Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease
Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease
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.
Actigraphy, Cognition, Cortisol, Sickle cell, Sleep, Sleep disorders
100128
Kölbel, Melanie
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Kirkham, Fenella J
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Iles, Ray K
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Stotesbury, Hanne
1104423d-f215-4585-bb50-29b7fdd6c518
Halstead, Elizabeth
ce71140c-9b85-463a-a8a5-ab6ab24ea35b
Brenchley, Celia
9dad6ce1-d3c4-4d53-9df6-b0db5290ad1a
Sahota, Sati
f9b12b9d-4b65-42db-97b2-30db56b9d84e
Dimitriou, Dagmara
3b510b78-4c3d-49d9-8960-84450c33c5c9
12 March 2022
Kölbel, Melanie
2b9cb7ea-3fdf-450d-9b39-0f44d4ec46a7
Kirkham, Fenella J
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Iles, Ray K
bafb2268-6af0-4f57-835d-b3030cd43ad4
Stotesbury, Hanne
1104423d-f215-4585-bb50-29b7fdd6c518
Halstead, Elizabeth
ce71140c-9b85-463a-a8a5-ab6ab24ea35b
Brenchley, Celia
9dad6ce1-d3c4-4d53-9df6-b0db5290ad1a
Sahota, Sati
f9b12b9d-4b65-42db-97b2-30db56b9d84e
Dimitriou, Dagmara
3b510b78-4c3d-49d9-8960-84450c33c5c9
Kölbel, Melanie, Kirkham, Fenella J, Iles, Ray K, Stotesbury, Hanne, Halstead, Elizabeth, Brenchley, Celia, Sahota, Sati and Dimitriou, Dagmara
(2022)
Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease.
Comprehensive psychoneuroendocrinology, 10, , [100128].
(doi:10.1016/j.cpnec.2022.100128).
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.
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Accepted/In Press date: 22 February 2022
e-pub ahead of print date: 4 March 2022
Published date: 12 March 2022
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© 2022 The Authors
Keywords:
Actigraphy, Cognition, Cortisol, Sickle cell, Sleep, Sleep disorders
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Local EPrints ID: 470152
URI: http://eprints.soton.ac.uk/id/eprint/470152
ISSN: 2666-4976
PURE UUID: 65bc3424-ae71-4ba3-8fad-19ffd94a156f
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Date deposited: 04 Oct 2022 16:37
Last modified: 17 Mar 2024 02:53
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Contributors
Author:
Melanie Kölbel
Author:
Ray K Iles
Author:
Hanne Stotesbury
Author:
Elizabeth Halstead
Author:
Celia Brenchley
Author:
Sati Sahota
Author:
Dagmara Dimitriou
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