Characteristics of transgender health-related provider-to-provider consultations in Brazil's public primary health care system: A cross-sectional study from a Southern Brazilian telehealth service.

Adolescence marks a period of drastic biological and social changes (). Sleep plays an indispensable role in adolescent health and functioning during this critical developmental period (). Despite this, the existing literature on adolescent sleep has primarily focused on cross-sectional comparisons between ethnic/racial groups (; ; ). Less clear is how sleep duration changes over time across different ethnic/racial groups. Additionally, there is limited research documenting developmental trajectories of changes and stability in sleep during this period. Examining developmental patterns allows for more accurate representations of within-person trajectories in sleep duration (). Considering initial levels and rates of change is important given prior evidence that insufficient sleep duration has been associated with greater depressive symptoms and poorer academic outcomes (). This study addresses these gaps by using linear growth modeling to examine levels of sleep duration and rates of change across the three years of high school among racially/ethnically diverse adolescents. Adolescents are vulnerable to sleep deprivation due to rapid biological and social changes at this development stage (). Chronic adolescent sleep deprivation has emerged as a national and global epidemic in the past decade (). The prevalence of short sleep (i.e., getting less than 8 hours of sleep on average) has increased to 78% of United States adolescents from 2009 (69%) to 2019 (), with 70% U.S. adolescents reporting short sleep on school nights (). This pervasive sleep deprivation among U.S. youth has garnered increasing public attention (). Sleep insufficiency is detrimental to youth, leading to behavioral deficits, poor mood, struggles in academic performance, and chronic health issues (). Sleep-deprived adolescents are particularly susceptible to sleep-related health consequences such as obesity, cardiovascular dysfunction, and immune deficiency (). Prior empirical evidence has shown sleep duration to decline after the transition into adolescence (). Many have attributed this decline to the slowing of homeostatic pressure and pubertal maturation as well as later bedtimes, increased homework, and extracurriculars () that often occurs during the transition to adolescence. In addition, more recent studies have highlighted the increasing prevalence of social media use among U.S. youth, which has been found to be associated with shortened sleep duration (; ). Although many adolescents seem to suffer from sleep insufficiency, studies have also shown evidence of ethnic/racial disparities in sleep duration among U.S. youth (). One review of 23 studies found that children and ethnically/racially minoritized adolescents tend to sleep less compared to their White peers (). Relative to their White peers, Asian adolescents slept 41 minutes less, Latiné adolescents slept 23 minutes less, and Black adolescents reported a difference of 25 to 28 minutes less sleep (). Consistent with these findings, a recent review of 23 studies suggested that White youth had the best average sleep duration, followed by Asian youth, then Latiné youth, and Black youth having the shortest sleep duration across all ethnic/racial groups (). This pattern has been supported by recent research (, ). Most of the work on ethnic/racial sleep disparities has focused on differences between ethnically/racially minoritized and White individuals. However, it is also important to examine differences between ethnically/racially minoritized adolescents (). Such research investigating ethnic/racial differences between ethnically/racially minoritized adolescents can help disaggregate and expand on the current understanding of sleep health disparities ().