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Female sleep patterns, shift work, and fecundability in a North American preconception cohort study

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  • Sydney Kaye Willis, Boston University School of Public Health
  • ,
  • Elizabeth Elliott Hatch, Boston University School of Public Health
  • ,
  • Amelia Kent Wesselink, Boston University School of Public Health
  • ,
  • Kenneth Jay Rothman, Boston University School of Public Health, RTI International
  • ,
  • Ellen Margrethe Mikkelsen
  • Lauren Anne Wise

Objective: To prospectively evaluate the association between female sleep patterns, shift work, and fecundability. Design: Web-based preconception cohort study, Pregnancy Study Online (PRESTO). Setting: Not applicable. Patient(s): North American Women aged 21–45 years attempting pregnancy. Intervention(s): Not applicable. Main Outcome Measure(s): At baseline, self-reported average sleep duration per 24-hour period in the previous month, the frequency of trouble sleeping within the last 2 weeks (as measured by the Major Depression Inventory), and shift work patterns. Pregnancy status determined by follow-up questionnaires completed every 8 weeks for up to 12 months or until conception. Result(s): The analyses were restricted to 6,873 women attempting pregnancy for ≤6 months at enrollment from June 2013 through September 2018. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders. Relative to 8 hours of sleep per day, FRs for <6, 6, 7, and ≥9 hours of sleep/day were 0.89 (95% CI, 0.75–1.06), 0.95 (95% CI, 0.86–1.04), 0.99 (95% CI, 0.92–1.06), and 0.96 (95% CI, 0.84–1.10), respectively. Compared with no trouble sleeping, FRs for trouble sleeping <50% of the time or trouble sleeping >50% of the time were 0.93 (95% CI, 0.88–1.00) and 0.87 (95% CI, 0.79–0.95), respectively. The results were slightly stronger among women with higher depressive symptoms and perceived stress levels. There was no association between shift work and fecundability. Conclusion(s): Trouble sleeping at night was associated with modestly reduced fecundability. A weaker inverse association was observed between shorter sleep duration and fecundability.

Original languageEnglish
JournalFertility and Sterility
Pages (from-to)1201-1210.e1
Number of pages10
Publication statusPublished - 2019

    Research areas

  • Cohort studies, fertility, preconception, sleep, time-to-pregnancy

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