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When It Comes to Fertility, Does Sleep Really Matter?

July 5, 2022

Our modern society’s need to go–go–go is finally catching up with our body’s need to physically slow down. The ability to operate on the fewest hours of sleep has been praised as an accomplishment, as though compromising health for wealth is an admirable trait. Unfortunately, this go–go–go mentality does not help us achieve our best health. Overwork and lack of sleep has been linked to mental health issues such as anxiety and depression, as well as physical health issues, among other things effecting the function of our cardiovascular, immune, metabolic, and hormonal systems.

Notably, this also includes fertility health. As with all our body’s systems, sleep is a requirement for the reproductive system to work properly.

Lack of Sleep Is Nothing to Be Proud Of
Human beings have developed as diurnal creatures over the last 5–7 million years, meaning we are meant to be awake during the daytime and asleep at night. Adults are now getting an average of 6.8 hours of sleep per night compared to nine hours just a century ago, and 40% of adults now sleep fewer than six hours per night.

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults aged 18–60 years sleep at least seven hours each night to promote optimal health and well-being. Disruptions to this light–dark cycle timing alters the brain’s output of many hormones, changes how the body functions, and is associated with chronic illnesses. “Sleeping less than seven hours per day is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress,” according to the CDC website.

Hormones that are disrupted with decreased duration, poor quality, and wrong timing of sleep include:

  • Luteinizing Hormone (LH): Triggers ovulation
  • Follicular Stimulating Hormone (FSH): Stimulates egg growth
  • Progesterone: Regulates menstruation and facilitates and supports pregnancy
  • Thyroid Stimulating Hormone (TSH): Stimulates hormone production and controls how other hormones function
  • Leptin: Regulates energy balance by inhibiting hunger
  • Melatonin: Initiates the onset of sleep and is found in amounts 2 times higher around ovaries
  • Prolactin (PRL): If levels are too high, this can result in an egg not being released, polycystic ovarian syndrome (PCOS), and endometriosis
  • Estrogen (E): Maintains uterine lining needed
    for implantation
  • Testosterone (T): In men, regulates libido and aids in production of sperm; in women, testosterone is converted into estradiol and plays a role in reproduction

How Can Sleep Disruptions Be So Harmful to Our Fertility?
For women, decreased sleep coincides with postpartum depression, pregnancy difficulties, menopausal transition issues, and premenstrual stress. For men, it can result in infertility.

  • Unexplained Infertility: The blue light emitted by your electronics suppress melatonin, a key hormone that both helps you sleep and protects your eggs when they are close to ovulation. Without adequate melatonin production, egg quality can suffer and make achieving pregnancy more difficult.
  • PCOS: Without the proper timing of sleep LH is not lowered appropriately, keeping testosterone higher and progesterone lower than the body requires and leading to further ovulation problems.
  • Endometriosis/Estrogen Dominance: Poor sleep schedules and partial sleep deprivation are associated with increased levels of estrogen, which can decrease by 60% with regular sleep schedules.
  • Insulin Resistance: Eating later in the evening when sleep should be occurring can increase insulin levels. Testosterone production in the theca cells of the ovaries may also increase, further worsening fertility issues.
  • Recurrent Pregnancy Loss: Melatonin has been shown to be higher in follicular fluid than the general circulation and levels exhibit a 24-hour rhythm, increasing values as the egg enlarges and ovulation approaches. Melatonin aids in ensuring optimal placental function and successfully maintains pregnancy as
    well as corpus luteum development and progesterone production.
  • Luteal Phase Defect: FSH and LH are directly influenced by the light–dark cycle. When it’s dark, the brain signals the release of FSH and when the sun rises, LH rises.
  • Atypical Neurodevelopment of Offspring: Melatonin signal disruptions in the mother during pregnancy has been shown to increase the frequency of ADHD and autism in offspring.
  • Eating Disorders in Offspring: Prenatal exposure to excess testosterone has led to enlarged fat cells and binge-eating disorders in offspring.
  • Male Infertility: Improper sleep decreases testosterone production and sperm motility.

For these and many more reasons, sleep hygiene is important when struggling to conceive.

Recommendations for Good Sleep Hygiene

  • When: No later than 11 pm; 10 pm or earlier would be best
  • How Long: 7–8 hours, minimum
  • Quality: Follow light–dark cycle
  • Turn off electronics by 9 pm or use blue-light blocking or rose-colored glasses at night. These glasses have been shown to increase melatonin secretion by 70%.
  • Do not keep a TV in the bedroom.
  • Do not turn on the light at night; use red bulbs if necessary. Skin cells communicate light exposure to the pineal gland, which then decreases melatonin production in the overnight hours.
  • Wear a sleep mask if ambient light is in the room.
  • Watch the sun rise or at least get sunlight first thing prior to cell phone light, get some exposure to mid-day sun, and watch the sunset.
  • Try 10,000 lux of full spectrum light for 20 minutes from a light box first thing in the morning.

Sleep disorders are known to be associated with reproduction challenges, and research is now showing that it is not only the time of day you sleep, but also the quality and quantity, that can impact fertility. According to a peer-reviewed article in Fertility and Sterility, “both stable circadian rhythms and cyclic melatonin availability are critical for optimal ovarian physiology and placental function. Because light exposure after darkness onset at night disrupts the master circadian clock and suppresses elevated nocturnal melatonin levels, light at night should be avoided.”

Heed this warning when trying to conceive and/or if you are having difficulty. Fighting against a functional system that has been developed over 5 million years is bound to have consequences.

Dr. Nicole Kerr, ND, LAc, operates Fertility Oasis, an all-natural fertility clinic in Wallingford, CT. At Fertility Oasis, Dr. Kerr teaches her patients the importance of preconception care and about all treatment options available to couples struggling to conceive. Male and female infertility factors are addressed by Dr. Kerr to offer comprehensive fertility care to her patients. Fertility Oasis, 857 N Main St Ext Suite 1, Wallingford CT, 203.265.0459.
www.fertilityoasis.com