Endocrine Abstracts

JOINT1927

Background: Delayed sleep patterns and the reversal of sleep-wake cycles, where children and adolescents sleep during the morning and remain awake at night, are increasingly prevalent. These disruptions can adversely affect endocrine function, growth, and development, highlighting the need for a comprehensive understanding of their physiological and developmental impacts.

Objective: To evaluate the effects of delayed sleep patterns and sleep-wake cycle reversal on growth hormone secretion, cortisol rhythms, pubertal hormones, glucose metabolism, and overall development in children and adolescents.

Methods: A systematic review of the literature published between 2000 and 2024 was conducted. A total of 12 studies, involving over 5,000 children and adolescents, were analyzed. Key studies addressing the impact of altered sleep patterns on endocrine function were identified and reviewed.

Results: Delayed sleep phase syndrome (DSPS) and delayed sleep-wake phase disorder (DSWPD) are associated with significant disruptions in endocrine function. Altered sleep patterns reduce growth hormone secretion, which predominantly occurs during slow-wave sleep, impairing linear growth and development. Cortisol secretion rhythms are disrupted, with increased evening cortisol levels impairing stress responses and metabolic functions. Pubertal hormones, including luteinizing hormone (LH) and follicle-stimulating hormone (FSH), are also affected, potentially delaying pubertal progression. Sleep disturbances also negatively impact glucose metabolism, leading to decreased glucose tolerance and insulin sensitivity. These changes may contribute to an increased risk of metabolic disorders in adolescents with persistent sleep misalignment.

Conclusion: Delayed sleep patterns and the reversal of sleep-wake cycles pose significant risks to endocrine function, growth, pubertal development, and metabolic health in children and adolescents. The misalignment of circadian rhythms disrupts critical hormonal processes, including growth hormone secretion, cortisol regulation, pubertal hormone synthesis, and glucose metabolism. Early identification and management of DSPS and DSWPD are essential to mitigate these risks and promote optimal development.