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Current Pediatric Reviews


ISSN (Print): 1573-3963
ISSN (Online): 1875-6336


Association between Sleep Duration and Early Pubertal Timing in Children and Adolescents: A Systematic Review and Meta-analysis

Author(s): Nafiseh Mozafarian, Maryam Yazdi, Mahin Hashemipour*, Silva Hovsepian and Mohammad Reza Maracy*

Volume 19, Issue 3, 2023

Published on: 14 September, 2022

Page: [318 - 328] Pages: 11

DOI: 10.2174/1573396318666220819145346

Price: $65


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.

Keywords: Early pubertal, timing, sleep duration, systematic, review, meta-analysis, children and adolescents.

« Previous
Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969; 44(235): 291-303.
[] [PMID: 5785179]
Oerter Klein K. Precocious puberty: Who has it? Who should be treated? J Clin Endocrinol Metab 1999; 84(2): 411-4.
[] [PMID: 10022393]
Sørensen K, Mouritsen A, Aksglaede L, Hagen CP, Mogensen SS, Juul A. Recent secular trends in pubertal timing: Implications for eval-uation and diagnosis of precocious puberty. Horm Res Paediatr 2012; 77(3): 137-45.
[] [PMID: 22508036]
Islam MS, Hussain MA, Islam S, Mahumud RA, Biswas T, Islam SMS. Age at menarche and its socioeconomic determinants among fe-male students in an urban area in Bangladesh. Sex Reprod Healthc 2017; 12: 88-92.
[] [PMID: 28477938]
Euling SY, Herman ME, Lee PA, et al. Examination of US puberty timing data from 1940 to 1994 for secular trends: Panel findings. Pediatrics 2008; 121 (Suppl. 3): S172-91.
[] [PMID: 18245511]
Abreu AP, Kaiser UB. Pubertal development and regulation. Lancet Diabetes Endocrinol 2016; 4(3): 254-64.
[] [PMID: 26852256]
Herman ME, Steffes J, Harris D, et al. Secondary sexual characteristics in boys: Data from the pediatric research in office settings net-work. Pediatrics 2012; 130(5): e1058-68.
[] [PMID: 23085608]
Eckert LC, Busch AS, Petersen JH, et al. Worldwide secular trends in age at pubertal onset assessed by breast development among girls: A systematic review and meta analysis. Jama Pediatrics 2020; 174(4), 195881.
Kim Y, Je Y. Early menarche and risk of metabolic syndrome: A systematic review and meta-analysis. J Womens Health (Larchmt) 2019; 28(1): 77-86.
[] [PMID: 30285527]
Cheng TS, Day FR, Lakshman R, Ong KK. Association of puberty timing with type 2 diabetes: A systematic review and meta-analysis. PLoS Med 2020; 17(1), e1003017.
[] [PMID: 31905226]
Prentice P, Viner RM. Pubertal timing and adult obesity and cardiometabolic risk in women and men: A systematic review and meta-analysis. International journal of obesity 2013; 37(8): 1036-43.
Bubach S, De Mola CL, Hardy R, Dreyfus J, Santos AC, Horta BL. Early menarche and blood pressure in adulthood: Systematic review and meta-analysis. J Public Health (Oxf) 2018; 40(3): 476-84.
[] [PMID: 28977577]
Chen X, Liu Y, Sun X, et al. Age at menarche and risk of all cause and cardiovascular mortality: A systematic review and dose response meta analysis. Menopause 2019; 26(6): 670-6.
[] [PMID: 30562317]
Day FR, Elks CE, Murray A, Ong KK, Perry JRB. Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: The UK Biobank study. Sci Rep 2015; 5(1): 11208.
[] [PMID: 26084728]
Hardy R, Kuh D, Whincup PH, Wadsworth MEJ. Age at puberty and adult blood pressure and body size in a British birth cohort study. J Hypertens 2006; 24(1): 59-66.
[] [PMID: 16331102]
Ong KK, Bann D, Wills AK, et al. Timing of voice breaking in males associated with growth and weight gain across the life course. J Clin Endocrinol Metab 2012; 97(8): 2844-52.
[] [PMID: 22654120]
