The relationship between insomnia and endometriosis

Association of Sleep Traits, Physical Activity, and Sedentary Leisure Behavior With Female Reproductive Health: A Two-Sample Mendelian Randomization Analysis

Purpose

Living habits affect female endocrine function and fertility, along with aging and other life factors. Because of this, female reproductive health can be promoted through living habit adjustment.

Methods

We used two-sample Mendelian randomization analysis with summary datasets from a genome-wide association study to investigate the causal relationships between sleep traits, sedentary leisure behavior, physical activity, and reproductive health traits in women, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Exposure genetic instruments were used for variants that were significantly related to traits. The inverse-variance weighted (IVW) method was used for the main analysis, and we also performed MR-Egger and weighted median analyses to supplement the sensitivity test. Horizontal pleiotropy was detected using the MRE intercept and MR-PRESSO methods, and heterogeneity was assessed using Cochran's Q statistics, IVW, and MR-Egger.

Results

Insomnia showed a significant inverse causal association with endometriosis [OR (95% CI) IVW = 1.80 (1.16, 2.80), P = 0.009] and abnormal menstruation [OR (95% CI) IVW = 2.37 (1.34, 4.20), P = 0.003]. Sleep duration was negatively related to menopause age (beta IVW = -0.034, P = 0.001), and long sleep duration could be a protective factor of endometriosis [OR (95% CI) IVW = 0.07 (0.01, 0.72), P = 0.024]. Strenuous sports were also negatively correlated with female infertility [OR (95% CI) IVW = 0.10 (0.02, 0.68), P = 0.019]. Sensitivity analysis revealed no signs of horizontal pleiotropy or heterogeneity.

Conclusion

Our findings suggest that insomnia is an adverse factor correlated with endometriosis and abnormal menstruation and that longer sleep duration protects against endometriosis. Adequate sleep and regular schedules may decrease the risk of endometriosis and abnormal menstruation, helping improve the reproductive health of women.

Premenopausal Women With a Diagnosis of Endometriosis Have a Significantly Higher Prevalence of a Diagnosis or Symptoms Suggestive of Restless Leg Syndrome: A Prospective Cross-Sectional Questionnaire Study

BACKGROUND

Endometriosis and restless leg syndrome (RLS) are both chronic conditions that can negatively affect a woman's quality of life. A higher prevalence of RLS is seen in women and particularly in those who are pregnant, suggesting a possible ovarian hormonal influence. Endometriosis is a common (affecting 1 in 10 women) estrogen driven gynecological condition, and the prevalence of RLS in women with symptoms or a diagnosis of endometriosis is unknown.

METHODS

A prospective, cross-sectional, observational self-completed questionnaire study was distributed to 650 pre-menopausal women attending the gynecological department at Liverpool Women`s Hospital over a period of 4 months. 584 questionnaires were returned and 465 completed questionnaires were included in the final dataset. Data on RLS-associated (The International Restless Leg Syndrome Study Group rating scale) and endometriosis-associated (modified-British Society of Gynaecological Endoscopists pelvic pain questionnaire) symptoms were collected.

RESULTS

Women who reported a prior surgical diagnosis of endometriosis had a greater risk of having a prior formal diagnosis of RLS (OR 4.82, 95% CI 1.66,14.02) and suffering RLS symptoms (OR 2.13, 95% CI 1.34-3.39) compared with those without a diagnosis. When women with either a formal surgical diagnosis or symptoms associated with endometriosis were grouped together, they also have a significantly increased risk of having either a formal diagnosis or symptoms suggestive of RLS (OR 2.49, 95% CI 1.30, 3.64). In women suffering with endometriosis-associated symptoms, the cumulative endometriosis-associated symptom scores demonstrated a modest positive correlation with RLS severity scores (r=0.42 95% CI 0.25 to 0.57).

CONCLUSIONS

This is the first study highlighting an association between the symptoms relevant to the two chronic conditions RLS and endometriosis, showing that women with a reported prior surgical diagnosis or symptoms suggestive of endometriosis have a significantly higher prevalence of a prior formal diagnosis or symptoms suggestive of RLS. This data will help in facilitating the discovery of novel therapeutic targets relevant to both conditions. The simultaneous treatment of these conditions could potentially lead to improvement in the overall quality of life for these women.