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Biological processes related to positive development after preterm birth: the interplay between sleep, hypothalamic-pituitary-adrenal axis activity, and autonomic functioning, and the role of parental insomnia symptoms

Urfer-Maurer, Natalie. Biological processes related to positive development after preterm birth: the interplay between sleep, hypothalamic-pituitary-adrenal axis activity, and autonomic functioning, and the role of parental insomnia symptoms. 2018, Doctoral Thesis, University of Basel, Faculty of Psychology.

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Official URL: http://edoc.unibas.ch/diss/DissB_12685

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Abstract

Biological processes, including sleep, the hypothalamic-pituitary-adrenocortical (HPA) axis, and the autonomic
nervous system (ANS), play an important role in positive development across the life-span. They are highly
susceptible to early life experiences such as very preterm (VP) birth and to concurrent environmental factors
such as parental sleep. Yet, research examining sleep, HPA axis activity, and ANS functioning in children and
adolescents is rare. Therefore, the goal of this cumulative dissertation containing three studies is (a) to extend
knowledge of the interplay between sleep, HPA axis activity, and ANS functioning during childhood and
adolescence, (b) to examine the role of VP birth in these biological processes, and (c) to test whether parental
insomnia symptoms are related to their children’s sleep as well as to parental perception of children’s sleep-related
behavior. The samples included in the studies of this dissertation derived from the second wave of the
Basel Study of Preterm Children investigating VP and full-term (FT) children and adolescents. Findings from
Study 1 (Maurer et al., 2016) showed an association between elevated post-awakening HPA axis activity and a
later sleep onset time, shorter sleep duration, and shorter rapid eye movement latency across the whole sample.
Additionally, Study 2 (Urfer-Maurer et al., 2018) showed that predominant sympathetic activity of the ANS at
rest and during different sleep stages was related to increased post-awakening HPA axis activity across the
whole sample. Further, Study 1 showed that VP children had an earlier sleep onset time and lower HPA axis
activity compared to FT children. Mediation analyses showed that earlier sleep onset time partially accounted for
lower post-awakening HPA axis activity in VP children. Moreover, Study 2 showed that VP children had a
dominance of parasympathetic over sympathetic activity of the ANS when awake and during stage 2 sleep. The
results of Study 3 (Urfer-Maurer et al., 2017) revealed that maternal but not paternal insomnia symptoms were
related to less restorative sleep in children. Finally, parental insomnia symptoms were related to parents’ reports
of their children’s sleep-related behavior, and maternal insomnia symptoms were additionally related to paternal
reports of sleep-related behavior in children. Findings of the present dissertation highlight the important role VP
birth plays in altered development of biological processes, especially HPA axis activity during childhood and
adolescence. Additionally, they emphasize that parental sleep difficulties may affect the sleep of their own
children as well as how they perceive their children’s sleep. This dissertation outlines the practical implications
of these results for the design of new treatments to foster positive development associated with sleep, HPA axis
activity, and ANS functioning.
Advisors:Grob, Alexander and Lemola, Sakari
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Society & Choice > Entwicklungs- und Persönlichkeitspsychologie (Grob)
UniBasel Contributors:Grob, Alexander and Lemola, Sakari
Item Type:Thesis
Thesis Subtype:Doctoral Thesis
Thesis no:12685
Thesis status:Complete
Number of Pages:1 Online-Ressource (V, 60 Blätter)
Language:English
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Last Modified:05 Sep 2018 04:30
Deposited On:04 Sep 2018 15:04

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