Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study

Abstract

Background Increased incidence of central precocious puberty (CPP) after coronavirus infectious disease-19 lockdown has been reported. Our study aims in investigating changes in CPP rates and in sleep patterns in CPP and healthy controls. Methods CPP were retrospectively evaluated from April 2020 to April 2021. Parents of girls diagnosed with CPP during lockdown and of matched healthy controls filled out a questionnaire about sleep disturbances (SDSC questionnaire) and sleep schedules. Results Thirty-five CPP and 37 controls completed the survey. Incidence of new CPP cases significantly increased in 2020–2021 compared to 2017–2020 (5:100 vs 2:100, p = 0.02). Sleep disturbance rates did not differ between CPP and healthy controls before lockdown. During lockdown, CPP reported higher rates of sleep disturbs for total score (p = 0.005), excessive somnolence (p = 0.049), sleep breathing disorders (p = 0.049), and sleep–wake transition disorders (p = 0.005). Moreover, CPP group more frequently shifted toward later bedtime (p = 0.03) during lockdown compared to controls. Hours of sleep and smartphone exposure around bedtime did not differ between groups. Conclusions Our study confirms the observation of increased incidence of CPP after lockdown measures. Additionally, CPP showed higher rates of sleep disturbances and later bedtime compared to controls. The causality link between sleep disturbances and CPP should be further investigated to gain knowledge in this association.

Precocious puberty under stressful conditions: new understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic

“…This study did not find any differences in anthropometric parameters ( 105 ). Subsequently, other Italian groups ( 108 , 118 , 119 , 122 – 124 ) reported similar results. Turriziani Colonna A et al.…”

“…reported a high rate (48.9%) of RPPP in females with CPP during the COVID-19 outbreak, with an increased number of children at Tanner stages 3 and 4-5 at diagnosis ( 118 ). Interestingly, another Italian group described, in subjects with CPP, a later bedtime with higher rates of sleep disturbances, such as excessive somnolence, sleep breathing disorders, and sleep–wake transition disorders ( 119 ). The collaborative Italian study by Chioma et al.…”

Precocious Puberty Diagnoses Spike, COVID-19 Pandemic, and Body Mass Index: Findings From a 4-year Study

“…A significant increase in those newly diagnosed with CPP in the first total lockdown (March–July 2020), compared with the same period in previous years (March–July 2015-2019; 37 vs 89) were reported by Stagi et al [ 1 ], as well as by Barberi et al [ 6 ], who found a significant increase of CPP diagnosed between March 2020 and April 2021 compared with the previous 13 months. Other authors [ 2 , 4 , 5 ] reported either a total increase of 108% of girls diagnosed between March and September 2020 compared with the same period of the previous year (246 vs 118) or a 2.5-fold higher incidence rate of CPP diagnosed in 12 months (April 2020–April 2021), compared with the 3 previous years (35 vs 34). Chioma et al [ 7 ], in turn, confirmed a 1.57-fold increase in the incidence of PP, together with a general change in daily habits during COVID-19, including a reduction of physical activity, an overall greater use of electronic devices, and behavioral changes.…”

COVID-19 lockdown and the rate of central precocious puberty

“…The Italian government imposed the national lockdown on March 9th, 2020: as of that moment, the population was compelled to stay at home. Among the consequences of this restrictive measure, it is important to point out a drastic change in children’s lifestyle, which lasted several months [ 9 ].…”

“…Several Italian and international studies have observed that the incidence of new cases of Central Precocious Puberty (CPP) increased significantly during this period of restrictions, especially in female subjects [ 9 – 15 ]; moreover, the rate of pubertal progression in patients already suffering from CPP also increased compared with the rate observed in the previous years [ 10 ]. Despite several hypotheses regarding the mechanism responsible for such an increased incidence of CPP cases following the 2020 lockdown have been put forward, the real pathogenic explanation has yet to be uncovered.…”