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Sleep, cognitive, and socio-emotional development in preterm children during middle and late childhood

English title Sleep, cognitive, and socio-emotional development in preterm children during middle and late childhood
Applicant Lemola Sakari
Number 143962
Funding scheme Project funding (Div. I-III)
Research institution Fakultät für Psychologie Universität Basel
Institution of higher education University of Basel - BS
Main discipline Psychology
Start/End 01.10.2012 - 30.06.2015
Approved amount 193'337.00
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All Disciplines (4)

Discipline
Psychology
Endocrinology
Paediatrics
Neurophysiology and Brain Research

Keywords (8)

late childhood; sleep-EEG; socio-emotional development; middle childhood; HPA-axis function; sleep; preterm birth; cognitive development

Lay Summary (English)

Lead
Lay summary

Background of the Study

Preterm birth has become more frequent during the last three decades: The number of children born at a birth weight of <1500g has more than doubled since the late 1970s. Reasons for this development are the progress in reproductive medicine, more frequent indicated preterm births due to maternal illnesses, and increasing maternal age. Moreover, survival rates of the very preterm children have increased dramatically due to improved methods of neonatal care. Although the large majority of prematurely born children are generally healthy when entering school age, they remain at increased risk for cognitive delay, school-, and socio-emotional problems. In a related vein, preterm children also more often show sleep disturbances, particularly breathing problems, which parents can easily identify as snoring. There is a large body of evidence that sleep disturbances in childhood (and in particular breathing problems during sleep) are important for healthy cognitive and socio-emotional development. The present study investigates the role of sleep and breathing problems for cognitive, behavioral, and socio-emotional development in school age children born very preterm (25th to 31st gestational week) and in a comparison group of children born at term.

Research Methods

Approximately 60 preterm children and 60 term born children aged between 6 and 10 years are studied repeatedly with portable polysomnography (PSG) at their homes. The children are allowed to sleep in their own beds while wearing a PSG-recorder for one night. The PSG-recorder measures the electrical activity of the brain during sleep. Based on the recorded brain waves it is possible to find out the children’s sleep duration, sleep quality, and sleep depth (amount of light sleep, deep (or slow wave) sleep, and rapid eye movement (REM) sleep). Deep sleep and REM sleep are well known to play a role in consolidation of memory traces and emotional processing and therefore contribute to good cognitive and socio-emotional adjustment when the children are awake. Furthermore, tests of cognitive and socio-emotional development are conducted at the children’s homes, while the mothers and fathers complete questionnaires on the children’s typical behavior and sleep habits.

Relevance and Impact of the Study

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.

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Salivary and hair glucocorticoids and sleep in very preterm children during school age.
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.
Gait in very preterm school-aged children in dual-task paradigms
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, 1-18.
Intra-individual long-term stability of the sleep-EEG in school-age children
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.
Long-term outcomes of very preterm birth: Mechanisms and interventions
Lemola Sakari (2015), Long-term outcomes of very preterm birth: Mechanisms and interventions, in European Psychologist, 20, 128-137.
Morning cortisol secretion in school-age children is related to the sleep pattern of the preceding night.
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.
The role of sleep and the hypothalamic-pituitary-adrenal axis for behavioral and emotional problems in very preterm children during middle childhood
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.
In school-age children who were born very preterm sleep efficiency is associated with cognitive function
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.

Collaboration

Group / person Country
Types of collaboration
Universitäts Kinderspital beider Basel, Abteilungen Radiologie und Neonatologie Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Technische Universität Dresden, Department of Psychology Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Association for Psychological Science, 27th Annual Convention, New York Poster Are psychological well-being and optimism related to morning cortisol secretion and objective measures of sleep in school-age children? 23.05.2016 New York, United States of America Lemola Sakari;
Eingeladener Vortrag, Alpen Adria Universität Klagenfurt Individual talk Kognitive und sozio-emotionale Entwicklung bei frühgeborenen Kindern in der mittleren Kindheit: Die Bedeutung des Schlafes und der Stressachsenaktivität 23.01.2015 Klagenfurt, Austria Lemola Sakari;
Konferenz der Deutschen Gesellschaft für Psychologie in Bochum Talk given at a conference Cognitive and socio-emotional development of preterm children during late childhood: a morphometric (VBM)-MRI study 22.09.2014 Bochum, Germany Lemola Sakari;
21. Fachgruppentagung Entwicklungspsychologie der DGPs Universitat des Saarlandes Talk given at a conference Fruhgeburtlichkeit und langfristige kindliche Entwicklung. Symposium 16.09.2013 Saarbrücken, Germany Lemola Sakari; Perkinson-Gloor Nadine;
16th European Conference on Developmental Psychology in Lausanne. Talk given at a conference Cognitive and socio-emotional development in preterm children/children with very low birth weight during childhood, adolescence, and young adulthood. Symposium 02.09.2013 Lausanne, Switzerland Lemola Sakari; Hagmann-von Arx Priska; Grob Alexander; Perkinson-Gloor Nadine;


Associated projects

Number Title Start Funding scheme
159362 Socio-emotional development and mental health of preterm children: The role of HPA-axis function, sleep, neuroplasticity, and physical exercise during the transition to adolescence 01.08.2015 Project funding (Div. I-III)

Abstract

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.
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