  How to Have Happier Bedtimes & Better Sleep
Here's how to help your kids fall asleep, stay asleep and wake up in their own bed - no matter
what their age.
By Lori Miller Kase
Introduction
Like most
parents, my husband and I have struggled, bleary-eyed, through our share of sleep
problems, from bedtime battles to bad dreams. But it wasn't until several months ago that we realized our 2 children's
sleeping patterns had gone seriously awry.
Not a
night went by without my 6-year-old son slipping into our bed in the middle of the night or my 4-year-old daughter
relocating to the sleeping bag that was permanently parked on our bedroom floor.
Clearly, it was high time that they - and we - were sleeping through the night.
We've
since followed the advice in this article and are all enjoying more peaceful nights. But there are plenty of
other parents who are still suffering from the bedtime blues.
A survey
of studies revealed that 25 to 30% of all children experience some kind of sleep difficulty.
And if you think your kids will eventually outgrow their sleep problems, think again.
One survey
found that 27% of elementary-school-age children resist bedtime, while another 11% have trouble
falling asleep and difficulty waking in the morning.
It should
come as no surprise, then, that a recent survey by the National Sleep Foundation found that 60% of children
ages 1 to 18 complain of being tired during the day. Chances are, their parents are as sleep-deprived
as they are.
A good
night's sleep is crucial for children's healthy growth and immune function. And sleep affects behavior - exhausted kids are more likely to be cranky and impatient and to do
poorly in school.
Though there are sometimes biological explanations for disrupted sleep,
"the vast majority of sleep problems are caused by parents unintentionally not allowing
children to get the sleep they need," asserts Marc Weissbluth, M.D., author of Healthy Sleep Habits, Happy Child (Ballantine,
1999) and an associate professor of pediatrics at Northwestern University Medical School.
"There are too many activities - both parents' and child's - that interfere with an early bedtime." Other
experts point out that many children, having been rocked or nursed to sleep (or allowed to fall asleep in their parents' beds) since birth, have simply never learned to
fall asleep on their own.
The good
news is that you can help your child learn how to get a solid night's sleep.
And most experts agree that the earlier you start, the easier it is to establish healthy sleep
habits in your children.
0 to 5 Months
Newborns
slip between the waking and sleeping states with little regard for day or night, typically
feeding every 2 to 4 hours. Not until about 6 to 8 weeks does a more regular cycle begin to emerge, in which the baby sleeps more at night and stays awake more during the day.
Making
sure that your infant is exposed to sunlight during the day and kept in a darkened room at night establishes
this pattern.
By 3 or
4 months, babies' sleep cycles begin to vaguely resemble those of adults,
passing through cycles of active sleep (REM, or rapid
eye movement) and deep sleep.
Both stages
are critical to development. "We know that the human growth hormone is released during deep sleep,
so children require this stage of sleep to grow," notes Paul Saskin, clinical director of
the Regional Center for Sleep Disorders at Sunrise Hospital, in Las Vegas.
"And
it's thought that REM is needed for learning and memory. Like a computer backing up its hard drive, the brain is organizing
its filing system."
Newborns
sleep about 16 to 17 hours a day. By 4 months, total sleep
decreases to about 15 hours, the longest sleep period (which,
with luck, occurs at night) stretches from about 4 to 9 hours and midmorning and midafternoon naps develop.
At this point, parents can start reinforcing their child's biological rhythms by anticipating their baby's
natural sleepiness, soothing him and putting him down to sleep before he gets overtired, says Dr. Weissbluth.
"Helping your child fall asleep is like surfing: You want to catch the wave of drowsiness as it's rising,
before your baby crashes into an overtired state," he explains. A good rule of thumb is to put your baby down to sleep every 2 hours.
As their baby approaches 6 months of age, "parents often ask, 'Why is my child
still waking up 3 and 4 times a night?' " says Mark D. Widome, M.D., a professor of pediatrics at Pennsylvania State University
College of Medicine, in Hershey.
"Instead, they should be asking, 'Why does my child need my help to get back to sleep
when he wakes up?'"
Indeed,
researchers at McGill University, in Montreal, videotaped a group of infants and found that all woke up an average of 4 times
a night. Many, however, didn't call out but managed to soothe themselves back to sleep (the so-called good sleepers).
Those described as problem sleepers tended to cry out and make their awakenings known.
"By 5
or 6 months, if a healthy child is waking up at night for feedings, it's a learned behavior," says Dr. Widome.
"Don't be so quick to take her out of bed and feed her. If you do, you're not giving her ample opportunity to try to get back
to sleep herself."
