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Short Sleep, Insomnia Symptoms, and Evening Chronotype Are Associated with Poorer Mood and Quality of Life in Adolescent Transgender Males

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Short Sleep, Insomnia Symptoms, and Evening Chronotype Are Associated with Poorer Mood and Quality of Life in Adolescent Transgender Males Short sleep, insomnia symptoms, and evening chronotype are associated with poorer mood and quality of life in adolescent transgender males Anne E. Bowen, BS1; Syd Staggs, BA2; Jill Kaar, PhD2; Stacey L. Simon, PhD1,2; Natalie Nokoff, MD1,2 1Children’s Hospital Colorado; 2University of Colorado BACKGROUND RESULTS RESULTS • Transgender youth, individuals whose gender Sample Characteristics • Shorter weekend sleep duration was associated identity differs from the sex assigned to them at Insomnia Chronotype with poorer physical QOL (p<0.05) birth, are at higher risk for depression, anxiety, • Later weekend waketimes were correlated with and suicide poorer physical QOL (p<0.05) • Gender-affirming hormone therapy reduces None (36.8%) Morning anxiety and depression • No weekday actigraphy variables were (26.3%) associated with mood or QOL • Short sleep duration is correlated with depression symptoms and suicidal ideation in general Subthreshold Evening • There were no differences by GnRHa status populations of adolescents (47.4%) (42.1%) • Over 70% of high schoolers sleep less than the Clinical (15.8%) Middle (31.6%) CONCLUSIONS recommended 8 hours • This is the first study to investigate associations • Yet, there is a significant literature gap on sleep in between sleep and mood in transgender transgender adolescents adolescents Anxiety Depression • The ongoing study will evaluate changes in sleep AIMS after initiation of testosterone therapy Normal (42.1%) Normal (43.8%) Characterize sleep and investigate association • Average sleep duration of the sample was less between sleep and mood symptoms in than the recommended 8-10 hours transgender male adolescents Mild (26.3%) Mild (25.0%) • Over half the sample endorsed subthreshold or METHODS Moderate Moderate clinically significant insomnia, consistent with adult literature reporting high levels of sleep (21.1%) Baseline visit of a longitudinal, observational study (18.8%) disturbance in transgender people Participants Severe (10.5%) Severe (12.5%) • It is recommended that future studies •13-16 year old transgender males (female sex longitudinally examine the effect of hormone assigned at birth) with plans to start testosterone therapy on sleep, mood, and HRQOL in in 6 months or less; N=8 + gonadotropin releasing adolescents undergoing medical transition, and hormone analog (GnRHa); N=11 -GnRHa Correlations Between Questionnaires assess circadian rhythm via melatonin collection Measures • Insomnia symptoms were • Healthcare and mental health providers should •Sleep Monitoring: 7 days of home actigraphy positively associated with routinely assess sleep behaviors and insomnia with concurrent sleep diary depression and anxiety symptoms during care for transgender youth •Chronotype: Morningness Eveningness Scale for symptoms Children (MESC) • Participants with more FUNDING •Insomnia Symptoms: Insomnia Severity Index insomnia symptoms had lower BIRCWH K12 (K12 HD 057022-11) (ISI) physical, emotional, social, Center for Women’s Health Research •Mood: Patient-Reported Outcomes Measurement and wellbeing QOL CCTSI MicroGrant (CTSA Grant UL1 TR002535) CCTSI CO-Pilot Information System (PROMIS) for Anxiety and • Evening-oriented individuals PROMIS for depression GI & Liver Innate Immune Program (GALLIP) Transformational had poorer physical quality of Research Funding •Quality of Life (QOL): PedsQL Generic Core life Endocrine Fellow Foundation Scale and Wellbeing Scale *p<0.05, **p<0.01 Doris Duke .
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