Poor Sleep and Altered Hypothalamic-Pituitary-Adrenocortical and Sympatho-Adrenal-Medullary System Activity in Children

Katri Raikkonen, Karen A. Matthews, Anu-Katriina Pesonen, Riikka Pyhala, E. Juulia Paavonen, Kimmo Feldt, Alexander Jones, David I. W. Phillips, Jonathan R. Seckl, Kati Heinonen, Jari Lahti, Niina Komsi, Anna-Liisa Jarvenpaa, Johan G. Eriksson, Timo E. Strandberg, Eero Kajantie

Research output: Contribution to journalArticlepeer-review


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 alpha-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 alpha-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. (J Clin Endocrinol Metab 95: 2254-2261, 2010)

Original languageEnglish
Pages (from-to)2254-2261
Number of pages8
JournalJournal of Clinical Endocrinology & Metabolism
Issue number5
Publication statusPublished - May 2010


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