Does the timing of growth hormone injections affect children’s sleep quality?

The timing of growth hormone (GH) injections—whether in the morning or evening—does not affect children’s sleep quality or activity levels, according to a study that concluded that GH therapy can be administered at a time that best suits the family’s routine without compromising treatment effectiveness.

Researchers conducted an open-label, randomized crossover trial involving 20 children aged 5-14 years diagnosed with isolated growth hormone deficiency or idiopathic short stature. Each participant received GH injections for 2 weeks in the evening and 2 weeks in the morning. Sleep-wake patterns and activity levels were assessed using a 7-day actigraphy device during the second week of each treatment schedule.

Results showed no significant differences in sleep quality between morning and evening injections. Total sleep time, sleep efficiency, onset latency, and the number of nighttime arousals remained within recommended ranges, regardless of injection timing. In addition, there were no differences between boys and girls or between children with growth hormone deficiency and those with idiopathic short stature.

Given these findings, researchers recommend allowing GH injections to be administered at a time that best fits a family’s routine.

Reference
Levshtein A, Sharkia M, Shimshi-Barash M, et al. Morning vs. evening growth hormone injections and their impact on sleep-wake patterns and daytime alertness. Front Endocrinol (Lausanne). 2025 Feb 17;16:1483199. doi: 10.3389/fendo.2025.1483199. PMID: 40034226; PMCID: PMC11872712.