Keep in
mind, too, that the more often you put your baby to bed when she's still awake, the more practice she'll get
soothing herself to sleep.
6 to 18 Months
Some parents
are surprised to find that around 8 or 9 months, their baby, who had been sleeping through the
night, suddenly begins to wake in the middle of the night and cry for them.
"They're at that developmental stage when they're starting to understand object permanence,"
explains Claire Lerner, a child-development specialist at Zero To Three, a nonprofit organization devoted to promoting healthy
development in the first 3 years of life. "They're beginning to understand that you exist out there even though they can't
see you, so, naturally, they call for you."
Whether your child has regressed or has never quite mastered the skill of going to sleep solo, teaching him to fall asleep on his own takes a great deal of resolve.
Some experts,
echoing the advice of child-care expert Dr. Benjamin Spock, recommend putting your baby to bed and letting him cry it out.
Within a couple of nights, the crying should dissipate and healthy sleep habits should prevail.
Parents
who consider this method too harsh often turn to "Ferberizing" - the more gradual method described by Richard Ferber, M.D.,
director of the Center for Pediatric Sleep Disorders at Children's Hospital, in Boston, in his best-selling book Solve
Your Child's Sleep Problems (Fireside, 1985).
If a baby
cries when put in his crib, parents are advised to give their child a reassuring pat and leave the room. If
the crying continues, they wait 5 minutes and return to calm the child - but they aren't to pick him up.
Parents wait for increasingly longer intervals between reassuring visits until the child finally falls asleep.
Ideally, the whole process should take as little as 3 days.
"It's horrible to hear
your child scream," concedes Lerner. "Parents have to know how much they can tolerate. Don't start any kind of sleep training until you're committed to following through - if you let your baby cry one night
and then go to him the next, it may worsen the problem."
Some parents
balk at the idea of letting their child cry at all, worrying that by not responding to their baby's cries, they'll lose her
trust. "You have to balance the building of trust with teaching certain skills.
Children do need to learn to fall asleep on their own," points out Jodi Mindell, Ph.D., author of Sleeping Through the Night:
How Infants, Toddlers and Their Parents Can Get a Good Night's Sleep (HarperCollins, 1997)
and an associate professor of psychology at St. Joseph's University, in Philadelphia.
"Trust isn't going to be affected by 2 or 3 evenings of your child being upset while learning how to fall asleep. It'll be balanced
out by the other hours in the day in which you respond to your child and her cries."
18 to 36 Months
By 18 months, most babies
have given up their morning nap; at 3, some will be ready to give up their afternoon nap as well. At this stage, there's so
much excitement in a toddler's life that she can't wind down at night, even when she's exhausted.
If you find that
your toddler has a cranky period toward the end of the day, it may be a sign that she needs to go to
sleep earlier. "Well-rested children don't behave like that," notes Dr. Weissbluth.
Children often wind up in your bed
at this age as a result of 2 major developmental milestones:
- Instead of just crying, they can now actually call out "Mommy"
or "Daddy," which is a lot harder to ignore
- The move into a big-kid bed means they
don't even need to call - they can just show up at your bedside.
Anat Schecter's older
son, Jake, made it into a game. "We'd put him in, he'd run out, we'd put him in, he'd run out," says his mom. "This
could go on for as long as an hour. So I ended up sitting outside the bedroom door.
Whenever Jake left the
room, I would walk him back to bed. This went on for several weeks until he realized that we weren't going to give
in."
3 to 5 Years
Nightmares and night terrors,
which usually strike preschoolers, are common causes of night disturbance and resistance to bedtime at this age.
"Nightmares
are scary to kids, but night terrors are scarier to parents," says Dr. Widome.
Children don't even remember
having had night terrors, which are a partial arousal from deep sleep usually occurring
within the first couple of hours after your child goes to sleep. She might sit up and scream, but she isn't awake and not
conscious that you're there. Night terrors tend to occur when your child is overtired, according to Dr. Widome.
If she experiences them
repeatedly, taking a very short nap in the late afternoon can reduce her fatigue.
Nightmares, on
the other hand, tend to be concentrated in the 2nd half of the night during REM sleep. Bad dreams are young children's way
of playing out unresolved feelings or experiences, says Claire Lerner.
Since they can't yet distinguish between fantasy and reality, the scary feelings remain. In addition to
providing comfort, help your child figure out ways to combat her fears.
After having 2 bad dreams, my 4 year-old, Sara, was afraid to go back to sleep. Fortunately,
her preschool class was making Native American "dream catchers" - Sara's resembled a spiderweb with a feather dangling down.
