Zhang Yuxian, Gu Dongling, Xie Yanyuan, Li Bing
Health Department, Guangzhou Baiyun District Maternal and Child Health Hospital, Guangzhou, 510405, China.
Health Education Department, Guangdong women and children hospital, Guangzhou, 511442, China.
Reprod Health. 2025 Aug 7;22(1):141. doi: 10.1186/s12978-025-02106-x.
Fertility outcomes are increasingly influenced by modern lifestyle factors, including sleep behaviors. However, the relationship between sleep and time to pregnancy (TTP) is underexplored.
We conducted a prospective cohort study of 1,684 couples in Guangzhou, China. Sleep behaviors were assessed via structured interviews. Cox proportional hazards models were used to estimate fecundability ratios (FRs), adjusting for potential confounders. Sleep-wake regularity was assessed for all women. Among those with regular patterns (n = 1506), we further analyzed sleep duration, bedtime, perceived sleep sufficiency, and insomnia.
Among all participants, 178 (10.6%) had irregular sleep. Time-varying models revealed that compared to regular sleepers, irregular sleepers exhibited a decreasing fecundability ratio (FR < 1) after approximately 2.6 months of attempting pregnancy, with the association becoming statistically significant after 4.1 months. In women with regular sleep, longer sleep duration was associated with higher fecundability (adjusted FR = 1.18, 95% CI: 1.09-1.27; p < 0.001). Spline analysis indicated a linear increase in fecundability with sleep durations exceeding 7.5 h. Perceived insufficient sleep was linked to reduced fecundability (adjusted FR = 0.62, 95% CI: 0.48-0.81; p < 0.001), while later bedtime was associated with lower fecundability (adjusted FR = 0.91, 95% CI: 0.84-0.98; p = 0.045). Insomnia showed no significant effect (adjusted FR = 0.86, 95% CI: 0.67-1.11, p = 0.241).
Irregular sleep patterns may reduce fecundability over time. Among women with regular sleep, longer duration, earlier bedtime, and sufficient perceived sleep were associated with improved reproductive potential. Sleep optimization could be a modifiable behavioral target to enhance fertility.
ChiCTR2300068809 registered 1/3/2023.
生育结果越来越受到现代生活方式因素的影响，包括睡眠行为。然而，睡眠与怀孕时间（TTP）之间的关系尚未得到充分研究。
我们对中国广州的1684对夫妇进行了一项前瞻性队列研究。通过结构化访谈评估睡眠行为。使用Cox比例风险模型来估计受孕能力比率（FRs），并对潜在的混杂因素进行调整。对所有女性的睡眠-觉醒规律进行了评估。在睡眠模式规律的女性（n = 1506）中，我们进一步分析了睡眠时间、就寝时间、感知到的睡眠充足程度和失眠情况。
在所有参与者中，178人（10.6%）睡眠不规律。时变模型显示，与睡眠规律的人相比，睡眠不规律的人在尝试怀孕约2.6个月后受孕能力比率下降（FR < 1），在4.个月后这种关联具有统计学意义。在睡眠规律的女性中，较长的睡眠时间与较高的受孕能力相关（调整后的FR = 1.18，95% CI：1.09 - 1.27；p < 0.001）。样条分析表明，睡眠时间超过7.5小时，受孕能力呈线性增加。感知到睡眠不足与受孕能力降低有关（调整后的FR = 0.62，95% CI：0.48 - 0.81；p < 0.001），而较晚的就寝时间与较低的受孕能力相关（调整后的FR = 0.91，95% CI：0.84 - 0.98；p = 0.045）。失眠没有显著影响（调整后的FR = 0.86，95% CI：0.67 - 1.11，p = 0.241）。
随着时间的推移，不规律的睡眠模式可能会降低受孕能力。在睡眠规律的女性中，较长的睡眠时间、较早的就寝时间和充足的感知睡眠与生殖潜力的提高有关。优化睡眠可能是提高生育能力的一个可改变的行为目标。
ChiCTR2300068809于2023年1月3日注册。
