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 .