Kölbel, Melanie;
Kirkham, Fenella J;
Iles, Ray K;
Stotesbury, Hanne;
Halstead, Elizabeth;
Brenchley, Celia;
Sahota, Sati;
(2022)
Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease.
Comprehensive Psychoneuroendocrinology
, 10
, Article 100128. 10.1016/j.cpnec.2022.100128.
(In press).
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Abstract
Background: Neurocognitive impairment is common in people with Sickle Cell Disease (SCD) and evidence is accumulating that sleep disturbances play a role. The interaction between cortisol and sleep in the general population is associated with cognition as well as general wellbeing but there are few data in SCD. We aimed to understand the relationship between cortisol and sleep in individuals with SCD and explored associations with cognition. Methods: Forty-five participants of black heritage (SCD: N = 27, 9–29 years, 16 females; Controls: N = 18, 11–25 years, 13 females) were recruited from the community between 2018 - 2020. Participants completed standardized questionnaires about their sleep behaviour and wore actigraphy MotionWatch8 for 7 nights to assess nocturnal sleep patterns. Salivary cortisol samples were taken on wakening and 3 times after 14:00. Cognition was assessed using the Wechsler Intelligence Scales for children and adults. Results: People with SCD took longer to fall asleep and experienced greater wake bouts, mobile minutes and fragmented sleep compared to controls. Although non-significant, people with SCD experienced lower morning cortisol, with a flattened diurnal cortisol ratio compared to controls. Interestingly, SCD participants, but not controls, with low diurnal variation scored lowest on processing speed (PSI) and perceptual reasoning index (PRI). A moderator analysis revealed that the effect of morning cortisol and diurnal cortisol ratio on PRI by group health (i.e., SCD and healthy controls) depended on sleep quality. Discussion: Sleep and cortisol may play a crucial role in the expression of cognitive difficulties seen in SCD. This should be considered for the development of interventions to optimise cognitive functioning and sleep. This, in turn, could positively impact on secretion of cortisol and general health in SCD.
| Type: | Article |
|---|---|
| Title: | Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.cpnec.2022.100128 |
| Language: | English |
| Additional information: | © 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Sickle cell, Cortisol, Cognition, Sleep, Sleep disorders, Actigraphy |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development UCL > Provost and Vice Provost Offices > School of Education UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10145593 |
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