We hung it by her bed and talked about how the dream catcher would ensnare the bad dreams, while the good dreams would slide
down the feather into her mind.
The dream
catcher worked - Sara hasn't had bad dreams since. Similarly, if your child is afraid of monsters, you might
offer him a means of keeping them at bay (that is, in his control):
- One mother gave her son a bottle of "monster
spray" (a water spritzer)
- another let her daughter choose a stuffed animal as her protector
Nightmares
aside, if your preschooler is still waking up at night, you might want to consider using a system of rewards
and consequences. Dr. Weissbluth recommends providing a set of sleep rules (close your
eyes; stay quiet; stay in bed; try to sleep).
For every night that he follows the sleep rules, the child earns a star. When he accumulates
a certain number of stars, he receives a reward. When he doesn't follow the rules, he loses a privilege the next day.
This method
worked well with both our 4 and 6 year-olds. After just 3 nights, they were finally sleeping in their own
beds until morning.
6 to 11 Years
Insufficient sleep is the most insidious sleep problem among older children. They're going to sleep
later yet waking up at the same time.
A growing
body of research suggests that sleep deprivation has a significant impact
on school behavior and performance.
"Instead
of becoming quiet and somnolent, as adults do, kids become hyperactive and out of control," says David Gozal,
M.D., director of the Comprehensive Sleep Medicine Center at Tulane University Hospital Clinics, in New Orleans.
"Their ability to pay attention decreases, as does their ability to
concentrate, solve problems and retain what they learn."
Experts
agree that parents must set limits, not only on how late school-age kids can stay up but on what they can do
before bedtime. Watching TV, playing computer and video games and surfing the Net are stimulating activities that keep kids'
minds working overtime.
And a
full plate of after-school commitments prevents them from finishing their homework at a reasonable hour. "Families
need to make sleep a priority and put it into their schedules," says sleep expert Mary Carskadon,
Ph.D., a professor of psychiatry and human behavior at Brown University.
Sleep shouldn't be a last
resort after activities - or energy - run out.
Copyright© 2004. Reprinted with permission from the August 1999 issue of Parents magazine. Found at Parents.com!
Newborn Baby Sleep Solutions
- Tips and Wisdom - By Marvin Perry
As a new mother
or father, one of your priorities should be to develop good sleeping habits for your newborn
baby.
It's important
for your baby to learn how to sleep on his or her own. The transition from sleeping with parents to sleeping on their own
can be demanding and take some time.
Of
course, the need for a full night of rest, for the parents, should be adequate motivation to help one's newborn
baby learn how to sleep on their own.
In order to instill
good sleeping habits in your baby, you have to research and investigate a variety of baby sleep tips and solutions:
Don't be afraid
to trust your parental instincts also.
Most baby sleep
methods converge around the concept of determining routines and associations for your child's naptime and sleep. The sooner
your little one starts to relate bedtime with sleep, the more likely he is capable of going to sleep with no problem at all
and sleeping through most of the night.
A period that's
commonly disregarded in forming day and night associations, is the "transition" period, the time between being awake and falling
asleep.
The following are
a list of some transitioning techniques to try:
1. "Fathering Down" is good method
parents should use in encouraging your baby's sleep routine. Prior to placing the baby in bed, the father should cradle the
baby so that the newborn's head rests on the father's neck.
The father should
then talk gently to the newborn until the child falls asleep. Babies are usually more soothed and calmed by a male's deeper
speech and can fall asleep more smoothly upon hearing it for some time.
2. You can
also attempt to execute a technique that's sometimes referred to as the "Wearing Down" method. If your baby is extremely energetic
throughout the day and becomes so aroused that, at night, he or she can't sleep, then this would be a very effective technique
to use.
All you have to
do is "wear" your baby in a sling or carrier for about 30 minutes to an hour before their bedtime. Simply go about performing
your normal household duties and over time, the baby will gradually fall asleep.
The idea and process
of the baby being next to his or her parent and slowly rocked before bedtime aids the newborn in making an easier transition
from being awake to being asleep.
3. Finally, if you've exhausted all the other
options and nothing works, you can attempt to employ the rarely used but effective "Driving Down" method. Unfortunately, most
parents are informed about this procedure as a last resort.
This technique
involves placing your baby in the car and driving him or her around until they fall asleep. This method, while inconvenient,
usually works all the time and if you desperately need a full night of sleep, it's the most trusted and reliable method to
use.
Apparently, you shouldn't have to drive around
every night or carry him in a sling to make your baby sleep through the night. The initial idea is to begin with these more
demanding methods and slowly ease out of them. Keep in mind that your baby is going through major development while he is
yet very young and small.
They've never slept
on their own before and it may take a while for them to adjust to their new sleeping routine. Newborns simply don't know how
to transition from being awake to being asleep and it may require much patience on the part of the parents.
However,
by utilizing these effective techniques you'll be slowly conditioning your baby's sleep pattern and habits, which will
ensure that both you and your little one will obtain a good night of sleep.
The 7 Most Common Nap Traps -
By Cathryn Tobin, MD
Have you been tripped
up by any of these situations?
Nap Trap #1: "My baby wakes up the instant
I put him down."
He shouldn't fall asleep
in your arms in the first place. Remember the rule: to bed semi-awake.
Nap Trap #2: "My
baby refuses to nap."
Typically, the problem is timing. A baby won't nap unless he's tired. Try too early and he'll resist;
try too late and he'll catch a second wind. In general, a young baby needs to nap after 2 hours of activity.
Nap Trap
#3: "My baby takes only short naps." There are several equally good reasons a baby may take only catnaps.
First, a short nap may be all she needs; some babies are fully energized after 30 to 40 minutes of sleep.
But this next reason is more likely the culprit:
Your baby may be having problems going from a shallow to a deep sleep
state. She may wake up after 20 minutes because she can't settle down. Here are some ways to help your baby
relax.
Turn Down
the Volume.
Remember, it takes 10 to
20 minutes for a young baby to fall into a deep sleep. You must proceed with caution during the transition. The fewer distractions,
the greater the likelihood he'll nod off.
Young
babies sleep best surrounded by white noise, but sometimes loud, sudden household noises interfere with drifting
off.
If there are older siblings at home, consider using white noise to minimize outside distractions.
Like the mantra "om . . . om . . . om . . .," white noise allows a baby to dive into a deeper level of consciousness. Once
he's asleep, there's no need to keep the troops quiet.
Get There First.
If
your baby consistently wakes up after a 30-minute nap, tiptoe into her room around the 20-minute mark and charm her back to
sleep once she starts the wake-up shuffle. Don't leave the room before she's in a deep sleep. If you try to sneak out too
early, she'll notice and wake up.
Think Outside the Crib.
Even when your baby's sleeping,
his gifted brain is busy soaking up outside signals. A dark room sends the message "go back to sleep" and can extend naptime.
So hang dark curtains and get rid of the night-light.
Nap Trap #4: "My
baby naps best in her car seat."
A baby who loves to sleep in her car seat is most likely one who loves to feel cuddled,
as though she's in a cocoon - which isn't surprising, considering a baby spends 9 months curled up in the womb.
Swaddling is the
best way to re-create this comfort. According to recent studies, swaddling helps babies sleep longer.
Nap Trap #5: "My baby power-naps in the car on the way home from daycare and then refuses to go to bed."
Some things can't be helped, but that doesn't mean you shouldn't try.
Here are some suggestions:
Nap Trap #6: "My
baby only catnaps because we're always on the go."
Some families are so busy that it's hard to squeeze in a good nap. There's nothing intrinsically wrong
with short naps, as long as your baby is well rested.
However,
if your baby falls apart at the end of the day, is hard to please, dozes off the instant he's in the car seat, or is high
maintenance, I'd rethink your activities. If you have an older child with a jam-packed schedule, perhaps it's time to simplify.
In an effort to allow stay-at-home naptime, I suggest you cut back on commitments, carpool, or hire a sitter.
Nap Trap #7: "My baby will nap only if I lie down with her." There is nothing wrong with lying
down with your baby, provided you're prepared to do this for a long time; it's the kind of habit that's hard to break.
Instead, sit beside her bed and charm her to sleep. She'll feel the same sense of closeness and ultimately sleep
for longer stretches. Best of all, you can sneak out of the room as she becomes more adept at self-soothing to sleep.
Reprinted from: The Lull-a-Baby Sleep Plan: The Soothing, Superfast Way to Help Your New Baby
Sleep Through the Night . . . And Prevent Sleep Problems Before They Develop by Cathryn Tobin, MD (August 2006; $14.95US;
1-59486-222-2) © 2006 Cathryn Tobin, MD. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are
sold or directly from the publisher by calling at (800) 848-4735.
From Crib to Big-Kid Bed
Expert hints to make the bedtime switch as smooth as possible.
By Ann Colin Herbst
Introduction
When Paul
Ryan, of Thornwood, New York, discovered that his 2 year-old son, Tim, had climbed out of his crib in the middle
of the night, he knew it was time for the toddler to switch to a bed.
