It is no secret that emotional distress can lead to problems with sleep patterns, and it should come as no surprise that women undergoing IVF sometimes find their situation stressful.
This is important because research shows that sleep disturbance may interfere with female reproductive processes. Therefore, the sleep routines of women undergoing IVF treatment, as they experience increased stress associated with that treatment, need to be better understood to improve ART outcomes. However, there is little data on the scale of the issue.
Now a team in Taiwan has looked into the matter in more detail, investigating two aspects in particular:
(1) The emotional distress (measured as levels of anxiety and/or depression) and sleep quality of women receiving the hormonal stimulation phase of IVF treatment
(2) The factors that predict sleep disturbances among these women
They studied 97 women (average age 36) who answered detailed questionnaires during the hormonal stimulation phase of IVF treatment, and the results were interesting:
- 30% had poor sleep quality
- 19% required more than 30 minutes to fall asleep
- 56% had less than 7 hours per sleep per day
Not only that, but up to 74% of the women reported some degree of daytime dysfunction, which they felt was a result of poor sleep quality.
In terms of depression and anxiety scores, the results were also indicative of a high level of stress:
- 43% were determined as having some level of anxiety, with half of these demonstrating moderate to severe anxiety
- 30% were found to have a level of depression, with a third of these demonstrating moderate to severe depression
The research found, as might be expected, a strong relationship between emotional distress, particularly anxiety and sleep disturbance.
What then are the recommendations for women undergoing IVF in terms of achieving good sleep patterns that may be of benefit to the successful outcome of their treatment?
Firstly, few of the women were taking any medicines to promote sleep. However, the researchers do not advocate that drugs are the answer. Instead they suggest that ‘medical care staff could consider non-medical methods for improving the sleep quality of these patients, such as cognitive behavioural therapy, bedtime ambient light adjustments, physical and mental relaxation therapy, and the use of music to achieve the purpose of relaxation.
The researchers also suggest that health care professionals in the IVF setting should take more time to understand these common issues when assisting women undergoing ART. In terms of practical advice, they recommend including sleep history in initial assessments so that the information can be used to provide a more comprehensive care plan for patients.
From the clinic point of view, it is also part of the process of patient education to reassure patients that their full condition is understood, not just the narrow focus of physiological aspects of IVF. It certainly helps for patients to know that that the way they feel is not unusual, and that there are options for dealing with anxiety, depression and poor sleep quality.
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