A biopsychosocial approach to sleep health during puberty: Individual and contextual aspects and the role of gender differences. A narrative review

Puberty is a period of rapid physical, psychological, and social development marked by significant hormonal shifts and brain reorganization. These changes influence various aspects of early adolescents’ lives, including sleep patterns. Sleep is essential for healthy development, impacting cognitive functions, psychological well-being, and physical health. During puberty, sleep-wake regulation undergoes substantial modifications, often leading to changes in subjective sleep quality, daytime alertness, sleep timing, efficiency, duration, and sleep-related behaviours. This review aims to examine the intricacies of sleep during puberty, taking a biopsychosocial approach to the factors at different levels that affect sleep health changes, including individual-level (hormonal, neurocognitive, and psychological), contextual-level (school, family, peers, and social media use), and cultural and environmental-level (social roles, socio-economic factors and cultural aspects), with a focus on the differences observed between boys and girls. Clinical implications for promoting sleep health and treating sleep difficulties in puberty will be discussed. Understanding the different factors affecting sleep health in puberty and the sex-specific sleep patterns is crucial for addressing the unique needs of pubertal girls and boys and promoting their overall well-being.