Evidence map›Paper›PMID 41700659›Full record

ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026

Mediating role of sleep disorders in the association between depression and infertility: A cross-sectional study using the National Health and nutrition examination survey.

JuanJuan Zhang, Juan Zhang, Chun Zhao, Xiufeng Ling, Xin Li

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Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

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5 authors.

JuanJuan ZhangDepartment of Reproductive Medicine, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.
Juan ZhangDepartment of Reproductive Medicine, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.
Chun ZhaoDepartment of Reproductive Medicine, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.
Xiufeng LingDepartment of Reproductive Medicine, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.
Xin LiDepartment of Reproductive Medicine, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China.ORCID https://orcid.org/0000-0001-6432-3966

Funding

National Natural Science Foundation of China 82204469
6 · The paper itself

Abstract

backgroundSleep disorders and depression are prevalent conditions that can affect reproductive health. However, the complex interplay between these factors and infertility remains poorly understood, particularly the potential mediating role of sleep disorders in the association between depression and infertility.

methodsWe analyzed data from 2068 female participants in the National Health and Nutrition Examination Survey (NHANES), including 244 women with self-reported infertility. Multivariable regression analyses examined associations between depression, sleep disorders, and infertility. Subgroup analyses were conducted to identify effect modifications, and mediation analysis was performed to assess whether sleep disorders mediate the association between depression and infertility.

resultsThe infertility group had significantly higher prevalence of sleep disorders compared to the non-infertility group (33.78% vs. 24.12%, P = 0.034). In subgroup analyses, sleep disorders were significantly associated with infertility among participants without depression (odds ratio [OR] 1.94, 95% confidence interval [CI] 1.16-3.23, P = 0.012), those with obesity (OR 1.99, 95% CI 1.05-3.79, P = 0.037), never smokers (OR 1.84, 95% CI 1.11-3.04, P = 0.018), and individuals with impaired fasting glucose (OR 4.75, 95% CI 1.16-19.48, P = 0.032). Depression was significantly associated with infertility among participants aged <35 years (OR 1.83, 95% CI 1.05-3.20, P = 0.035). Most importantly, mediation analysis revealed that sleep disorders significantly mediated the association between depression and infertility, accounting for 67.6% of the total effect (coefficient = 0.01839, 95% CI: 0.00634-0.03589, P < 0.001).

conclusionOur findings suggest that sleep disorders might play a critical mediating role in the relationship between depression and infertility. This highlights the importance of addressing sleep health in reproductive-aged women, particularly those with depression, as a potential strategy for improving fertility outcomes.

Indexed as

DepressionInfertility, FemaleSleep Wake DisordersAdultCross-Sectional StudiesFemaleHumansNutrition SurveysObesityPrevalenceRisk FactorsUnited StatesYoung Adultcross‐sectional studydepression infertilityNHANESsleep disorder

Identifiers

PMID41700659
PMCPMC13377323

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.