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Understanding behavioral markers may support early identification and intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether poor sleep behaviors from childhood to adolescence are prospectively associated with a diagnosis of PCOS at age 14 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Sleep behavior data (Child Behavior Checklist) from a longitudinal study of 226 female participants of the Raine Study cohort (37 with PCOS), assessed at ages 5, -8, -10, and -14 years, with PCOS diagnosis at age 14 years were analyzed. PCOS diagnosis was based on both hyperandrogenism and ovulatory dysfunction according to the 2023 PCOS Guideline adolescent diagnostic criteria. Generalized estimating equations examined longitudinal sleep behavior differences by PCOS status at age 14; logistic regression explored specific sleep behavior associations with PCOS risk at age 14.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After adjustment for covariates, results showed higher sleep behavior problem scores from childhood to adolescence, with differences becoming more pronounced over time among girls with PCOS at age 14 (adjusted mean difference = 0.49; 95% CI = 0.10-0.87; P = .013). Analysis of individual items showed significant associations between PCOS at age 14 and \u201ctrouble sleeping\u201d at age 10 (odds ratio [OR] = 2.95; 95% CI = 1.30-6.69) and \u201csleeping less than most kids\u201d at age 10 (OR = 2.48; 95% CI = 1.18-5.22).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sleep difficulties may serve as early, modifiable behavioral markers of PCOS risk. Poor sleep may worsen hormonal and metabolic dysfunction, promoting insulin resistance, obesity, and sleep disturbances.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag078","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:43:49Z","timestamp":1771937029000},"page":"e2006-e2017","source":"Crossref","is-referenced-by-count":1,"title":["Childhood sleep behaviors and polycystic ovary syndrome risk in adolescence: the Raine study cohort longitudinal study"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1139-1086","authenticated-orcid":false,"given":"Nur K","family":"Abdul Jafar","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, Monash University , Clayton, VIC 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2446-3814","authenticated-orcid":false,"given":"Joanne 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