Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.
Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Sleep Med. 2022 Oct;98:13-25. doi: 10.1016/j.sleep.2022.06.009. Epub 2022 Jun 19.
Many factors may be hidden behind the global fertility decline observed in Western countries. Alongside the progressively increased age of infertile couples, environmental and behavioural factors, including non-optimal lifestyle habits, should be considered. Among these, sleep disorders have been suggested to be linked to human fertility.
This is a narrative review, describing first sleep physiology, its disturbances, and the tools able to quantify sleep dysfunction. Then, we consider all available studies aimed at investigating the connection between sleep disorders and human fertility, providing a comprehensive view on this topic.
Forty-two studies investigating the relationship between sleep habits and human reproduction were included. All the published evidence was grouped according to the aspect of human fertility considered, i.e. i) female reproductive functions, ii) male reproductive functions, iii) natural conception and iv) assisted reproduction. For each of the sub-groups considered, the connection between sleep dysregulation and human fertility was classified according to specific sleep characteristics, such as sleep duration, quality, and habits. In addition, possible physio-pathological mechanisms proposed to support the link between sleep and fertility were summarized.
This review summarizes the most relevant findings about the intricate and still largely unknown network of molecular pathways involved in the regulation of circadian homeostasis, to which sleep contributes, essential for reproductive physiology. Thus, many mechanisms seem correlate sleep disorders to reproductive health, such as adrenal activation, circadian dysregulation, and genetic influences. This review highlights the need to properly designed trials on the topic.
许多因素可能隐藏在西方国家观察到的全球生育率下降背后。除了不孕夫妇的年龄逐渐增加之外，环境和行为因素，包括非最佳生活习惯，也应该被考虑。在这些因素中，睡眠障碍被认为与人类生育能力有关。
这是一篇叙述性综述，首先描述了睡眠生理学、睡眠障碍及其量化工具。然后，我们考虑了所有旨在调查睡眠障碍与人类生育能力之间联系的现有研究，全面探讨了这一主题。
共纳入了 42 项研究，调查了睡眠习惯与人类生殖之间的关系。所有已发表的证据均根据人类生育的考虑方面进行分组，即 i）女性生殖功能，ii）男性生殖功能，iii）自然受孕和 iv）辅助生殖。对于考虑的每个亚组，根据特定的睡眠特征，如睡眠持续时间、质量和习惯，对睡眠失调与人类生育能力之间的联系进行了分类。此外，还总结了可能支持睡眠与生育之间联系的生理病理机制。
本文综述了关于调节生殖生理学的昼夜节律内稳态的复杂且仍知之甚少的分子途径网络的最相关发现，睡眠对昼夜节律内稳态的调节至关重要。因此，许多机制似乎将睡眠障碍与生殖健康相关联，例如肾上腺激活、昼夜节律失调和遗传影响。本综述强调了需要对此主题进行适当设计的试验。
