Sex hormones, insomnia, and sleep quality: subjective sleep in the first year of hormone use 147 3.4. Sleep- and wake durations In the trans men, the reported total sleep time (TST) and sleep onset latency (SOL) do not show changes in either the adjusted or unadjusted models after 12 months of GAHT. However, trans men’s reported sleep efficiency (SE) is estimated to decrease by 2.8% (95% CI: -5.5; -0.2) in the unadjusted model and by 2.7% (95% CI: -5.7; 0.2) in the adjusted model. In the trans women, the reported TST and SE do not show significant changes after 12 months of GAHT, but their reported SOL is an estimated 9 minutes shorter (95% CI: -15; -3) in the unadjusted model and 10 minutes shorter (95% CI: -17; -3) in the adjusted model. Figure 5.3 also displays the estimated values and 95% confidence intervals of the TST, SOL, and SE per measurement time point and group. Figure 5.3. Pittsburgh Sleep Quality Index (PSQI) outcomes per hormone user group and measurement timepoint, each panel displays the estimated group means and 95% confidence intervals from the unadjusted models. Panel A displays reported total sleep time (TST), panel B displays reported sleep onset latency (SOL) and panel C displays reported sleep efficiency (SE). Dotted lines and asterisks indicate significant changes (p<0.05) within the group after 12 months of Gender-Affirming Hormone Therapy (GAHT); the SOL significantly decreases in the trans women and the SE significantly decreases in the trans men.
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