Date of Award

2026

Degree Type

Thesis

Degree Name

Master of Arts (MA)

Department

Psychology

First Advisor

Amy Bohnert

Abstract

Sleep undergoes a shift during puberty, increasing the risk for psychological and insomnia symptoms, particularly among girls. However, little research has examined how the onset of menarche may contribute to vulnerability in sleep and psychological functioning. The Sleep Health framework provides a standardized, multidimensional way to conceptualize sleep health (RU-SATED: satisfaction, alertness, timing, efficiency, duration, and regularity). Although prior studies have provided proof-of-concept for assessing sleep health using a composite score (SHc), its measurement properties have yet to be explored. The primary aims of this longitudinal study were to (1) evaluate the factor structure of a sleep health composite, (2) examine changes in sleep health, and (3) determine whether the SHc predicts psychological symptoms across the menarcheal transition among adolescent girls. Participants were adolescent girls recruited from a larger longitudinal study examining the trajectory of dysmenorrhea during puberty. Girls wore actigraphy devices and completed sleep diaries over seven days, along with self-report measures of anxiety and depressive symptoms. A multidimensional Sleep Health Composite was derived from actigraphy and sleep diary variables to represent several dimensions of sleep: satisfaction, alertness, timing, efficiency, duration, and regularity. One-factor confirmatory factor analyses were conducted, and longitudinal invariance tests were used to examine whether the SHc remained stable across menarche. Hierarchical stepwise regression analyses were conducted to examine whether the premenarcheal SHc predicted post-menarcheal anxiety and depressive symptoms. Results indicated that the factor structure of the SHc did not remain consistent across the menarcheal transition, suggesting that sleep health is captured differently before and after menarche. Mean-level changes were also observed within specific sleep health dimensions, including declines in duration and regularity, as well as overall sleep health (SHc), following the onset of menarche. The premenarcheal SHc did not predict post-menarcheal psychological symptoms. Overall, these findings highlight developmental shifts in sleep health around menarche and indicate that measurement tools capture these changes differently across development. This study underscores the importance of developing comprehensive assessment and treatment approaches to better understand sleep health and its relation to emerging psychological risk in adolescence.

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