Childhood sleep behaviors and polycystic ovary syndrome risk in adolescence: the Raine study cohort longitudinal study.

BACKGROUND

Sleep disturbances are common in women with polycystic ovary syndrome (PCOS), but no prospective studies have explored whether childhood-adolescence sleep disturbances are associated with later PCOS risk. Understanding behavioral markers may support early identification and intervention.

OBJECTIVE

To examine whether poor sleep behaviors from childhood to adolescence are prospectively associated with a diagnosis of PCOS at age 14 years.

MATERIALS AND

METHODS

Sleep behavior data (Child Behavior Checklist) from a longitudinal study of 226 female participants of the Raine Study cohort (37 with PCOS), assessed at ages 5, -8, -10, and -14 years, with PCOS diagnosis at age 14 years were analyzed. PCOS diagnosis was based on both hyperandrogenism and ovulatory dysfunction according to the 2023 PCOS Guideline adolescent diagnostic criteria. Generalized estimating equations examined longitudinal sleep behavior differences by PCOS status at age 14; logistic regression explored specific sleep behavior associations with PCOS risk at age 14.

RESULTS

After adjustment for covariates, results showed higher sleep behavior problem scores from childhood to adolescence, with differences becoming more pronounced over time among girls with PCOS at age 14 (adjusted mean difference = 0.49; 95% CI = 0.10-0.87; P = .013). Analysis of individual items showed significant associations between PCOS at age 14 and "trouble sleeping" at age 10 (odds ratio [OR] = 2.95; 95% CI = 1.30-6.69) and "sleeping less than most kids" at age 10 (OR = 2.48; 95% CI = 1.18-5.22).

CONCLUSION

Sleep difficulties may serve as early, modifiable behavioral markers of PCOS risk. Poor sleep may worsen hormonal and metabolic dysfunction, promoting insulin resistance, obesity, and sleep disturbances.