INTRODUCTION Sex differences in mental health emerge during adolescence, a period marked by the onset and the establishment of menstrual cycle. However, is rarely examined how menstrual cycle regularity, a marker of hormonal function, modulates mental health. OBJECTIVE to analyse sex differences in mental health symptoms among adolescents considering the menstrual cycle regularity and sleep. METHODS A three-group design (female students with regular cycles/FR, n=77; with irregular cycles/FI, n=59; and male students/M, n=76) in a sample of Brazilian high-school adolescents (n=212; 14–18 years) enrolled in morning and full-time classes was used to test the hypothesis that mental health symptoms follow a graded pattern across these groups. RESULTS Mean DASS-21 scores across all groups fell at or above the Mild severity threshold for mental health subscales. GLMs confirmed a monotonic gradient increase in group order (M→FR→FI) which was associated with higher scores on all outcomes (stress β/step=4.33, p<.001; anxiety β/step=4.08, p<.001; and depression β/step=2.34, p=.010; model R²=.16, .13, .08 respectively). However, no differences were observed in sleep duration, social jetlag, chronotype, sleep quality, or sleep-debt. Then, a secondary analysis assessed sex-specific associations between socioeconomic status (SES) and mental health; higher SES was inversely related to stress, anxiety, and depression, being protective only in males (stress Males β=−2.68, p=.011/Females β=0.46, p=.614). CONCLUSION These findings support the reframing of menstrual irregularity not only as a reproductive health concern but also as a biological determinant of mental health risk in female adolescents, a vulnerability that sleep disruption and socioeconomic resources do not adequately explain.
F. M. C. Diogo, Lucas G. S. França, M. Leocadio-Miguel et al.· bioRxiv· 0 citations
The phase delay on the sleep-wake cycle resulting from biopsychosocial changes related with adolescence is exacerbated by the level of urbanization. However, early school start times conflict with this delay, leading to several negative consequences. This study aims to compare sleep habits and quality, daytime sleepiness, and attention between adolescents from morning and afternoon shifts across different urbanization levels. A total of 159 Brazilian adolescents from technical high school (15.3 ± 0.8 years old; 101 girls/58 boys) completed the following questionnaires: "Health and Sleep," the Pittsburgh Sleep Quality Index, and the Pediatric Daytime Sleepiness Scale, in addition to a 10-d sleep diary that included the Maldonado Sleepiness Scale. Attention was evaluated by a continuous performance task. Sleep and attention were compared between shifts (Morning: n = 78/Afternoon: n = 81) and degrees of urbanization (High: n = 97/Low: n = 62) using MANCOVA. Independent of urbanization level, morning-shift students woke-up earlier, had a shorter time in bed at night and over a 24-h period (nocturnal sleep + nap), showing higher irregularities in wake-up times, along with higher sleep debt at night and over 24-h, social jetlag, daytime sleepiness, sleepiness upon wake-up time, frequency of naps, and non-spontaneous waking during the week than those in the afternoon shift. However, there were no differences in attention performance. Independent of shift, students from higher urbanization regions showed later bed and wake-up times and a shorter time in bed at night and over 24 h on weekends, and higher sleepiness upon wake-up time on weekdays. Despite longer reaction time in phasic alertness and selective attention, they showed a lower percentage of wrong responses in tonic and phasic alertness, selective attention, and a higher time‑on‑task stability. Thus, early school starting time is a strong modulator for adolescents' sleep-wake cycle regardless of the urbanization level. Further studies are necessary to analyze the relationship between attention and school shift.
Z. C. M. Bessa, F. M. C. Diogo, A. M. Câmara et al.· Chronobiology International· 0 citations
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