The study found that individuals who underwent gender-affirming therapies were less likely to experience sleep disorders, indicating a potential protective effect.
A study led by Michigan Medicine has found that transgender and gender-nonconforming teens and young adults are four times more likely to have a sleep disorder than cisgender youth. The study analyzed claims data from over 1.2 million individuals aged 12 to 25, including 2,603 who identified as transgender or gender-nonconforming.
The results, published in the Journal of Clinical Sleep Medicine, show that transgender youth have a 5.4 times higher likelihood of insomnia and a three times higher likelihood of sleep apnea or other sleep disorders.
Sleep health has rarely been examined in transgender and gender-nonconforming youth, but these results show a concerning number of individuals with disorders that harm sleep quality, says first author Ronald Gavidia, M.D., M.S., sleep medicine physician in the University of Michigan Health Department of Neurology’s Division of Sleep Medicine and an assistant professor of neurology at U-M Medical School.
“Given this higher prevalence of sleep disorders in relation to cisgender youth, clinicians should consider screening and testing this population for such disorders,” Gavidia said.
Reports on transgender youth and adults have shown a high prevalence of depression and anxiety symptoms, which are known to affect sleep quality and health. Researchers suspect suboptimal mental health may contribute to the association between transgender and gender-nonconforming identity and insomnia.
“Transgender and gender-nonconforming identity may precede mental health disorders and both influence insomnia diagnosis,” said senior author Galit Levi Dunietz, Ph.D., M.P.H., an epidemiologist in the Department of Neurology’s Division of Sleep Medicine and assistant professor of neurology at U-M Medical School.
Of transgender youth in the study, more than half had pursued gender-affirming therapy. That group was half as likely to have any sleep disorder than transgender individuals who did not pursue the therapy.
Gender-affirming therapy, the authors conclude, could be protective against worsening sleep health brought about by psychological stressors from prejudice and discrimination against the transgender community.
“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.
Researchers say future studies should further examine the burden of sleep disorders prior to and following gender-affirming therapy for these populations.
Reference: “Gender identity and transition: relationships with sleep disorders in US youth” by Ronald Gavidia, MD, MS, Daniel G. Whitney, Ph.D., Shelley Hershner, MD, Ellen M. Selkie, MD, MPH, Riva Tauman, MD and Galit Levi Dunietz, Ph.D., MPH, 1 November 2022, Journal of Clinical Sleep Medicine.
The study was funded by the National Institute of Neurological Disorders and Stroke, the University of Michigan Office of Health Equity and Inclusion Diversity Fund, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute.