Insomnia and Female Reproductive Diseases: A Cross-Sectional and Mendelian Randomization Study.
Level 3 - non-randomized controlled study
Mendelian randomization and observational analysis (graded by design analogy, not clinical CEBM)
PubMed 39990928 · doi:10.2147/IJWH.S498231
What was done
The authors conducted a Mendelian randomization (MR) analysis using 268 genome-wide significant genetic variants (P < 5×10⁻⁸) as instrumental variables for insomnia. Summary-level outcome data were gathered from UK Biobank and FinnGen for ovarian cysts, polycystic ovarian syndrome (PCOS), endometriosis, premature ovarian insufficiency (POI), ovarian cancer, uterine fibroids, endometrial cancer, and female infertility. BMI mediation analysis was also performed. In addition, cross-sectional logistic regression using NHANES 2013-2014 data examined the association between insomnia and risk of ovarian and endometrial cancer.
What was found
Genetically predicted insomnia was associated with increased risk of ovarian cysts (OR 1.44, 95% CI 1.21-1.72, P < 0.05), PCOS (OR 1.67, 95% CI 1.44-1.94, P < 0.05), and endometriosis (OR 1.43, 95% CI 1.16-1.76, P < 0.05). No significant associations were observed for POI, ovarian cancer, uterine fibroids, endometrial cancer, or female infertility. BMI mediated approximately 10% of the effect of insomnia on ovarian cysts and PCOS. Cross-sectional NHANES analysis showed no association between insomnia and ovarian or endometrial cancer.
Why it matters
This study provides genetic epidemiological evidence that insomnia may play an etiological role in common benign female reproductive conditions, with a small portion of the risk mediated through BMI.
Limits
The abstract does not report participant sample sizes for the UK Biobank, FinnGen, or NHANES cohorts. Mendelian randomization relies on assumptions of no horizontal pleiotropy, and summary datasets predominantly represent individuals of European ancestry.
Cited by
- contradicts Self-reporting poor sleep is associated with double the rate of infertility.