"We were just lucky he didn't hurt
himself," Ryan says.
Like Tim,
many kids between the ages of 2 and 3 are ready to make the move to a bed and climbing out (or
trying to) is a clear sign that it's time. "Fortunately, most kids suffer only minor bumps or bruises when
they take a spill climbing out of a crib," reports Alan Kulberg, M.D., a pediatrician in Pittsfield, Massachusetts, "but you
don't want to risk serious injury or have your child wandering around in a room that's not childproofed."
Even if
your child still seems content in his crib, he may have outgrown it. If he's 35 inches tall or the railing reaches
midchest level, he could scale the crib railing at any time - and probably needs more room to sleep comfortably too.
Another
reason many families make the switch is the imminent arrival of a new baby who's going to need a place to sleep.
But while most toddlers are thrilled by the status of a big-kid bed, some may be reluctant to give up the cozy security of the crib. "It takes some time for them to feel comfortable in a less enclosed space," says Dr. Kulberg.
And some
kids feel ambivalent about leaving this vestige of babyhood behind. But by planning ahead and anticipating the trouble spots, you can make the transition trauma-free.
Talk About a Bed While Your Child is Still in the Crib
Start
the conversation casually. Say something like "You're getting so big. Pretty soon, we're going to have to get
you a big-boy bed, like the one Mommy and Daddy sleep in."
By making the bed a symbol
of maturity, you can turn the move into a celebration, not a loss, says Pam Shaw, M.D., a clinical associate professor
of pediatrics at the University of Kansas Medical Center, in Kansas City.
It's especially
important to emphasize your child's grown-up status if you're expecting a new baby. "This way, you keep the
focus on the older child and avoid the unintentional message of 'We're having a new baby, so you have to move,'" says Dr.
Shaw.
It's definitely better not to wait until the new baby arrives to make the switch. "Ideally, you want a
gap of a couple of months between the time a toddler leaves his crib and the time the new brother or sister moves into it,
particularly if they're going to be sharing a room," notes Vanessa K. Jensen, Psy.D., head of pediatric psychology at the
Cleveland Clinic, in Ohio.
To help your child feel more involved in the change, let her
pick out her own bedding. Choosing Little Mermaid sheets or a comforter in her favorite color can make her feel independent
and grown-up.
"When Heather and Connor picked out their own sheets, it made them feel it was their bed
and not this thing my husband and I were forcing on them," says Maria Fisher, a mother of 3 children in Farmington, Utah.
"In each
case, by the time the bed arrived, my kids were excited about sleeping in it."
On the night you make the switch, dismantle the crib first and put it away; for many toddlers, out of
sight is out of mind.
If you don't want to take the crib apart because you'll need it for a new baby, Jensen suggests
letting your child use it as a pretend bed for dolls or stuffed animals.
"Putting her own 'babies' in it for a while will reinforce the idea that cribs
are for infants and beds are for big kids," she advises. "Then you can casually mention that eventually the new baby will
sleep there, too, without making a big deal out of it."
Be Firm About Staying in Bed
When it's bedtime, keep your
nightly routine the same, though you may want to introduce a new ritual that incorporates the bed, like snuggling in it together
while reading a story or tucking your child in with his new comforter.
If he seems anxious the first night, promise that you'll check
on him in a few minutes -- and return when you said you would. If he gets out of bed to come find you, Dr. Shaw recommends
saying calmly, "It's time to go back to bed" and walking him back to his room. If you give your child lots of extra attention
or cave in to his demands for a story or glass of water, you're setting yourself up for weeks of bedtime chaos.
What if your child gets out of bed but doesn't leave his room?
Should you make him get back under the covers? Surprisingly, most experts say no. "I recommend doing nothing if the room is
properly childproofed," Dr. Shaw says. "Most kids will fall asleep on their own when they're ready. And chances are, after
a few nights, they'll settle down right away."
If, despite all your preparations, your child insists that he
still wants to sleep in his crib, Dr. Shaw recommends standing firm. "Letting a child go back to sleeping in the crib is not
a good solution, especially if he might fall out and get hurt," she notes. However, if prolonged crying continues for longer
than two weeks, consider whether there are other stresses in his life that are making the transition difficult, such as a
new day-care teacher or the death of a grandparent. Helping him cope will probably solve the bedtime problem as well.
Still, most 2-year-olds rise to the challenge of sleeping in
a real bed. "The vast majority are eager to make the switch," says Jensen. "Doing what the big kids do is a tangible sign
of the independence they've been striving for."
