A - 50 Menstruation Problems and Sleep Interactions: Implications for the Mental Health of Adolescent Females

Abstract Objective Adolescent females frequently experience internalizing symptoms like sadness and anxiety during this developmental period of hormonal, emotional, and sleep changes. However, the interaction between sleep, menstruation-related challenges, and internalizing symptoms is not currently understood. Methods Data from 2814 postmenarcheal female adolescents (Year 3, Mean-age = 13.03, [12–15] years) in the ABCD Study® were analyzed. Internalizing symptom scores were obtained from the Brief Problem Monitor and menstrual cycle characteristics were obtained from a customized questionnaire. The Munich Chronotype Questionnaire measured sleep duration and bedtime. Linear mixed-effect models explored the relationship between menstrual problems, sleep, and internalizing symptoms, with covariates including time since menarche, body mass index, parental education, and socio-demographic factors. Results Among adolescent females, greater internalizing problems were associated with menstrual cycle irregularity (p < 0.01), more premenstrual symptoms (p < 0.01), shorter sleep duration (p < 0.01) and later bedtimes (p < 0.01). Those with longer menstrual periods (p < 0.01) and heavier flow (p < 0.01) exhibited higher levels of internalizing symptoms, particularly in those with short sleep duration (p = 0.016, p = 0.003). Additionally, more intense menstrual pain (p < 0.01) and its significant impact on daily activities (p < 0.01) were linked to more internalizing problems; these relationships were both moderated by later bedtimes (pain x bedtime p = 0.004; pain impact x bedtime p = 0.002). Conclusion Internalizing symptoms are associated with menstrual cycle characteristics and menstrual pain in female adolescents, especially in those with shorter sleep and later bedtimes. The relationship between the menstrual cycle, sleep, and psychophysiology needs to be integrated in healthcare practice to promote well-being and resilience in young female adolescents.