0730 Polysomnographic characteristics among transgender adults; Influence of gender-affirming hormone therapy

Abstract

Abstract Introduction Gender differences in polysomnographic characteristics (PC) among cisgender people may be influenced by gonadal hormones. Data on PC among transgender people (TP) receiving or not gender-affirming hormone therapy (GAHT) is sparse. This study aimed to describe PC among TP and explore associations between gender identity (GI), GAHT, and PC. Methods This cross-sectional study identified TP at a large academic sleep medicine center through medical record review. We included TP aged ≥18 years with available polysomnography data. The sample was stratified by GI (transfeminine and transmasculine) and further classified by GAHT use. Descriptive statistics were calculated for GI and GAHT groups. Linear regression models adjusted for age, obstructive sleep apnea, and depression diagnoses were utilized to examine associations between GI, GAHT, and PC (total sleep time [TST], sleep onset latency, rapid eye movement sleep latency [REMSL], arousal index, wake after sleep onset [WASO], sleep stage rapid eye movent [REM], non-REM [N] 1, 2, and 3 percentage, sleep efficiency, and periodic limb movement index [PLMI]). Results Seventy-seven individuals met inclusion criteria. Of these, 52% were transfeminine, mean age was 39.2±13.3 years, mean body mass index was 35.1±9.0 Kg/m2, and 56% used GAHT. Transmasculine people had significantly higher stage N3% (13.9±13.6 vs 7.7±10.0%), and lower PLMI (3.5±5.8 vs 10.6±18.6/h) compared to transfeminine participants. Among transmasculine people, REMSL was shorter in participants using GAHT compared to those not on GAHT (145.0±66.9 vs 217.1±104.1 minutes). In transfeminine people, stage N3% and REMSL were increased in those on GAHT compared to individuals not on GAHT (10.6±11.5 vs 4.9±7.7%; 214.8±126.9 vs 133.6±85.5 minutes, respectively), although not statistically significant. Adjusted analysis showed associations between transmasculine identity and decreased TST (β=-42.8, 95% CI [-84.7, -0.9] minutes), feminizing GAHT use and longer REMSL (β=84.2, 95% CI [0.1, 168.4] minutes), and suggested decreased REMSL and WASO with masculinizing GAHT use (β=-59.4, 95% CI [-134.2,15.3]; β=-28.7, 95% CI [-72.5, 15.0] minutes respectively). Conclusion This report highlights differential associations between GI, GAHT, and PC in TP. Despite some enhanced PC, transmasculine identity significantly decreased TST. In addition, feminizing GAHT contributed to mixed PC outcomes, while masculinizing GAHT appeared to improve them. Support (if any) None