Childhood Sleep Behaviours and Polycystic Ovary Syndrome Risk in Adolescence: The Raine Study Cohort Longitudinal Study

Abstract Background Sleep disturbances are common in women with polycystic ovary syndrome (PCOS), but no prospective studies have explored whether childhood-adolescence sleep disturbances are associated with later PCOS risk. Understanding behavioural markers may support early identification and intervention. Objective To examine whether poor sleep behaviours from childhood to adolescence are prospectively associated with a diagnosis of PCOS at age 14 years. Materials and methods Sleep behaviour data (Child Behavior Checklist) from a longitudinal study of 226 female participants of the Raine Study cohort (37 with PCOS), assessed at ages 5, -8, -10, and -14 years, with PCOS diagnosis at age 14 years were analyzed. PCOS diagnosis was based on both hyperandrogenism and ovulatory dysfunction according to the 2023 PCOS Guideline adolescent diagnostic criteria. Generalized estimating equations examined longitudinal sleep behaviour differences by PCOS status at age 14; logistic regression explored specific sleep behaviour associations with PCOS risk at age 14. Results After adjustment for covariates, results showed higher sleep behaviour problem scores from childhood to adolescence, with differences becoming more pronounced over time among girls with PCOS at age 14 (adjusted mean difference=0.49; 95% CI=0.10–0.87; P=0.013). Analysis of individual items showed significant associations between PCOS at age 14 and ‘trouble sleeping’ at age 10 (OR=2.95; 95% CI=1.30-6.69) and ‘sleeping less than most kids’ at age 10 (OR=2.48; 95% CI=1.18 to 5.22). Conclusion Sleep difficulties may serve as early, modifiable behavioural markers of PCOS risk. Poor sleep may worsen hormonal and metabolic dysfunction, promoting insulin resistance, obesity, and sleep disturbances.