The connection between sleep and fertility is not always self evident, although getting to bed early with your partner may for some couples have obvious benefits.
You may not realise that the quality and quantity of your sleep influences sex hormones, sperm production, ovulation, immune factors, weight gain, mood, stress levels and longevity as well as the more obvious stamina.
Getting enough good quality sleep is an essential part of preparing for conception for all these reasons. Acupuncture has a proven track record (reviewed in several medical journals) of assisting to establish sound sleep patterns.
Schedule: acupuncture 1-2 treatments per week.
8-9 hours of uninterrupted slumber is what is recommended as ideal by sleep scientists. Before you dismiss this as impossible lets look in more detail at the benefits.
Benefits of adequate sleep
- menstrual regularity
- sex hormones
- sperm production
- weight loss
- immune factors
- emotional stability
- stress levels
- full term pregnancy
According to the National Sleep Foundation, 70 percent of us in the developed world don’t get enough sleep. Yet sleep is integral to our quality of life, overall health, and fertility.
Sleep, sex hormones and fertility
Lack of sleep affects ovulation, causing menstrual irregularity and delaying conception. A large proportion (50%) of women who work in notoriously sleep-deprived professions such as flight attendants and nurses and other night shift workers experience irregular and erratic periods. In some cases they stop having periods altogether. Sleep disrupted by night shifts at the time of ovulation and conception may increase the odds of miscarriage. In general, getting less than 8 hours a night sleep is considered a risk factor for first trimester miscarriage. (1)
In an ideal world men and women trying to conceive should avoid shift work, or skimping on sleep, or if this is impossible they should make a concerted effort to catch up on sleep when they can.
Lack of sleep can also cause a slump in sperm production. Testosterone production in men occurs during the night, normally increasing 20 – 30%; a good night’s sleep is important for optimum testosterone levels. Cutting back on sleep drastically reduces a healthy young man’s testosterone levels, according to a recently published study in the Journal of the American Medical Association.(2) This may be one of the reasons for the observed decline in male fertility in modern times.
Conversely, levels of sex hormones have a profound effect on sleep patterns, especially in women, which in turn has an effect on neuro-endocrine functioning. Since the same part of the brain that regulates sleep-wake hormones also stimulates daily pulses of reproductive hormones for men and women, some feedback between these systems is likely.
Sleep, weight loss, metabolism and fertility.
We have discussed the effect of excess weight on fertility in the section on treatment to aid weight loss.
As it turns out tired people can’t lose weight so easily.One recent study looked at people trying to lose weight and observed that if they didn’t get enough sleep this reduced the amount of weight lost by 55%. Less sleep time resulted in increased hunger but lower resting metabolic rate; a sure recipe for weight gain, not weight loss. Lack of sleep also raised levels of ghrelin. This hormone not only reduces energy expenditure but promotes the retention of fat. (3)
At the extreme, people who get very little sleep (less than 5 hours a night) are more likely to suffer from obesity, which we know seriously compromises fertility in men and women.
So important is the role of sleep in weight loss that the Stanford Sleep Medicine Center in California has suggested that sleep needs to be included in weight loss packages that have traditionally focused on just diet and exercise.
And its not just weight loss, its general health too that is affected by lack of sleep. The odds of having metabolic syndrome (including diabetes, heart disease, high blood pressure) are nearly doubled in men and women who sleep less than six hours, compared to those who sleep between seven and eight hours per night. (4) Little sleep also leads to significantly raised blood sugar and insulin resistance. (5)
Sleep, your immune system and fertility
The complex and intimate interactions between sleep and the immune system have been the focus of study for several years. Likewise the impact of immune factors on fertility are currently the object of intense research.
We know that certain immune factors (cytokines) regulate sleep and in turn are altered by sleep and sleep deprivation. People with chronic insomnia tend to have higher levels of some cytokines, notably interleukin-6 and tumor necrosis factor. (6) These immune factors can impact certain parts of the reproductive system, particularly implantation of the embryo and placental development. Some researchers have proposed that a suboptimal cytokine environment can contribute to miscarriage. (7) Certain cytokines can lead to clotting of the placental vessels in cases of early or late pregnancy loss or interference of angiogenesis in cases of occult pregnancy loss.