Is Your Child Ready for a Bunk Bed?
By Don
VanPelt
For every child, growing up
is a series of transitions from one stage to another. Sometimes we can tell they're happening, sometimes we make them happen,
and sometimes we wonder if they should wait.
We bring babies home to cribs
& they outgrow them. We hold our breath as they sleep that first night in a “big kid” bed, hoping they won’t
roll out, or sleepwalk, or decide to get up before we do & make us a ketchup sandwich for breakfast!
If you're thinking you’d like to switch to bunk beds for your children, here are some things to consider before making this transition.
If your child is very young,
consider the type of bunks you might buy to help them make that first move from a crib. One option is to purchase a bunk with
a double bed on the bottom & a twin on top & remove the ladder. If your child isn't a climber, this option will serve
you well. They have room enough to roll around without falling out of bed & they might like the sheltered feeling of having
a bunk overhead.
If your child is older, or
you have children getting ready to share a room, bunks can be a lifesaver. Children who have to share a room sometimes feel
their space is invaded, so bunk beds can help them claim a part of the room for their own. They also might like the space-saving
aspect of bunks, especially if they learn to store items neatly underneath.
If your children need to share
& aren't close in age, consider a futon bunk bed. Your older child will have a double-size bed that can become a sofa
& your younger child will have a regular twin-size bed above it. This option is nice to transition that room & its
occupants for when there’s only one – the sofa can stay a sofa & the child feels more grownup, having it there.
Many bunk beds have the option
to be separated or stacked, depending on the need & the space they'll fit, so you have many choices. Some have optional
furniture to fit in with them, should you need it. If you think your child is ready, or you need a change, consider the flexible
option of bunk beds.
source: click here
Help Teens Get the Sleep they Need - By Patti Teel
Teenagers are one of the most sleep deprived segments of the population. Most teens require at least 9 hours of sleep but get much, much
less.
It's a time when school, homework, community service, extracurricular activities,
active social lives & part-time jobs keep them busy from early in the morning until late at night. They're likely to try
to make up for a lack of sleep by "sleeping in" on the weekends.
Unfortunately,
this contributes to an irregular sleep schedule & actually makes the problem worse,
setting them up for a kind of jet lag when Monday morning rolls around.
In addition
to having a difficult time turning off the worries of their day, most teens show signs of delayed circadian rhythms - which contributes to their inability to fall asleep until later at night. Since
many teens aren't sleepy until around 11 p.m., but need to be at school by 7:30 or 8 a.m., they can't get an adequate amount of sleep.
During puberty,
the biological clock in the brain naturally resets to a later time. The pineal gland releases melatonin later at night &
this causes teens to fall asleep later. Then, when it's time to get up, a teenager's body clock is likely to still be producing the nighttime hormones. This makes it hard for them to feel active & energetic
in the morning.
A growing body of research suggests that starting high school later,
more in line with their natural biorhythms, improves attendance, tardiness, achievement & grades. A few years ago in a
landmark study, test scores on the SAT college entrance exams in Edina, Minnesota jumped more than 100 points on average,
when the morning school bell was delayed for an hour.
Unfortunately,
most schools aren't set up to start later & accommodate teen's sleep needs.
Lack of sleep can
be very dangerous for young drivers & it's vitally important to warn teenagers about the dangers of driving while drowsy.
Although parents always warn their teens about the dangers of drinking & driving, many of us forget to warn our teens not to drive when they're drowsy, a very real danger today.
Drowsiness is
the principal factor in about 100,000 car crashes each year, killing adults, teens & children.
If you feel your
teenager has a serious problem falling asleep at night & simply can't get going in the morning, check with your physician. If
you choose to consult with a naturopath, he or she may prescribe melatonin supplements &/or light therapy.
Helping our teenagers to get adequate sleep is a daunting task, but there are things that you can do to
help:
-
Stress the importance of a consistent bedtime
-
Help teens to learn relaxation techniques
in order to unwind & signal the body that it's time for sleep.
-
Encourage them to practice creative visualization
& progressive relaxation techniques.
-
Putting their thoughts & worries in a journal
often helps them to put their problems to rest, enabling them to sleep.
-
Have them turn off all electronic equipment (including phones) at least an hour before bed.
-
Discourage them from drinking caffeinated drinks
in the afternoon & evening.
-
Encourage regular exercise,
especially outside in the morning. (Morning sunshine can help to reset the internal
clock.)
-
Although teens are likely to sleep in on the weekend, don' t let them sleep in for more than a total of
2 hours over the entire weekend.
