Previous reports account for beneficial effects of female sexual hormones administration (both estrogens and progestogens) and hormone replacement therapy in postmenopausal women, both as hypnogenic agents and potential therapeutic alternatives for obstructive sleep apnea and insomnia. Data are scarce for premenopausal women and the effects of hormonal contraceptives on sleep are still inconclusive. The current study sought to evaluate the impact of contraceptive use (both combined therapy and progestogens-only) on subjective sleep-related self-reports among premenopausal women.
This was a web-based cross-sectional trial. A set of questionnaires evaluating contraceptive use, sleep-related characteristics and related features was available online between July 2016 and February 2017. Sleep assessment tools comprised the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Only premenopausal women between 18 a 40 years-old were considered eligible. Statistical comparison were performed between contraceptive users and those who reported no current use. Analyses were repeated to compare users of combined contraceptives with users of progestogens-only therapies.
Among 2057 respondents, 1212 met the inclusion criteria. Of those, 868 were currently taking hormonal contraceptives (combined therapy: 796; progestogens-only: 72). Contraceptive users reported more frequent sleep complaints and had lower scores on PSQI, ESS and ISI, denoting a worse sleep quality, increased excessive daytime somnolence and more insomnia symptoms. No significant differences were observed between users of combined and progestogens-only therapies.
Our results failed to demonstrate any beneficial effect of contraceptive use on subjective sleep self-report. Contraceptive users have an overall worse sleep, including more sleep-related problems and worse scores on PSQI, ESS and ISI. Additionally, no significant differences were noted between combined and progestogen-only users. Our data do not corroborate the aforementioned hypothesis, suggesting that contraceptives have no effect as complementary therapy for insomnia and other sleep-related complaints.
Support (If Any)
AFIP, CNPq and FAPESP.
Journal Article. 0 words.
Subjects: Neurology ; Sleep Medicine ; Clinical Neuroscience ; Neuroscience