0752 Later chronotype, insufficient and disturbed sleep are linked to menstruation problems in early adolescent girls

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Abstract Introduction Adolescence in girls is a vulnerable transitional period, characterized by substantial hormonal and physical development, the onset of menarche, dramatic brain development and changes in behavior, including sleep. Menstrual problems, including painful menses, are common among female adolescents, and contribute to school absenteeism. They may also be symptoms of gynecological conditions, which can negatively affect reproductive and general health of women. Limited work has linked sleep disturbances and menstrual problems in adolescents. Here, we examined the association between sleep behavior and menstrual problems in a large sample of adolescent girls in the Adolescent Brain Cognitive Development (ABCD) Study®. Methods We fitted linear mixed effect models to examine the associations between sleep behavior and menstrual problems in 1837 post-menarcheal girls (Year 3, Mean-age = 13.03, [12-15] years), assessed as part of the ongoing ABCD Study®. Sleep was assessed with the Munich Chronotype questionnaire (youth-report) and the sleep disturbance scale for children (caregiver-report). Girls answered questions about menstrual cycles and associated problems. We considered age, time since menarche, BMI, use of hormonal contraceptives, and socio-demographic characteristics in the models. Results Short sleep duration was related to higher menstrual pain intensity (p<.01), irregular menstrual cycles (p<.01) and more premenstrual symptoms (p=.01). Higher total sleep disturbance score (caregiver-reported) was also associated with higher menstrual pain intensity (p<.01) and greater impact of menstrual pain on usual activities (p<.01). Participants with a later chronotype (p=.04) and later wake-up time (p=.02) were more likely to experience an irregular menstrual cycle. Later wake-up time was also related to higher menstrual pain intensity and impact on daily life (p<.01). Girls with recent menarche reported heavier menstrual flow (p=.02), higher menstrual pain intensity, more premenstrual symptoms, and a greater overall impact of menstrual pain on their usual activities (p<.01). Conclusion Our results indicate multiple associations between sleep behavior and menstrual problems in adolescent girls. Both menstrual problems and insufficient sleep/sleep disturbances are important for female adolescent health and should be routinely screened for by healthcare providers and school health education providers. Future work is needed with longitudinal analyses to determine directionality of the associations we found between sleep and menstrual problems. Support (if any) NIH U01DA041022

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