-
Simulate the dawn by opening the curtains &
turning on the lights an hour before your teen needs to get up.
-
And don't forget to warn them about the dangers
of driving while drowsy!
Poor Sleep Can Affect A Student's Grades, Increase Emotional, Behavioral
Disturbance
Insufficient sleep among adolescents may not only contribute
to lower grades and a lack of motivation, but may also increase the odds of serious levels of emotional and behavioral disturbances,
including ADHD, according to a research abstract presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated
Professional Sleep Societies (APSS).
The study, authored by Fred Danner, PhD, of the University of Kentucky, focused
on 882 high school freshmen who provided information about their sleep habits and school grades and also completed psychological
and behavioral assessments.
According to the results, students reported sleeping, on average, 7.6 hours per school
night, with 48 percent reporting less than eight hours. Hours of sleep per school night were significantly positively associated
with GPA and level of motivation, and significantly negatively associated with clinically significant levels of emotional
disturbance and ADHD. Each additional hour of sleep on school nights lowered the odds of scoring in the clinically significant
range of emotional disturbance and ADHD by 25 percent and 34 percent, respectively.
"Since these findings are based
on associations rather than direct experimental manipulation, they cannot conclusively prove that insufficient sleep causes
a loss of motivation, poor grades, ADHD, and emotional disturbance during adolescence," said Dr. Danner. "The results, however,
are consistent with a growing body of research that many adolescents do not get sufficient sleep and that even mild chronic
sleep deprivation has serious effects on their psychological functioning. Lack of sleep should no longer be considered a traditional
adolescent rite of passage because it can have serious consequences."
It is recommended that adolescents get nine
hours of nightly sleep.
The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good
night's sleep:
- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Get a full night's sleep every night.
- Avoid foods or drinks that contain caffeine, as well as any
medicine that has a stimulant, prior to bedtime.
- Do not stay up all hours of the night to "cram" for an exam,
do homework, etc. If after-school activities are proving to be too time-consuming, consider cutting back on these activities.
- Keep computers and TVs out of the bedroom.
- Do not go to bed hungry, but don't eat a big meal before bedtime
either.
- Avoid any rigorous exercise within six hours of your bedtime.
- Make your bedroom quiet, dark and a little bit cool.
- Get up at the same time every morning.
Those who suspect that they might be suffering from a sleep disorder
are encouraged to consult with their primary care physician or a sleep specialist.
----------------------------
Article
adapted by Medical News Today from original press release.
----------------------------
More information about
"teens and sleep", including a new questionnaire that assesses the level of sleepiness in adolescents, is available from the
AASM at: http://www.sleepeducation.com/Topic.aspx?id=71.
The annual SLEEP meeting (9-12 June, 2008) brings together
an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new
findings and medical developments related to sleep and sleep disorders.
More than 1,000 research abstracts will be
presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific
meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and
treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea. SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment
available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities. Source:
Kathleen McCann American Academy of Sleep Medicine
Getting Your Child To Sleep
Practically every parent has had a hard time getting
his or her child to go to bed, to stay there, and to sleep
through the night. For children with mental health issues, sleep problems
can be even more common and have a greater impact on their well-being.
A regular sleep schedule is essential for successful
treatment of mental health issues and for a child’s
overall health, both mental and physical.
COMMON STRUGGLES INCLUDE:
• Establishing a consistent bedtime routine
• Managing a child’s tantrums once he
or she is in bed
• Dealing with a child who wakes up repeatedly
during the night
• Getting a child to sleep through the night
in his or her own bed
HERE ARE SOME SUGGESTIONS FOR SUCCESS:
1. Set a regular bedtime and stick to it.
2. Develop a soothing, regular routine to prepare
for bedtime, including 30–45 minutes of “quiet
time."
3. Turn off the television or remove the television
from your child’s bedroom.
4. Restrict drinks, especially caffeinated beverages,
in the evening. Do not let your child take a bottle or sippy
cup to bed.
5. Offer your child a “transitional object”
for bedtime. A transitional object is something that lets
him or her know it is time for bed, such as a favorite blanket, stuffed animal, or toy.
6. Comfort your child for a minute or so before leaving
the room, but remember you want him or her to learn to put
himself or herself to sleep.
7. End your child’s bedtime routine with your
child in bed, although not necessarily asleep.
8. Expect that your child will go to sleep - do not
play or have a conversation with your child after you say
good night. If your child gets out of bed, calmly return your child to bed
and say, “It’s time to sleep.”
