Evidence map›Paper›PMID 35028729›Full record

SynthesisEuropean journal of pediatrics2022

The role of daytime napping on salivary cortisol in children aged 0-5 years: a systematic review and meta-analysis.

Arthur E Mesas, Mairena Sánchez-López, Diana Patricia Pozuelo-Carrascosa, Irene Sequí-Domínguez, Estela Jiménez-López, Vicente Martínez-Vizcaíno

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Arthur E MesasHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID http://orcid.org/0000-0002-0088-8607
Mairena Sánchez-LópezHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID http://orcid.org/0000-0002-0217-0623
Diana Patricia Pozuelo-CarrascosaHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID http://orcid.org/0000-0002-0527-5498
Irene Sequí-DomínguezHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain. irene.sequidominguez@uclm.es.ORCID http://orcid.org/0000-0001-8981-4331
Estela Jiménez-LópezHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID http://orcid.org/0000-0001-8553-7701
Vicente Martínez-VizcaínoHealth and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.ORCID http://orcid.org/0000-0001-6121-7893
University of Castilla-La Mancha · ESHospital Virgen de la Luz · ESUniversidad Autónoma de Chile · CLUniversidade Estadual de Londrina · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cortisol levels are implicated in emotional and cognitive development in children. However, it is not clear whether daytime napping influences cortisol levels in early childhood. This systematic review and meta-analysis aimed to synthesize the available evidence regarding the association between daytime napping and salivary cortisol in early childhood. The Medline, Embase, Web of Science, PsycINFO, and Cochrane Collaboration databases were searched for observational and experimental studies reporting data about napping behavior and salivary cortisol in children 0-5 years of age. Salivary cortisol levels were analyzed in three situations: CAR, cortisol awakening response from nap awakening; PRE-POST, before and after a daytime nap; and DIURNAL, from morning awakening to bedtime. Five studies showed a significant CAR after napping (mean difference, MD: 0.11μg/mL; 95% confidence interval, CI: 0.04, 0.18). In the PRE-POST analysis, a small decrease was observed for at-home naps (MD: -0.05 μg/mL; 95% CI: - 0.09, - 0.02) but not for at-childcare naps (MD: 0.04 μg/mL; 95% CI: - 0.01, 0.09). A similar pattern of DIURNAL salivary cortisol decrease was observed when children took a nap (MD: - 0.34 μg/mL; 95% CI: - 0.41, - 0.28) and when they did not sleep during the day (MD: - 0.28 μg/mL; 95% CI: - 0.38, - 0.19).

conclusionsDaytime napping plays a minor role in the fluctuation of salivary cortisol levels during the day. The conditions of the home or the childcare environment under which napping occurs might have a greater influence on cortisol levels than daytime napping itself in early childhood. PROSPERO Identifier: CRD42020212249. WHAT IS KNOWN: • The regulation of sleep involves circadian rhythmicity of cortisol secretion via activation of the HPA axis and a subsequent release of cortisol upon morning awakening followed by a decline throughout the day. WHAT IS NEW: • The available evidence supports the occurrence of a cortisol awakening response after a daytime nap. • A small decrease in cortisol after napping was observed when the nap occurred at home but not at childcare. • The conditions of the home or childcare environment under which the nap occurs and the activities before and after napping may have a greater influence on cortisol levels than napping itself.

Indexed as

HydrocortisoneHypothalamo-Hypophyseal SystemChildChild, PreschoolCircadian RhythmHumansInfantInfant, NewbornPituitary-Adrenal SystemSleepHydrocortisoneChildrenCortisolDaytime nappingMeta-analysisSystematic review

Identifiers

PMID35028729
OpenAlexW4205837681

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.