Association between sleep quality in adolescence and dysmenorrhea severity in young adulthood: A prospective cohort study.

OBJECTIVE: To prospectively investigate the association between adolescent sleep quality and dysmenorrhea severity in young adulthood, and assess the moderating effect of initial dysmenorrhea status. METHODS: We used data from 614 girls in the Amsterdam Born Children and their Development study. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) at ages 15 to 16. Dysmenorrhea severity was assessed by modified Menstrual Disorder of Teenagers (MDOT) questionnaire at ages 19 to 20. Modified Poisson regression and multivariate logistic regression models were conducted to examine the association between overall sleep quality and its components and dysmenorrhea severity, while controlling for demographic, reproductive, psychosocial, and lifestyle factors. The moderation function of initial dysmenorrhea status was assessed by adding interaction term with sleep quality into models. RESULTS: At ages 19 to 20, 77.7% (n=477) girls reported moderate/severe dysmenorrhea. At the beginning of the study, 45.5% (n=261) reported poor sleep quality at ages 15 to 16, of whom 84.3% (n=220) reported moderate/severe dysmenorrhea. Poor sleep quality (RR: 1.08, 95% CI: 0.99-1.19), global PSQI score (RR: 1.02, 95% CI: 1.01-1.04), longer sleep latency (RR: 1.05, 95% CI: 1.01-1.10), and lower sleep efficiency (RR: 1.11, 95% CI: 1.06-1.17) were associated with greater dysmenorrhea severity later in life. The effect of poor sleep quality was attenuated among girls with baseline dysmenorrhea at ages 15 to 16. CONCLUSIONS: Poorer sleep quality in adolescence, particularly longer sleep latency and lower sleep efficiency, is prospectively associated with increased dysmenorrhea severity in young adulthood. These findings suggest that sleep problems may be a potential risk factor for the development of dysmenorrhea.