Abstract
BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with a high prevalence of obstructive sleep apnea (OSA); however, its impact on the clinical manifestations of PCOS remains unclear. OBJECTIVE: This study aimed to investigate the clinical characteristics, reproductive endocrine profiles, and glucose-lipid metabolic features in women with PCOS complicated by OSA and to evaluate their potential implications for pregnancy outcomes. METHODS: A total of 294 infertile women with PCOS treated at Heze Municipal Hospital between February 2023 and December 2024 were enrolled after excluding ineligible participants. Clinical characteristics and reproductive endocrine and metabolic parameters were collected, and factors associated with OSA in women with PCOS were analyzed using the univariate analysis and the logistic regression analysis. Additionally, 101 women with PCOS and OSA were randomly assigned to either a lifestyle intervention control group or a lifestyle intervention and continuous positive airway pressure (CPAP) group, and changes in hormonal and metabolic parameters as well as pregnancy outcomes were evaluated. RESULTS: The prevalence of OSA in women with PCOS was 34.4%, of whom 10.9% had moderate to severe OSA. Higher body mass index, hyperinsulinemia, elevated triglycerides (TGs), and reduced anti-Müllerian hormone (AMH) levels were independently associated with an increased risk of OSA in women with PCOS. Compared with the control group, the CPAP treatment group exhibited significant reductions in serum testosterone (T), insulin (INS), and triglyceride (TG) levels, along with a significantly higher clinical pregnancy rate (p < 0.05). CONCLUSION: Infertile women with PCOS and OSA exhibit significant disturbances in reproductive endocrine and glucose-lipid metabolism. CPAP therapy may improve these metabolic abnormalities, and when combined with ovulation induction and assisted reproduction, it may lead to better pregnancy outcomes, highlighting the potential benefit of early screening and intervention for OSA in women with PCOS.