo. No difference in the Epworth Sleepiness Scale (ESS) score was found. While available data suggest that GM diversity is not related to sleep disturbances, probiotics administration strongly improves sleep quality as a subjective perception. However, heterogeneity of data reporting in the scientific literature should be considered as a limitation.

A bibliometric analysis of the application of imaging in sleep in neurodegenerative disease

Objective

The purpose of this study was to examine the current state of the application of imaging in sleep research in degenerative disease, as well as hotspots and trends.

Materials and methods

A search was conducted on the Web of Science Core Collection (WoSCC) between 1 September 2012, and 31 August 2022 for literature related to sleep imaging. This study analyzed 7,679 articles published in this field over the past 10 years, using CiteSpace to analyze tendencies, countries, institutions, authors, and hotspots.

Results

There were 7,679 articles on the application of imaging to sleep research published by 566 institutions located in 135 countries in 1,428 journals; the number of articles was increasing on a yearly basis. According to keyword analysis, the research direction of the application of imaging in sleep research focused on the effects of degenerative diseases on sleep, such as Parkinson's disease, Alzheimer's disease, and small vessel disease. A literature evaluation found that Parkinson's disease, insomnia, sleep quality, and rapid eye movement sleep behavior disorder were the top research trends in this field.

Conclusion

A growing body of research has focused on sleep disorders caused by degenerative diseases. In the application of imaging to sleep research, magnetic resonance functional brain imaging represents a reliable research method. In the future, more aging-related diseases may be the subject of sleep-related research, and imaging could provide convenient and reliable evidence in this respect.