Hoyt LT, Niu L, Pachucki MC, Chaku N. Timing of puberty in boys and girls: Implications for population health. SSM Popul Health 2020; 10, 100549.
[] [PMID: 32099893]
Zhu J, Kusa TO, Chan YM. Genetics of pubertal timing. Curr Opin Pediatr 2018; 30(4): 532-40.
[] [PMID: 29771761]
Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP. The timing of normal puberty and the age limits of sexual precocity: Variations around the world, secular trends, and changes after migration. Endocr Rev 2003; 24(5): 668-93.
[] [PMID: 14570750]
Golestanzadeh M, Riahi R, Kelishadi R. Association of phthalate exposure with precocious and delayed pubertal timing in girls and boys: A systematic review and meta analysis. Environ Sci Process Impacts 2020; 22(4): 873-94.
[] [PMID: 32091510]
Diao H, Wang H, Yang L, Li T. The association between sleep duration, bedtimes, and early pubertal timing among Chinese adolescents: A cross sectional study. Environ Health Prev Med 2020; 25(1): 21.
[] [PMID: 32560630]
Tiyuri A, Ghannadkafi M, Tiyuri A, Bahramian N. Age at menarche and its related factors among students of Qaen, Eastern Iran: A school based cross sectional study. J Comp Pedia 2019; 10(3)
Tremblay L, Frigon JY. Precocious puberty in adolescent girls: A biomarker of later psychosocial adjustment problems. Child Psychiatry Hum Dev 2005; 36(1): 73-94.
[] [PMID: 16049645]
Murata K, Araki S. Menarche and sleep among Japanese schoolgirls: An epidemiological approach to onset of menarche. Tohoku J Exp Med 1993; 171(1): 21-7.
[] [PMID: 8122255]
Foley JE, Ram N, Susman EJ, Weinraub M. Changes to sleep wake behaviors are associated with trajectories of pubertal timing and tempo of secondary sex characteristics. J Adolesc 2018; 68(1): 171-86.
[] [PMID: 30099236]
Lipsey MW, Wilson DB. Practical meta analysis. (2nd ed.), Thousand Oaks, CA: Sage Publications 2001.
Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann Intern Med 2007; 147(8): 573-7.
[] [PMID: 17938396]
Borenstein M, Hedges L, Rothstein H. Meta analysis: Fixed effect vs. random effects Meta-analysis com 2007.
Cho GJ, Park HT, Shin JH, et al. Age at menarche in a Korean population: Secular trends and influencing factors. Eur J Pediatr 2010; 169(1): 89-94.
[] [PMID: 19504269]
Mary AC, Harvey K, Duke P, Thomas FA, Iris FL, William CD. Pubertal changes in daytime sleepiness. Sleep 1980; 2(4): 453-60.
[] [PMID: 7403744]
Murdey ID, Cameron N, Biddle SJH, Marshall SJ, Gorely T. Pubertal development and sedentary behaviour during adolescence. Ann Hum Biol 2004; 31(1): 75-86.
[] [PMID: 14742166]
Scholle S, Beyer U, Bernhard M, et al. Normative values of polysomnographic parameters in childhood and adolescence: Quantitative sleep parameters. Sleep Med 2011; 12(6): 542-9.
[] [PMID: 21601520]
Sadeh A, Dahl RE, Shahar G, Rosenblat SS. Sleep and the transition to adolescence: A longitudinal study. Sleep 2009; 32(12): 1602-9.
[] [PMID: 20041596]
Pesonen AK, Martikainen S, Heinonen K, et al. Continuity and change in poor sleep from childhood to early adolescence. Sleep 2014; 37(2): 289-97.
[] [PMID: 24497657]
Randler C, Bilger S, Díaz MJF. Associations among sleep, chronotype, parental monitoring, and pubertal development among German adolescents. J Psychol 2009; 143(5): 509-20.
[] [PMID: 19943401]
Lin-li P, Hong W, Fang H, Xu TC. Association between age of first spermatorrhea and physical activity or sleeping time in boys. J Shanghai Jiaotong Univ 2017; 37(3): 394.
Wen B, Dong Y-H, Yang Z-G, Li Y-H, Dong B, Ma J. Association between sleeping time and age at spermarche among Chinese boys aged 11-18 year. Chin J School Health 2018; 39(8): 1140-3.
