engleski

Stress perception, sleepiness, awakening cortisol indicators and advanced glycation end products in parents of children with chronic conditions

Introduction: Parents of children with chronic conditions are at risk of increased parental stress and poor sleeping habits. Increased cortisol levels due to chronic stress could play an important role in oxidative processes and accumulation of the advanced glycation end products (AGEs). The aim of this study was to investigate the association between parental stress, daytime sleepiness, awakening cortisol indicators, and AGEs in parents of children with chronic conditions. Methods: This cross sectional study took place in Zadar county, between March 2018 and March 2019. The sample included five groups: parents of children with Down syndrome (DS ; N=33), autistic spectrum disorder (ASD ; N=29), cerebral palsy (CP ; N=15), diabetes mellitus type 1 (DMT1 ; N=38), and a control group of parents of healthy children (CG ; N=33). Alongside with parental stress (assessed via Parental Stress Scale) and daytime sleepiness (Epworth Sleepiness Scale), we measured accumulation of AGEs in the skin, and collected five samples of salivary cortisol per subject, in order to estimate cortisol awakening response of the hypothalamic– pituitary–adrenal axis. Multiple linear regression models were used in order to assess the association between awakening cortisol indices (area under the curve with respect to the increase [AUCI] and area under the curve with respect to the ground [AUCG]), AGEs, parental stress, daytime sleepiness, self-health assessment, and sociodemographic variables. Results: We identified association between AUCI and parenting of a child with ASD (ß=-0.26 ; p=0.019), and DMT1 (ß=-0.30 ; p=0.008). Parental age was associated with AGEs (ß=0.34 ; p<0.001), while age, education level and self-perception of health were borderline insignificantly associated with AUCI. AUCG was associated with AGEs (ß=0.34 ; p<0.001), while daytime sleepiness was a significant predictor for both AUCG (ß=-0.30 ; p<0.001), and AGEs (ß=0.18 ; p=0.034). Conclusion: Total awakening cortisol secretion was associated with AGEs, while daytime sleepiness was associated with both of these traits, pointing to the fine interplay between chronic psychologic stress, lack of restorative sleep, and oxidative stress. Prevention of adverse health consequences in parents of children with chronic conditions should be a priority, in order to protect the health of both parents and their children.

parental stress ; awakening cortisol indicators ; advanced glycation end products ; sleepiness

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