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Sleep and Fertility: How Sleep Habits Affect Reproductive Health

Jessica Joseph, RN, BSN, MHA
July 1, 2023
Women opening curtains in the mornig after sleeping
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Sleep is crucial for overall health and mental well-being. Adequate sleep promotes vital functions in the body, such as regulating hormones, cell restoration, and memory functions.   Although sleep is widely recognized as essential, many still fail to prioritize it.  

Sleep negligence has been linked to health problems such as:


  • Diabetes

  • Obesity

  • Depression

  • High blood pressure

  • Anxiety

  • Stroke

  • Weakened immunity

  • Reduced libido



Sleep, Hormones, and Fertility


Adequate sleep, along with proper diet and exercise, promotes fertility. Irregular sleep patterns or insufficient sleep can disrupt the body's circadian rhythm, affecting the regularity of menstrual cycles. Studies have shown that women who experience irregular sleep patterns or chronic sleep deprivation may have irregular or absent menstrual cycles, which can pose challenges when trying to conceive.  Insufficient sleep negatively impacts fertility by misbalancing critical hormones.  Balanced hormones are a vital part of reproductive health.


Melatonin: Sleep is regulated by the hormone melatonin, produced by the brain's pineal gland, and is activated with darkness in the evening.  Growing evidence suggests that melatonin helps with egg quality by reducing oxidative stress.  Women who are trying to conceive may benefit from melatonin supplementation, particularly if they are experiencing age-related fertility decline or have irregular menstrual cycles.  While melatonin is generally considered safe, it is important to note that individual responses may vary. Some individuals may experience mild side effects such as drowsiness, headache, or gastrointestinal symptoms. It is always advisable to consult with a healthcare professional before starting any new supplementation.


Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH): LH and FSH are gonadotropins, hormones produced and released by the pituitary gland. Lack of sleep dysregulates these two key hormones responsible for reproduction. Both hormones are accountable for ovulation, menstruation, and sperm production.


LH secretion follows a pulsatile pattern, with surges occurring throughout the day and night. According to the Journal of Clinical Endocrinology and Metabolism  deep sleep or slow-wave sleep, plays a vital role in regulating LH pulses. During deep sleep, LH pulses tend to be more frequent and robust. Adequate sleep duration and quality are essential for maintaining the normal pulsatile release of LH, which is crucial for ovulation and reproductive function in women.


While the relationship between FSH and sleep is less extensively studied than that of LH, some evidence suggests that sleep disturbances can impact FSH levels. Sleep disruption or inadequate sleep may lead to alterations in FSH secretion, potentially affecting the reproductive function in both men and women. Further research is needed to fully understand the mechanisms behind this relationship.

Cortisol: Lack of sleep can increase stress levels and negatively affect mental well-being. Stress and psychological factors, in turn, can disrupt the delicate hormonal balance required for fertility. Chronic stress can interfere with the release of reproductive hormones, potentially affecting ovulation and sperm production.  Hormones that are considered detrimental to fertility when elevated, such as cortisol, are influenced by sleep.   Not getting enough sleep can raise cortisol levels, adversely impacting the chances of conception.


Sleep quality and duration can impact the quality and quantity of eggs produced by the ovaries. Research suggests that inadequate sleep and poor sleep quality may contribute to a decrease in ovarian reserve and a decline in the quality of eggs, potentially affecting fertility outcomes. Sleep disturbances can also affect male fertility. Studies have found a link between sleep disorders, such as sleep apnea, and decreased sperm quality and motility. Poor sleep can lead to hormonal imbalances, oxidative stress, and inflammation, negatively impacting sperm health and fertility.


Sleep Habit Tips


Establishing healthy sleep habits is essential for optimizing fertility. Daily routines, including activity level, diet, and medications, affect sleep habits.  Some tips from the National Sleep Foundation for creating good sleep habits are:


1. Stick to a regular sleep schedule. Make it a priority to go to bed and wake up at the same time, which will regulate sleep/wake      cycles. Try to keep your sleep schedule on vacations and weekends.

2. Do not try to force sleep; only get into bed once you feel sleepy.

3. Aim to get at least 7-8 hours of sleep each night.

4. Get enough natural light during the day, as this can regulate melatonin levels.

5. Avoid artificial light from cell phones, computers, and tablets at night.

6. Make dietary modifications as needed:

  • Avoid large meals before bed.

  • Limit caffeine, especially in the afternoon and evening.

  • Avoid alcohol one hour before bedtime when possible.

7. Get regular exercise during the day to help combat insomnia at night.

8. Create a conducive sleep environment by:

  • Making your bedroom dark and cool at night.

  • Investing in comfortable pillows and mattresses.

9. Limit fluid intake before bedtime to avoid waking up to use the bathroom at night.

10. Incorporate good bedtime rituals that provide relaxation, such as reading and meditation.


Espino J, Macedo M, Lozano G, Ortiz Á, Rodríguez C, Rodríguez AB, Bejarano I. Impact of melatonin supplementation in women with unexplained infertility undergoing fertility treatment. Antioxidants (Basel). 2019 Aug 23;8(9):338. doi: 10.3390/antiox8090338. PMID: 31450726; PMCID: PMC6769719.


Jeon B, Baek J. Menstrual disturbances and its association with sleep disturbances: a systematic review. BMC Womens Health. 2023 Sep 1;23(1):470. doi: 10.1186/s12905-023-02629-0. PMID: 37658359; PMCID: PMC10474748.

N. D. Shaw, J. P. Butler, S. M. McKinney, S. A. Nelson, J. M. Ellenbogen, J. E. Hall, Insights into Puberty: The Relationship between Sleep Stages and Pulsatile LH Secretion, The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 11, 1 November 2012, Pages E2055–E2062,

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