Sleep, mood, stress and fertility
We examined the effect of stress on fertility in detail here.
Anxiety levels increase incrementally the longer sleep loss continues. However emotional and physiological stress caused by lack of sleep is reversible once sleep loss is recovered. (8) Sleep restriction or prolonged wakefulness result in an activation of at least some of the biological mechanisms involved in the stress response. The two major neurobiological transmitters of the stress response (cortisol regulation and sympathovagal balance) show significant changes after just a few days of sleep restriction. (9)
Disturbed sleep also increases inflammatory processes in the body. (10)
Sleep and pregnancy
Sound sleep, especially in the early weeks and last weeks of pregnancy is important for maintaining a healthy pregnancy which goes to full term. Sleep disturbance appears to be associated with higher risk of preterm birth. (11)
As well as helping you be more energetic, healthier, lose weight, feel happier, be more fertile, sleeping enough also helps you to live longer.
By now you probably wont need any persuading that sleep is a crucial component of your overall preconception plan for maximising your health and that of the eggs and sperm. There are many ways that you can improve your sleep quality and some of these are listed below.
In the clinic we use acupuncture to help establish good sleep patterns. Several recently published review articles report that studies on acupuncture and insomnia consistently show significant improvement after treatment. Stanford University Medical School have conducted their own studies on the effect of acupuncture on sleep. (9,12,13)
1 Samaraweera Y, Abeysena C, Aust NZ Jnl Obst and Gyn 2010, vol. 50, 352-357
2 Leproult R, Van Cauter E. JAMA. 2011 Jun 1;305(21):2173-4.
3 Nedeltcheva AV, Ann Intern Med. 2010;153:435-441, 475-476.
4 Hublin C et al, Sleep. 2007 Oct;30(10):1245-53.
5 Nedeltcheva, A.V. Jnl of Clin Endocrin & Metab, online June 30, 2009
6 Rogers NL, et al Semin Clin Neuropsychiatry. 2001 Oct;6(4):295-307.
7 King K,et al. Hum Reprod. 2010 Jan;25(1):52-8.
8 Wu H et al Brain Res Bull. 2008 Nov 25;77(5):241-5.
9 Huang W et al, Sleep Med Rev. 2009; 13, 73-104
10 Vgontzas AN et al J Clin Endocrinol Metab 2004; 89, 2119 – 26.
11 Okun M et al, Sleep 2011; 34, 1493 – 98
12 Kalavapalli R, Singareddy R, Complement Ther Clin Pract. 2007 Aug;13(3):184-93.
13 Sok SR et al, J Adv Nurs. 2003 Nov; 44(4):375-84.
The following tips are provided by the American Academy of Sleep Medicine (AASM) and others to help you get the most out of sleep: although the optimal amount of sleep is about 8 hours on average, requirements vary from person to person and somewhat from season to season and even at different times of the menstrual cycle. If you have signs of drowsiness or poor concentration during the day, or it is hard to get out of bed in the morning you are not getting enough good quality sleep.
* Make your bedroom a comfortable and safe place. Reduce noise and extreme temperatures and keep the room dark.
* Use light and comfortable bed linens and garments. Overheating interferes with deep sleep and can have a subtle effect on fertility.
* Go to bed only when you are sleepy and use the bed only for sleeping and sex.
* Begin rituals to help you relax at bedtime, such as taking a soothing bath or enjoying a light snack and herbal tea.
* Go to bed and get up at the same time every day, including weekends and holidays.
* A short power nap after lunch helps night time sleep but keep it to less than one hour and take it before 3 p.m.
* Only drink caffeine in the morning, and avoid alcohol and cigarettes late in the day.
* Stay away from fatty, spicy foods that are likely to upset your stomach or cause heartburn.
* Set aside time during the day to relax and aim to get outdoors into the sunlight for about an hour each day. Exercise regularly but not just before bed.
* A course of acupuncture may help establish a good sleep pattern if you are still having difficulty.