SummaryRecent evidence suggests that poor sleep is a potential pathway underlying the association between stressful experiences and the diurnal cortisol profile. However, existing findings are largely limited to adults. The present study examines whether poor sleep (duration, quality) mediates the relation between stressful experiences and the diurnal cortisol profile in children and adolescents. Children and adolescents (N = 220, M age = 12.62) provided six saliva samples over two days to derive cortisol indices (bedtime, AUC AG , AUC TG , slope MAX ). Perceived stress, stressful life events, self-reported sleep duration, and sleep quality were measured. Using bootstrapping analyses, sleep quality mediated the relation between perceived stress and AUC TG (R2 = 0.10, F(7, 212) = 3.55, p = .001; 95% BCI[0.09, 1.15]), as well as the relation between stressful life events and AUC TG (R2 = 0.11, F(7, 212) = 3.69, p = .001; 95% BCI[0.40, 3.82]).These mediation models remained significant after adjusting for sleep duration, suggesting that poor sleep quality underlies the association between stressful experiences and the diurnal cortisol profile in children and adolescents. Longitudinal data combined with objectively-measured sleep is essential to further disentangle the complex association between sleep and stress.
KeywordsSleep; Cortisol; Stressful life events; Perceived stress; Child; Adolescent Stress is known to alter cortisol secretion. Exposure to acute laboratory-induced stressors elicits transient increases in cortisol level (Dickerson and Kemeny, 2004). Naturally occurring stressful experiences, including perceived stress and stressful life events, have also been associated with a disrupted diurnal cortisol profile. Adults who report greater perceived stress (i.e., nonspecific, subjective appraised stress, Cohen et al., 1995)
CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript awakening response, total cortisol level, and flatter diurnal slopes (Miller et al., 2007;Pruessner et al., 1999;Schulz et al., 1998). Greater stressful life events (e.g., unemployment, divorce) are associated with higher morning and evening cortisol levels and flatter diurnal slopes (Miller et al., 2007). Similar findings have been established in both children and adolescents (hereafter referred to as "youth" for parsimony). Youth who report greater stressful life events (e.g., family conflict, academic stress) have a higher cortisol awakening response and elevated afternoon cortisol levels than their less stressed counterparts (Gustafsson et al., 2010;Wolf et al., 2008). While there is convincing evidence that stressful experiences disrupt the diurnal cortisol profile, the potential pathways underlying this association remain unclear.Sleep is one plausible pathway by which stressful experiences disrupt the diurnal cortisol profile. The sleep-wake cycle has a close, temporal association with diurnal cortisol secretion. Nocturnal sleep onset reliably exerts an inhibitory effect on cortisol secretion (Van Cauter et al.,...