Sleep and the Transition to Adolescence: A Longitudinal Study

Study Objectives: To assess the links between sleep and pubertal development using a longitudinal design. Design: Three consecutive annual assessments of sleep and pubertal development. Sleep was assessed using a week of home actigraphy. Setting: Naturalistic sleep in the home setting of school children, Tel Aviv Area, Israel. Participants: A sample of 94 (41 boys) typically developing healthy school-age children (age range at first assessment: 9.9-11.2 years). Intervention: N/A Measurements and Results: The Petersen's Pubertal Development Scale (PDS) and Sexual Maturation Scale (SMS) were used to assess pubertal development, and a week of actigraphy served to assess naturalistic sleep patterns. The results reflect expected developmental trends: an increase in signs of pubertal maturation, delayed sleep onset, and shorter sleep time. After controlling for age, significant relationships were found between sleep onset time, true sleep time, and number of night wakings at Time 1 and pubertal ratings at Time 2, and pubertal changes from Time 1 to Time 2. Delayed and disrupted sleep at Time 1 predicted faster pubertal changes from Time 1 to Time 2. These results were supported by structural equation modeling. These findings were similar in boys and girls. Conclusions: Based on these longitudinal data, it appears that pubertal changes in sleep (delayed sleep phase and disrupted sleep patterns) antedate bodily changes associated with puberty. The underlying mechanisms explaining these predictive links should be further explored.