In females of reproductive age, menstruation is a physiological process that usually starts between the ages of 12 and 15 and ends between the ages of 45 and 50. Particularly in teenagers and women of reproductive age, depression, sleep disruption, and irregular menstrual cycles typically coincide, indicating similar biological and psychological mechanisms.
Hormonal imbalance and irregular menstrual cycles can result from mood disorders and sleep deprivation interfering with the control of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes. On the other hand, irregular menstruation and related symptoms can exacerbate mental discomfort and poor sleep quality, resulting in a reciprocal interaction. To identify at-risk persons early and to create integrated therapy methods that address mental health, sleep hygiene, and reproductive well-being, it is critical to understand the relationship between these illnesses.
This study investigates the relationship between irregular menstrual cycles, depressed symptoms, and sleep difficulties. Understanding how sleep disruptions and depression affect menstrual periods is essential for creating effective therapies, as both conditions are highly prevalent among women of reproductive age.
American women's NHANES data from 2005 to 2018 were used. The probabilities of irregular menstruation in connection to depression symptoms, sleep disorders, and their combined effects were estimated using weighted multivariate logistic regression models. Potential nonlinear connections were evaluated using restricted cubic spline analysis. Based on lifestyle and demographic characteristics, subgroup analyses were carried out. The possible indirect routes through triglycerides (TG) and fasting blood glucose (FBG) were assessed using mediation analysis.
Adjusted analyses comprised 3,594 individuals. Menstrual abnormalities were linked to both sleep disruption (OR = 1.69; 95% CI: 1.23–2.34; P = 0.002) and depressed symptoms (OR = 1.58; 95% CI: 1.13–2.23). Menstrual abnormalities were more common in those with both sleep difficulties and depressive symptoms (OR = 1.86; 95% CI: 1.29–2.67; P < 0.001).
The indirect relationship through FBG accounted for 1.56% of the overall association in mediation studies, whereas the indirect association through TG accounted for 4.31%. Overall, the findings of this study suggest that the incidence of irregular menstruation is increased by sleep problems and depressive symptoms, either separately or in combination.
Reference:
Qin, K., Liu, D., Yu, Y., Dong, Z., & Sun, Y. (2025). Association between depression, sleep disturbance, and irregular menstrual cycles: insights from the NHANES 2005-2018. BMC Women’s Health, 25(1), 626. https://doi.org/10.1186/s12905-025-04167-3
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