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Functional links between thermoregulation and sleep in children with neurodevelopmental and chronic health conditions
Susan M McCabe1, Chris R Abbiss1, Jean-Pierre Libert2
1School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Insights
Children
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Thermoregulation and Circadian Rhythms
Background:
- Sleep-wake patterns are crucial for all children, especially those with neurodevelopmental disorders (NDDs) or health conditions affecting biological rhythms.
- Existing research on sleep disruption in these populations primarily addresses respiratory, pharmaceutical, and behavioral factors.
- The significant impact of body thermoregulation and thermal comfort on children's sleep-wake cycles remains under-explored.
Purpose of the Study:
- To highlight the overlooked role of thermoregulation in children's sleep-wake patterns and associated behaviors.
- To provide information for researchers and clinicians on assessing and intervening in thermoregulatory functions.
- To promote improved sleep-wake regulation through enhanced thermoregulation and thermal comfort.
Main Methods:
- Literature review focusing on thermoregulation, thermal comfort, and sleep-wake patterns in children.
- Analysis of the interplay between biological functions, daily activities, and environmental factors on thermoregulation.
- Synthesis of current knowledge gaps regarding thermoregulation's impact on pediatric sleep.
Main Results:
- Circadian sleep-wake patterns are intrinsically linked to body temperature fluctuations and the ability to maintain thermoneutrality.
- Thermal comfort, closely related to thermoneutrality, influences sleep onset and maintenance.
- Children with NDDs or health conditions are particularly vulnerable to thermoregulatory disruptions affecting sleep-wake balance.
Conclusions:
- Thermoregulation and thermal comfort are critical, yet often neglected, factors influencing sleep in children, particularly those with NDDs.
- Further research and clinical attention are needed to understand and address thermoregulatory challenges impacting pediatric sleep.
- Interventions targeting thermoregulation could significantly improve sleep-wake regulation and overall well-being in vulnerable children.
Abstract:
The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children's sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are dependent on patterns of body temperature change, large enough to induce sleep preparedness but remaining within a range to avoid sleep disturbances when active thermoregulatory responses against heat or cold are elicited (to maintain thermoneutrality). Additionally, the subjective notion of thermal comfort (which coincides with the objective concept of thermoneutrality) is of interest as part of general comfort and associated behavioral responses for sleep onset and maintenance. Children's thermoregulation and thermal comfort are affected by diverse biological functions, as well as their participation in everyday activities, within their everyday environments. Hence, the aforementioned populations are additionally vulnerable to disruption of their thermoregulatory system and their capacity for balance of sleep and wakefulness. The purpose of this paper is to present hitherto overlooked information, for consideration by researchers and clinicians toward determining assessment and intervention approaches to support children's thermoregulation functions and promote their subjective thermal comfort, for improved regulation of their sleep and wake functions.
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