title: Sleep actigraphy pattern and behavioral/emotional difficulties in kindergarten children: association with hypothalamic-pituitary-adrenocortical (HPA) activity.
abstract: BACKGROUND
  Various studies of adult endocrinology and sleep show close connections between poor sleep quality, deterioration of the HPA axis and negative psychological characteristics. However, the extent to which these associations may have already emerged and developed in childhood remains unclear.
  
  
  METHODS
  A total of 82 preschoolers (age 4.91+/-0.48) underwent activity monitoring for seven consecutive days and nights, wearing a digital movement-measuring instrument. Additionally, on the first and on the last morning of sleep registration, the activity of the HPA axis was assessed via the amount of cortisol in the saliva. Psychological and behavioral assessments were also made.
  
  
  RESULTS
  Three sub-groups of good (22%), normal (58.5%) and poor (19.5%) sleepers were distinguished. Poor sleep patterns were associated with higher HPA activity and with behavioral/emotional difficulties.
  
  
  CONCLUSIONS
  The interplay between unfavorable sleep patterns, deterioration of the HPA axis and behavioral/emotional difficulties is already apparent in pre-school children.
authors.affiliation: Psychiatric Outpatient Department, University of Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Hatzinger
authors.forename: Serge
authors.initials: S
authors.lastname: Brand
authors.forename: Sonja
authors.initials: S
authors.lastname: Perren
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stadelmann
authors.forename: Agnes
authors.initials: A
authors.lastname: von Wyl
authors.forename: Kai
authors.initials: K
authors.lastname: von Klitzing
authors.forename: Edith
authors.initials: E
authors.lastname: Holsboer-Trachsler
mesh_terms: D056044:Actigraphy / Q000379:methods; D000704:Analysis of Variance; D001526:Behavioral Symptoms / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology; D005178:Faculty; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D009068:Movement; D010290:Parents / Q000523:psychology; D011863:Radioimmunoassay / Q000379:methods; D012463:Saliva / Q000737:chemistry*; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
chemical_list: D006854:Hydrocortisone