late childhood; sleep-EEG; socio-emotional development; middle childhood; HPA-axis function; sleep; preterm birth; cognitive development
Maurer Natalie, Perkinson-Gloor Nadine, Stalder Tobias, Hagmann-von Arx Priska, Brand Serge, Holsboer-Trachsler Edith, Wellmann Sven, Grob Alexander, Weber Peter, Lemola Sakari (2016), Salivary and hair glucocorticoids and sleep in very preterm children during school age., in Psychoneuroendocrinology
, 72, 166-174.
Hagmann-von Arx Priska, Manicolo Olivia, Perkinson-Gloor Nadine, Weber Peter, Grob Alexander, Lemola Sakari (2015), Gait in very preterm school-aged children in dual-task paradigms, in PLoS One
Perkinson-Gloor Nadine, Hagmann-von Arx Priska, Brand Serge, Holsboer-Trachsler Edith, Grob Alexander, Weber Peter, Lemola Sakari (2015), Intra-individual long-term stability of the sleep-EEG in school-age children, in Sleep Medicine
, 16, 1348-1351.
Lemola Sakari (2015), Long-term outcomes of very preterm birth: Mechanisms and interventions, in European Psychologist
, 20, 128-137.
Lemola Sakari, Perkinson-Gloor Nadine, Hagmann-von Arx Priska, Brand Serge, Holsboer-Trachsler Edith, Grob Alexander, Weber Peter (2015), Morning cortisol secretion in school-age children is related to the sleep pattern of the preceding night., in Psychoneuroendocrinology
, 52, 297-301.
Perkinson-Gloor Nadine, Hagmann-von Arx Priska, Brand Serge, Holsboer-Trachsler Edith, Grob Alexander, Weber Peter, Lemola Sakari (2015), The role of sleep and the hypothalamic-pituitary-adrenal axis for behavioral and emotional problems in very preterm children during middle childhood, in Journal of Psychiatric Research
, 60, 141-147.
Hagmann-von Arx P. Perkinson-Gloor N. Brand S. Albert D. Holsboer-Trachsler E. Grob A. W (2014), In school-age children who were born very preterm sleep efficiency is associated with cognitive function, in Neuropsychobiology
, 70, 244-252.
Background: Preterm birth has become more frequent during the past two decades due to progress in reproductive medicine, more frequent indicated preterm births due to maternal illnesses, and increasing maternal age. Moreover, survival rates of the very preterm have increased dramatically due to improved neonatal management. However, preterm children are at increased risk for poor cognitive function and socio-emotional problems, which is of growing public health concern. In a related vein, preterm children show an increased risk of sleep disturbances. As sound sleep is a major determinant of healthy cognitive and socio-emotional development it is important to study the role of sleep disturbance for the development of preterm children.Objective: We address six research questions: 1) Do preterm children (ages 6-10 years) differ from age and gender matched term born controls regarding cognitive and socio-emotional development? Based on prior research we expect that preterm children show lower cognitive scores and more socio-emotional problems. 2) Do preterm and term born children differ regarding indices of sleep duration, sleep quality, sleep macrostructure, sleep microstructure, spectral variables, and sleep disordered breathing? We hypothesize that preterm children are lower in sleep quality (as measured by sleep efficiency, sleep stage dynamics, analysis of cyclic alternating patterns, and sleep disordered breathing). 3) Are indices of sleep macrostructure, sleep microstructure, and spectral variables stable across the course of a one year follow-up period in preterm and term born children? We expect high relative stability of the indices of sleep macrostructure, microstructure, and spectral variables in preterm and term born children. 4) Are indices of sleep macrostructure, sleep microstructure, spectral variables, and sleep disordered breathing predictive of cognitive and socio-emotional development in preterm and term born children? We hypothesize that better sleep quality is positively related to cognitive and socio-emotional development. 5) Is higher sleep spindle density/sleep spindle frequency related to beneficial cognitive and socio-emotional development? Based on previous research we expect higher spindle density/sleep spindle frequency to be predictive of better cognitive and socio-emotional development. 6) Do preterm and term born children differ regarding HPA-axis function as measured by cortisol reactivity to social stress and cortisol awakening response? As results of previous research are not consistent we do not formulate an explicit hypothesis regarding the direction of the difference. As HPA-axis function was related to cognitive performance and socio-emotional development in previous research we also examine whether HPA-axis function accounts for deficits in cognitive and socio-emotional development of preterm children.Design and Method: Between August 2011 and March 2012 N=58 preterm children (<32nd week of gestation) born between June 2001 and December 2005 and treated at the University Children's Hospital Basel were recruited along with a control group of N=58 age and gender matched term born children. The first assessment wave included cognitive testing of the child, one night sleep EEG-assessment at the child’s home, assessment of children’s HPA-axis function by saliva samples, parental reports of the child’s socio-emotional development, the child’s general sleep patterns, family functioning, and parental well-being. Moreover, interview based diagnosis of childhood psychiatric disorders were established. A follow-up assessment wave of the same sample is planned to start in Autumn 2012 applying the same home-based measurements along with polysomnograhic assessment of sleep (including sleep disordered breathing). Additionally, the children and parents are invited for a laboratory based assessment of high-density resting EEG as well as assessment of stress reactivity in the paradigm of the Trier Social Stress Test for children (TSST-C). Relevance and impact: The study will provide information on the role of sleep for development in preterm and term born children. Interventions addressing sleep in preterm children will profit from the generated evidence.