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  • Title: Electroencephalographic sleep profiles and hypothalamic-pituitary-adrenocortical (HPA)-activity in kindergarten children: early indication of poor sleep quality associated with increased cortisol secretion.
    Author: Hatzinger M, Brand S, Perren S, Stadelmann S, von Wyl A, von Klitzing K, Holsboer-Trachsler E.
    Journal: J Psychiatr Res; 2008 Jun; 42(7):532-43. PubMed ID: 17645894.
    Abstract:
    OBJECTIVES: In children, objective data carried out from sleep EEG monitoring are scarce. Furthermore, results associating the hypothalamic-pituitary-adrenocortical (HPA)-activity with sleep EEG measurements in children are missing. Therefore, our study aimed to investigate in preschool-children the association between sleep patterns and endocrine activity. Furthermore, children's behavioral/emotional difficulties and competences were assessed in order to correlate psychological strain with sleep measures. PARTICIPANTS AND METHODS: Sixty-seven kindergarten children (35 boys and 32 girls) aged 5.34 underwent EEG-monitoring for one night. For baseline HPA-activity assessment, saliva samples were collected immediately after awakening, whereas saliva samples before, while and after a psychological challenge were used to assess the HPA-activity under stress conditions. RESULTS: Compared to girls, boys showed significantly more REM sleep time. After cluster analysis, children labeled as 'poor' sleepers (n=27; 40,30%) showed significantly increased morning cortisol values, as compared to 'good' sleepers (n=22; 32,83%). Furthermore, increased cortisol AUC values under stress conditions were significantly associated with an elevated number of awakenings after sleep onset, and more sleep time in stages 1 and 2. In addition, an increased sleep efficiency was significantly correlated with self-reported emotional/behavioral difficulties, i.e. with low degrees of impulsivity (r=-.31; p<.05) and lower degrees of social inhibition and peer victimiziation (r=-.26, p<.05). CONCLUSIONS: Our results underlined that already in preschool years, associations between objectively examined unfavorable sleep patterns, increased HPA-system activity and more difficult behavioral and psychosocial dimensions may be observed.
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