0809 Hormonal Contraceptives and Women’s Sleep Health: A Systematic Review

Abstract Introduction Sex hormones and hormonal contraceptives influence the regulation of sleep-wake behavior. However, there are very few large-scale studies to date that have comprehensively evaluated how hormonal contraceptives influence women’s sleep health. The purpose of this systematic review was to synthesize the existing research on hormonal contraceptive use and sleep in women ages 18-50. Methods The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement checklist. Searches were conducted in PubMed, Embase, CINAHL, PsycINFO, Scopus, Cochrane Central Register of Controlled Trials, Global Index Medicus, ProQuest Theses and Dissertations, and ClinicalTrials.gov beginning from the earliest publication data available until September 2024. Of 8,090 articles that were eligible for screening, 13 studies were included in this review. Data were extracted and evaluated for risk of bias and heterogeneity. Results The included studies demonstrated high heterogeneity in terms of objective and/or subjective sleep-related measures, as well as non-sleep primary study outcomes, thus precluding the ability to conduct a meta-analysis. Significant risk of bias concerns were also identified. A majority of the studies were conducted on health adults (85%) using cross-sectional data (54%) with participants using the combined pill (31%) or contraceptive formulas that were not specified (31%). Over half the studies did not report significant differences between groups regarding objective (e.g., sleep efficiency) or subjective (e.g., Pittsburgh Sleep Quality Index) sleep data. Conclusion While these findings underscore the need for methodological consistency in assessing women’s sleep health, several clinical guidelines can be gleaned from this existing research in terms of the behavioral assessment and treatment of sleep difficulties in women using hormonal contraceptives. For example, it may be useful to assess and track menstrual phase alongside sleep for the purposes of tailoring or modifying behavioral interventions. Additional investigation is needed to identify standardized research and clinical methodology guidelines for assessing and treating women’s sleep health. Support (if any)