title: Sex-specific associations between sleep problems and hypothalamic-pituitary-adrenocortical axis activity in children.
abstract: OBJECTIVE
  Sleep problems are associated with reduced physical and mental health. Altered function of the hypothalamic-pituitary-adrenocortical axis (HPAA) may be one underlying mechanism. We studied the associations between sleep problems and HPAA activity in children.
  
  
  METHODS
  A cross-sectional epidemiological cohort study.
  
  
  METHODS
  Salivary cortisol was sampled throughout one day at home and during the Trier Social Stress Test for Children (TSST-C) in clinic. Sleep disorders were measured with a parent-rated Sleep Disturbance Scale for Children, and sleep duration measured by actigraphy for one week.
  
  
  METHODS
  284 (51% girls) 8-year-old children.
  
  
  RESULTS
  Boys with sleep problems (≥ 85 th percentile in any of the sleep-wake transition, arousal, excessive daytime somnolence or sleep hyperhydrosis subscales) had lower diurnal salivary cortisol levels and salivary cortisol responses to TSST-C stress in comparison to boys without sleep problems. Girls with sleep problems (≥ 85 th percentile in disorders of initiating and maintaining sleep) displayed a higher overall level of salivary cortisol during the TSST-C. Salivary cortisol responses to stress were lower in boys and higher in girls with more than one sleep problem.
  
  
  CONCLUSIONS
  Sleep problems in children are associated with altered HPAA function, after controlling for actual sleep quantity measured by actigraphy. Boys with sleep problems had lower HPAA activity and girls with sleep problems had higher HPAA activity, compared to children without sleep problems.
authors: Institute of Behavioral Sciences, University of Helsinki, Finland.
authors: Anu-Katriina
authors: AK
authors: Pesonen
authors: Eero
authors: E
authors: Kajantie
authors: Kati
authors: K
authors: Heinonen
authors: Riikka
authors: R
authors: Pyhälä
authors: Jari
authors: J
authors: Lahti
authors: Alexander
authors: A
authors: Jones
authors: Karen A
authors: KA
authors: Matthews
authors: Johan G
authors: JG
authors: Eriksson
authors: Timo
authors: T
authors: Strandberg
authors: Katri
authors: K
authors: Räikkönen
mesh_terms: D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D020920:Dyssomnias / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D020447:Parasomnias / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism
chemical_list: D006854:Hydrocortisone