Male sleep duration and fecundability in a North American preconception cohort study

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e165">Objective</h5> <p id="P2">To evaluate prospectively the association between male sleep duration and fecundability.</p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e170">Design</h5> <p id="P3">Pregnancy Online Study (PRESTO), a web-based prospective cohort study of North American couples enrolled during the preconception period (2013–2017). </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e175">Setting</h5> <p id="P4">United States and Canada.</p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e180">Patients</h5> <p id="P5">Male participants were aged ≥21 years; female participants were aged 21–45 years.</p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e185">Interventions</h5> <p id="P6">None.</p> </div><div class="section"> <a class="named-anchor" id="S6"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e190">Main outcome measures</h5> <p id="P7">At enrollment, men reported their average nightly sleep duration in the previous month. Pregnancy status was updated on female follow-up questionnaires every 8 weeks for up to 12 months or until conception. Analyses were restricted to 1,176 couples who had been attempting to conceive for ≤6 cycles at enrollment. Proportional probabilities regression models were used to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders. </p> </div><div class="section"> <a class="named-anchor" id="S7"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e195">Results</h5> <p id="P8">Relative to 8 hours per night of sleep, multivariable-adjusted FRs for &lt;6, 6, 7, and ≥9 hours/night of sleep were 0.62 (95% CI: 0.45–0.87), 1.06 (95% CI: 0.87–1.30), 0.97 (95% CI: 0.81–1.17), and 0.73 (95% CI: 0.46–1.15), respectively. The association between short sleep duration (&lt;6 hours/night) and fecundability was similar among men not working night or rotating shifts (FR=0.60, 95% CI: 0.41–0.88) and among men without a history of infertility (FR=0.62, 95% CI: 0.44–0.87), and was stronger among fathers (FR=0.46, 95% CI: 0.28–0.76). </p> </div><div class="section"> <a class="named-anchor" id="S8"> <!-- named anchor --> </a> <h5 class="section-title" id="d7357435e200">Conclusions</h5> <p id="P9">Short sleep duration in men was associated with reduced fecundability. As male factor accounts for 50% of couple infertility, identifying modifiable determinants of infertility could provide alternatives to expensive fertility workups and treatments. </p> </div>