Puberty interacts with sleep and brain network organization to predict mental health.

Introduction: Along with pubertal development, the transition to adolescence brings about increased risk for sleep disturbances and mental health problems. Functional connectivity of overlapping large-scale brain networks, such as increased connectivity between the default mode and dorsal attention networks, has been reported to relate to both sleep and mental health problems. Clarifying whether pubertal development interacts with sleep disturbances and functional brain networks to predict mental health may provide information to improve the timing and design of interventions targeting sleep disturbances in adolescents.

Methods: To examine how pubertal status and tempo relate to sleep disturbances and shape the relationship between sleep disturbances and mental health problems, we harnessed a large sample of children aged 10-14 years from the Adolescent Brain and Cognitive Development (ABCD) Study (N ~ 3,000-10,000). We used graph theoretical tools to probe how pubertal development concurrently interacts with sleep disturbances and brain network organization to predict mental health problems.

Results: We found that advanced pubertal status, but not pubertal tempo, predicted sleep disturbances; however, both pubertal status and tempo interact with sleep disturbances to predict mental health problems and engage in three-way interactions with sleep and brain network organization to predict mental health problems.

Discussion: Overall, this work suggests that less advanced pubertal status and slower tempo are risk factors for the strongest links between sleep disturbances, brain organization, and mental health problems. Further, our findings speak to the importance of accounting for interactions in the constellation of factors that surround complex behavioral and clinical syndromes, here internalizing and externalizing disorders, and provide new context to consider for targeted interventions.