Title:Association between Sleep Duration and Early Pubertal Timing in Children
and Adolescents: A Systematic Review and Meta-analysis
Volume: 19
Issue: 3
Author(s): Nafiseh Mozafarian, Maryam Yazdi, Mahin Hashemipour*, Silva Hovsepian and Mohammad Reza Maracy*
Affiliation:
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
Keywords:
Early pubertal, timing, sleep duration, systematic, review, meta-analysis, children and adolescents.
Abstract:
Background: Early puberty increases the risk of diverse health outcomes during adolescence
and beyond. Several studies have explored the links between short sleep duration and early
puberty worldwide.
Objective: The current systematic review and meta-analysis aimed to evaluate the association between
sleep duration and early pubertal timing based on published evidence systematically.
Methods: We searched important electronic databases for articles that reported the association between
childhood sleep duration and puberty timing up to October 2020. A total of 848 papers were
identified from the databases and manual search. Finally, 10 studies including 23752 participants
were included in the meta-analysis. We calculated the pooled effect sizes using a random or fixed
effects model as appropriate.
Results: There was a significant inverse association between sleep duration and the risk of early puberty,
longer duration of sleep was associated with 0.34% decreased odds of early puberty (OR =
0.66, 95% CI = 0.58-0.77, I2 = 96.6%). In a subgroup analysis, when pubertal status was assessed
by physical examination compared with Pubertal Development Scale (PDS) or Sexual Maturation
Scale (SMS), the associations between sleep duration and age of puberty were attenuated. The
pooled OR (95% CI) of studies measuring pubertal timing by PDS/SMS and Tanner stage were
0.50(0.37-0.69) and 0.91(0.77-1.09), respectively. When pooling effect sizes was limited to studies
that had BMI level adjustment, the association of sleep duration and early puberty was not statistically
significant anymore (OR = 0.95, 95% CI = 0.89-1.01).
Conclusion: Longer sleep duration is associated with a lower risk of early puberty in children. The
association between sleep duration and risk of early puberty may be modified by other factors such
as BMI. To clarify the effect of sleep duration on the risk of early puberty in children, further prospective
studies are needed.