Li KQ, Wang H, Guo J, Yuan BC, Guan PY. Associated factors related to first spermatorrhea and menarche among high and primary school students, in Chongqing. Zhonghua Liu Xing Bing Xue Za Zhi 2016; 37(2): 169-73.
[PMID: 26917508]
Deng X, He M, He D, Zhu Y, Zhang Z, Niu W. Sleep duration and obesity in children and adolescents: Evidence from an updated and dose response meta analysis. Sleep Med 2021; 78: 169-81.
[] [PMID: 33450724]
Miller MA, Kruisbrink M, Wallace J, Ji C, Cappuccio FP. Sleep duration and incidence of obesity in infants, children, and adolescents: A systematic review and meta analysis of prospective studies. Sleep 2018; 41(4), zsy018.
[] [PMID: 29401314]
Cappuccio FP, Taggart FM, Kandala NB, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008; 31(5): 619-26.
[] [PMID: 18517032]
Fatima Y, Doi SAR, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: A systematic review and bias-adjusted meta-analysis. Obes Rev 2015; 16(2): 137-49.
[] [PMID: 25589359]
Lee Y, Styne D. Influences on the onset and tempo of puberty in human beings and implications for adolescent psychological develop-ment. Horm Behav 2013; 64(2): 250-61.
[] [PMID: 23998669]
Shalitin S, Phillip M. Role of obesity and leptin in the pubertal process and pubertal growth a review. Int J Obes 2003; 27(8): 869-74.
[] [PMID: 12861226]
Ahima RS, Dushay J, Flier SN, Prabakaran D, Flier JS. Leptin accelerates the onset of puberty in normal female mice. J Clin Invest 1997; 99(3): 391-5.
[] [PMID: 9022071]
Spiegel K, Tasali E, Penev P, Cauter EV. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141(11): 846-50.
[] [PMID: 15583226]
Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004; 1(3), e62.
[] [PMID: 15602591]
Mosavat M, Mirsanjari M, Arabiat D, Smyth A, Whitehead L. The role of sleep curtailment on leptin levels in obesity and diabetes melli-tus. Obes Facts 2021; 14(2): 214-21.
[] [PMID: 33756469]
Kim H, Kang I, Choe W, Yoon KS. Sleep duration and risk of obesity: A genome and epidemiological study. World Acad Sci J 2021; 3(2): 20.
Fu J, Wang Y, Li G, et al. Childhood sleep duration modifies the polygenic risk for obesity in youth through leptin pathway: The Beijing child and adolescent metabolic syndrome cohort study. Int J Obes 2019; 43(8): 1556-67.
[] [PMID: 31285522]
Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between obesity and puberty timing: A systematic review and meta-analysis. Int J Environ Res Public Health 2017; 14(10): 1266.
[] [PMID: 29064384]
Busch AS, Højgaard B, Hagen CP, Teilmann G. Obesity is associated with earlier pubertal onset in boys. J Clin Endocrinol Metab 2020; 105(4): e1667-72.
[] [PMID: 31761939]
Mozaffarian N, Heshmat R, Ataie JA, et al. Association of sleep duration and snack consumption in children and adolescents: The CAS-PIAN‐V study. Food Sci Nutr 2020; 8(4): 1888-97.
[] [PMID: 32328254]
Chaput JP, Katzmarzyk PT, LeBlanc AG, et al. Associations between sleep patterns and lifestyle behaviors in children: An international comparison. Int J Obes Suppl 2015; 5(S2): S59-65.
[] [PMID: 27152187]
Córdova FV, Barja S, Brockmann PE. Consequences of short sleep duration on the dietary intake in children: A systematic review and metanalysis. Sleep Med Rev 2018; 42: 68-84.
[] [PMID: 30001805]
Soliman A, De Sanctis V, Elalaily R. Nutrition and pubertal development. Indian J Endocrinol Metab 2014; 18(7): 39.
[] [PMID: 25538876]
Villamor E, Jansen EC. Nutritional determinants of the timing of puberty. Annu Rev Public Health 2016; 37(1): 33-46.
[] [PMID: 26789387]
Chen C, Chen Y, Zhang Y, et al. Association between dietary patterns and precocious puberty in children: A population based study 2018 2018; 4528704.
