Poor sleep and altered hypothalamic-pituitary-adrenocortical and sympatho-adrenal-medullary system activity in children
Räikkönen K., Matthews KA., Pesonen AK., Pyhälä R., Paavonen EJ., Feldt K., Jones A., Phillips DIW., Seckl JR., Heinonen K., Lahti J., Komsi N., Järvenpää AL., Eriksson JG., Strandberg TE., Kajantie E.
Context: Neuroendocrine alterations, with well-known links with health, may offer insight into why poor sleep is associated with poor health. Yet, studies testing associations between sleep and neuroendocrine activity in children are scarce. Objective: The aim of this study was to determine whether actigraphy-based sleep pattern is associated with hypothalamic-pituitary- adrenocortical axis and sympatho-adrenal-medullary system activity in children. Design and Setting: We conducted a cross-sectional study in a birth cohort in Helsinki, Finland. Participants: We studied 282 8-yr-old children. Main Outcome Measures: We measured diurnal salivary cortisol and salivary cortisol and α-amylase (a sympatho-adrenal-medullary system marker) responses to the Trier Social Stress Test for Children (TSST-C). Results: Children with short (≤7.7 h) vs. average sleep duration (7.8-9.3 h) displayed higher cortisol awakening response and nadir (P<0.042). Those with low (≤77.4%) vs. average-high sleep efficiency (>77.4%) displayed higher diurnal cortisol levels across the entire day (P<0.03), higher cortisol levels after the TSST-C stressor (P<0.04), and higher overall α-amylase levels across the entire TSST-C protocol (P < 0.05). The effects were not confounded by factors that may alter sleep or hormonal patterns. Conclusions: Poor sleep may signal altered neuroendocrine functioning in children. The findings may offer insight into the pathways linking poor sleep with poor health. Copyright © 2010 by The Endocrine Society.