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Higher Prevalence of Sleep Disorders in Studied Gender Identities Should Prompt Screening, Researchers Say
Youth who identified as transgender or gender-nonconforming (TGNC) experience a higher burden of sleep disorders than their cisgender peers, but gender-affirming therapy (GAT) may provide some protection. Results from the retrospective cross-sectional study conducted by Michigan Medicine were published in the Journal of Clinical Sleep Medicine.
“Given this higher prevalence of sleep disorders in relation to cisgender youth, clinicians should consider screening and testing this population for such disorders,” said lead author Ronald Gavidia, MD, MS, Division of Sleep Medicine, Department of Neurology, University of Michigan Health Department.
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The study included 1,216,044 youth drawn from a large, US-based administrative claims database. From the sample, 2603 were identified as TGNC. Of these, 1387 had elected to pursue GAT, with 868 identified as transmasculine and 519 identified as transfeminine. The authors utilized unadjusted and age-adjusted logistic regression models to examine the relationships between TGNC identity, GAT, and sleep disorders.
Adjusted analysis revealed that TGNC youth were 5.4 times (95% confidence internal 4.7, 6.2) more likely than their cisgender peers to have insomnia, and 3 times more likely to have sleep apnea (95% confidence interval 2.3, 4.0) as well as other sleep disorders (95% confidence interval, 2.5, 3.9). Of the TGNC youth, those receiving GAT experienced decreased odds of sleep issues (odds ratio= 0.5, 95% confidence interval 0.4, 0.7).
“As mood disorders and insomnia have a bidirectional relationship, gender transition through affirming therapies could improve mental health, which, in turn, may decrease the proportion of insomnia by improving gender dysphoria, poor mood, and minority stress,” Gavidia said.
Longitudinal studies of sleep disorders experienced prior to and post-GAT are needed to further explore the relationship between GAT and sleep in TGNC populations, the authors concluded.
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