Hatzinger Martin, Brand Serge, Perren Sonja, Stadelmann Stephanie, von Wyl Agnes, von Klitzing Kai, Holsboer-Trachsler Edith
Psychiatric Out-Patient Department, University Hospital Basel, Switzerland.
J Psychiatr Res. 2008 Jun;42(7):532-43. doi: 10.1016/j.jpsychires.2007.05.010. Epub 2007 Jul 23.
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.
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.
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).
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.
在儿童中，通过睡眠脑电图监测获得的客观数据稀缺。此外，儿童下丘脑-垂体-肾上腺皮质（HPA）活动与睡眠脑电图测量结果之间的关联尚不清楚。因此，我们的研究旨在调查学龄前儿童睡眠模式与内分泌活动之间的关联。此外，还评估了儿童的行为/情绪困难及能力，以便将心理压力与睡眠指标相关联。
67名5.34岁的幼儿园儿童（35名男孩和32名女孩）接受了一晚的脑电图监测。为进行基线HPA活动评估，醒来后立即采集唾液样本，而在心理挑战前、期间和之后采集的唾液样本用于评估应激条件下的HPA活动。
与女孩相比，男孩的快速眼动睡眠时间明显更长。聚类分析后，被标记为“睡眠不佳”的儿童（n = 27；40.30%）与“睡眠良好”的儿童（n = 22；32.83%）相比，早晨皮质醇值显著升高。此外，应激条件下皮质醇曲线下面积值升高与睡眠开始后觉醒次数增加以及第1和第2阶段睡眠时间延长显著相关。此外，睡眠效率提高与自我报告的情绪/行为困难显著相关，即与低冲动程度（r = -0.31；p <.05）以及较低的社交抑制和同伴受害程度（r = -0.26，p <.05）相关。
我们的结果强调，早在学龄前，就可以观察到客观检查出的不良睡眠模式、HPA系统活动增加与更困难的行为和心理社会维度之间的关联。
