{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:27:58Z","timestamp":1791404878693,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100017686","name":"Fujian Provincial Health Technology Project","doi-asserted-by":"publisher","award":["2023ZQNZD010"],"award-info":[{"award-number":["2023ZQNZD010"]}],"id":[{"id":"10.13039\/501100017686","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017686","name":"Fujian Provincial Health Technology Project","doi-asserted-by":"publisher","award":["2024QNA058"],"award-info":[{"award-number":["2024QNA058"]}],"id":[{"id":"10.13039\/501100017686","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013795","name":"Fujian Medical University","doi-asserted-by":"publisher","award":["2024QH1340"],"award-info":[{"award-number":["2024QH1340"]}],"id":[{"id":"10.13039\/501100013795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Observational studies have reported associations between various sleep traits and polycystic ovary syndrome (PCOS); however, it remains unclear whether these relationships are causal or driven by confounding factors. This study aimed to clarify the direction and magnitude of potential causal effects between eight self\u2010reported sleep characteristics and PCOS risk using a bidirectional and multivariable Mendelian randomization (MR) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Genome\u2010wide association study (GWAS) summary statistics for eight sleep traits (sleeplessness\/insomnia, sleep duration, snoring, daytime dozing, chronotype, getting up in the morning, daytime napping, and sleep apnea syndrome) and PCOS were analyzed. Univariable MR analyses were conducted using inverse\u2010variance weighted (IVW) meta\u2010analysis as the primary method, supplemented by weighted median and MR\u2010Egger regression. Sensitivity analyses included Cochran's Q test, the MR\u2010Egger intercept, MR\u2010PRESSO, and leave\u2010one\u2010out analyses. Multivariable MR analyses were further performed with adjustment for adiposity and insulin resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Genetically predicted sleeplessness\/insomnia was associated with an increased risk of PCOS (IVW OR\u2009=\u20091.67, 95% CI\u2009=\u20091.24\u20132.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20098.6\u2009\u00d7\u200910\n                      <jats:sup>\u22124<\/jats:sup>\n                      ). Sleep apnea syndrome was also associated with PCOS in univariable analyses (IVW OR\u2009=\u20091.07, 95% CI\u2009=\u20091.03\u20131.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.3\u2009\u00d7\u200910\n                      <jats:sup>\u22123<\/jats:sup>\n                      ); however, this association was attenuated after multivariable adjustment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20). No evidence of reverse causation from PCOS to sleep traits was observed. The results were consistent across sensitivity analyses, with no evidence of horizontal pleiotropy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our MR analyses support a potential causal role of sleeplessness\/insomnia in increasing the risk of PCOS, whereas the association with sleep apnea syndrome may be mediated by adiposity or other confounding factors. These findings highlight the importance of sleep management in strategies for the prevention of PCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70233","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:22:42Z","timestamp":1773102162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Causal Associations Between Sleep Traits and Polycystic Ovary Syndrome: A Univariable, Bidirectional, and Multivariable Mendelian Randomization Study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4495-0089","authenticated-orcid":false,"given":"Xueli","family":"Chen","sequence":"first","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Lin","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Lin","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Yang","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-9211","authenticated-orcid":false,"given":"Fa","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JinBang","family":"Xu","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics &amp; Gynecology and Pediatrics Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00511-3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2024.08.004"},{"issue":"10","key":"e_1_2_13_4_1","first-page":"6050","article-title":"Influence of Lifestyle on Polycystic Ovary Syndrome From the Theory of Health Preservation in Huangdi Neijing","volume":"37","author":"Li S.","year":"2022","journal-title":"China Journal of Traditional Chinese Medicine and Pharmacy"},{"issue":"13","key":"e_1_2_13_5_1","first-page":"20","article-title":"Analysis of Risk Factors in Infertile Patients With Obese Polycystic Ovary Syndrome","volume":"34","author":"Wang Y.","year":"2024","journal-title":"China Journal of Modern Medicine"},{"issue":"10","key":"e_1_2_13_6_1","first-page":"2763","article-title":"Overnight Melatonin Concentration and Sleep Quality Are Associated With the Clinical Features of Polycystic Ovary Syndrome","volume":"11","author":"Evans A. 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