Abstract
Adolescent health is influenced by a complex interaction of factors, including sleep, stress, and reproductive function. Despite sleep disturbances being common in adolescence, their impact on menstrual health remains poorly understood. This study aims to examine the relationship between sleep quality and menstrual cycle variation in a diverse population of adolescent females in Miami, FL, providing baseline data that can inform future interventions on sleep and menstrual health patient education.
This study was approved by the institution's IRB. An anonymous survey was distributed using REDCap to all new patients at their first pediatric gynecology appointment at a large university outpatient center. Participants were excluded if they were: over 21 years old, premenarchal, pregnant, non-English and non-Spanish speaking, on hormonal contraceptives or therapies, had prior chemotherapy or radiation treatments, or been diagnosed with uterine agenesis or primary ovarian insufficiency. Appropriate participant and parental/guardian consent (if under 18) was acquired. Participants provided responses on sleep quality (assessed through the Pittsburgh Sleep Quality Index (PSQI)), underlying medical conditions, menstrual cycle data, and demographics. Data analysis was done through SPSS.
A total of 134 adolescent girls took the survey, but only the 100 who completed all sections were included in the analysis (mean age 15.64 ± 1.794 years). 84% identified with Hispanic or Latino ethnicity, and 74% indicated being of White or Caucasian race. A majority, 63%, of participants were born in the United States compared to 36% that indicated being born outside of the country. 64 participants met the criteria for abnormal menses, which was defined as any departure from normal menstruation including duration, frequency, and flow. Notably, the PSQI global scores as a continuous variable was found to be a significant predictor for abnormal menses using linear regression (odds ratio=1.151, p=0.043). Poorer sleep quality was significantly associated with previous diagnoses of anxiety (x2=6.841, p=0.009) and depression (x2=3.893, p=0.048) using chi-square analysis.
Our results support an association between poor sleep quality and abnormal menstrual cycles and are consistent with existing research in other countries. They underscore the importance of assessing and improving sleep quality in managing menstrual health in adolescents, such as through schools and healthcare providers. This project calls for further investigations on how sleep modulates menstruation in adolescents.