Heart Rate Variability, Parental Stress, Child's Challenging Behaviour and Advanced Glycation End Products in Parents of Children With Chronic Conditions.

Child's challenging behaviours can pose complex, highly stressful demands on parents. Such chronic stress may affect autonomic regulation, particularly vagal balance, and increase oxidative stress and the risk of developing chronic diseases. This study investigated the association between the child's challenging behaviour and heart rate variability, psychological and oxidative stress in parents of children with chronic conditions. We included parents of children with autism spectrum disorder, cerebral palsy, Down syndrome, diabetes type 1, and parents of healthy children. Multivariate linear regression was used to determine the association between parenting, the child's challenging behaviour, parental stress, resilience, heart rate variability, and advanced glycation end products. Parents of children with autism spectrum disorder reported the highest level of child's challenging behaviour, while parents of children with diabetes type 1 showed lower stress resistance. Child's challenging behaviour was significantly associated with higher parental stress, reduced stress resilience, higher advanced glycation end products and longer mean interval between heartbeats. Advanced glycation end products were associated with parental age, nonsmoking, and time-domain parameter pNN50. Parents of children with chronic conditions had increased sympathetic activity and impaired sympathovagal balance. The study confirms the increased risk for the development of adverse health outcomes in parents of children with chronic conditions. A healthy lifestyle and non-pharmacological strategies, including heart rate variability biofeedback and emotional self-regulation, alongside respite care programs, may help prevent disrupted autonomic function, oxidative stress, and parental overload. Public health programs are essential to promote health and slow the ageing process in these vulnerable populations.