Cheng G, Buyken AE, Shi L, et al. Beyond overweight: Nutrition as an important lifestyle factor influencing timing of puberty. Nutr Rev 2012; 70(3): 133-52.
[] [PMID: 22364156]
Rogers IS, Northstone K, Dunger DB, Cooper AR, Ness AR, Emmett PM. Diet throughout childhood and age at menarche in a contempo-rary cohort of British girls. Public Health Nutr 2010; 13(12): 2052-63.
[] [PMID: 20529402]
Berkey CS, Gardner JD, Frazier AL, Colditz GA. Relation of childhood diet and body size to menarche and adolescent growth in girls. Am J Epidemiol 2000; 152(5): 446-52.
[] [PMID: 10981459]
Nguyen NTK, Fan HY, Tsai MC, et al. Nutrient intake through childhood and early menarche onset in girls: Systematic review and meta analysis. Nutrients 2020; 12(9): 2544.
[] [PMID: 32842616]
Marco CA, Wolfson AR, Sparling M, Azuaje A. Family socioeconomic status and sleep patterns of young adolescents. Behav Sleep Med 2012; 10(1): 70-80.
[] [PMID: 22250780]
Hale L. Who has time to sleep? J Public Health (Oxf) 2005; 27(2): 205-11.
[] [PMID: 15749721]
Tomfohr-Madsen L, Cameron EE, Dhillon A, et al. Neighborhood socioeconomic status and child sleep duration: A systematic review and meta-analysis. Sleep Health 2020; 6(5): 550-62.
[] [PMID: 32335039]
Knutson KL, Lauderdale DS. Sociodemographic and behavioral predictors of bed time and wake time among US adolescents aged 15 to 17 years. J Pediatr 2009; 154(3): 426-30.
Zhang J, Xu J, Liu L, et al. The prevalence of premature thelarche in girls and gynecomastia in boys and the associated factors in children in Southern China. BMC Pediatr 2019; 19(1): 107.
[] [PMID: 30975105]
Hiatt RA, Stewart SL, Hoeft KS, et al. Childhood socioeconomic position and pubertal onset in a cohort of multiethnic girls: Implications for breast cancer. Cancer Epidemiol Biomarkers Prev 2017; 26(12): 1714-21.
[] [PMID: 28939588]
Deardorff J, Abrams B, Ekwaru JP, Rehkopf DH. Socioeconomic status and age at menarche: An examination of multiple indicators in an ethnically diverse cohort. Ann Epidemiol 2014; 24(10): 727-33.
[] [PMID: 25108688]
James TT, Tehranifar P, Rich EJ, Titievsky L, Terry MB. The impact of socioeconomic status across early life on age at menarche among a racially diverse population of girls. Ann Epidemiol 2010; 20(11): 836-42.
[] [PMID: 20933190]
Calthorpe L, Brage S, Ong KK. Systematic review and meta‐analysis of the association between childhood physical activity and age at menarche. Acta Paediatr 2019; 108(6): 1008-15.
[] [PMID: 30588652]
Carwile JL, Willett WC, Spiegelman D, et al. Sugar sweetened beverage consumption and age at menarche in a prospective study of US girls. Hum Reprod 2015; 30(3): 675-83.
[] [PMID: 25628346]
Wohlfahrt VC, Mouritsen A, Hagen CP, et al. Pubertal onset in boys and girls is influenced by pubertal timing of both parents. J Clin Endocrinol Metab 2016; 101(7): 2667-74.
[] [PMID: 27014950]
Chen Y, Liu Q, Li W, Deng X, Yang B, Huang X. Association of prenatal and childhood environment smoking exposure with puberty timing: A systematic review and meta-analysis. Environ Health Prev Med 2018; 23(1): 33.
[] [PMID: 30021511]
Windham GC, Lum R, Voss R, et al. Age at pubertal onset in girls and tobacco smoke exposure during pre and postnatal susceptibility windows. Epidemiology 2017; 28(5): 719-27.
[] [PMID: 28661938]
Brix N, Ernst A, Lauridsen LLB, et al. Maternal pre pregnancy body mass index, smoking in pregnancy, and alcohol intake in pregnancy in relation to pubertal timing in the children. BMC Pediatr 2019; 19(1): 338.
[] [PMID: 31526385]

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