If you must return to comfort your child, interact
as little as possible.
9. Reward progress!
It is helpful to talk with your child’s pediatrician about
setting effective sleep routines that work best for your child. If you child
has an occupational therapist, talk to him or her for ideas as well.
source site: click here
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It's in the news....
Sleep Basics:
Grab these tips for more peaceful nights with baby.
Things to Know
Sleep issues consume a huge
amount of a new parent's waking hours - & her sleeping hours, too! Here are some basic pointers on getting your newborn
to sleep -
- A newborn averages about
16 hours of sleep a day but often can't snooze for more than a few hours at a time - so you may not get a good night's rest
for a while. By the time they're 3 or 4 months old, most babies will consistently sleep thru the night.
-
Newborns wake up frequently
because they get hungry. Most experts say a baby must weight 12 to 13 pounds before she can hold enough food in her stomach
to tide her over until morning.
-
To encourage drowsiness, don't
play or socialize with your baby during night-wakings. Keep the room dim, feed & change her quietly, then put her back
down.
-
Many newborns sleep more during
the day than during the night. To help her adjust to a more adult-friendly sleep schedule, give her plenty of daytime cues:
Play with her, keep the room light & feed her on demand.
-
If, after 3 weeks baby's still
sleeping more during the day than at night, try waking her earlier from her long stretch of daytime sleep. Gradually, she'll
start making up for that lost sleep after dark.
How to Put a Baby to Bed
- Make sure baby's sleeping
place is safe. She should sleep on a firm surface, without blankets or quilts, pillows, or stuffed animals. (See
Choosing and Using a Crib for more info below.)
- Turn overhead lights off,
but keep a dim lamp or nightlight on.
- Create a bedtime ritual -
read her a quiet story, sing lullabies or play soft music, rock her and stroke her. Keep the routine consistent, doing the same things in the same order each time you put baby down to sleep.
- If she's asleep in your arms
and you'd like to put her down, make sure she's in a deep stage of sleep first. What to look for: a motionless face and limp,
dangling limbs. Then, put her down as gently as you can and keep a hand on her tummy for a minute or two afterward.
- Always put baby to bed on
her back. Don't place her tummy-side down.
- If you're going into another
room, keep a baby monitor switched on, so that you'll be sure to hear when she wakes up.
Sleeping Dos & Don'ts
Start learning them now!
By Charlotte Latvala
Do
Put Baby to sleep on his back.
The American Academy of Pediatrics recommends this position because it reduces the risk of SIDS (sudden
infant death syndrome).
Dress her so she is cool but
comfortable; her hands & feet should be cooler than the center of her body. Keep the baby's room about 70 degrees during the day
& 60 degrees at night.
Create a dark environment.
When an infant is between 3 & 6 months, his internal body clock starts responding to light & dark.
Realize that waking at night
is normal. All babies wake about 4 or 5 times during the night; problems arise only when they can't get back to sleep on their
own.
Don't
Rush in at the first sound
your baby makes. "You want to give a child a chance to learn to return to sleep on her own," says Jodi Mindell, Ph.D., a sleep
specialist at Children's Hospital of Philadelphia. Likewise, don't keep your monitor at the loudest volume; your baby's every
amplified rustle & sigh will keep you from getting any rest.
Rely on a pacifier to get
your baby to sleep, unless you want to fetch it continually during the night. In addition, pacifier use may contribute to
dental problems; recent studies have also linked pacifiers to ear infections.
Put toys, pillows, or quilts
in the crib; they could suffocate an infant.
Use the crib for play, punishment,
or mealtime. "Your baby should associate his crib with one thing - sleep," says Daniel Glaze, M.D., of the Texas Children's
Sleep Laboratory, in Houston.
Baby & Toddler Sleep Tips
Our essential guide will help you solve your child's sleep problems and give your entire
family a better night's rest.
By Donna Christiano; Photo by Jason Todd
Baby's Awake - Again
-
Stick to a bedtime.
"Don't wait until your baby is rubbing his eyes or yawning to put him to bed," says Marc Weissbluth, MD, author of Healthy
Sleep Habits, Happy Child. "By then he's overtired." If you notice your child winding down at 8 p.m., make that his bedtime.
-
Get into the routine.
30 minutes to an hour before bedtime, start a calming ritual that may include giving a bath and reading a story or two.
-
Put your baby in her crib
awake. If your child is routinely rocked to sleep at bedtime, what happens when she wakes up alone at 3 a.m.?
Answer: She cries.
"All infants and toddlers wake 2 to 6 times a night," says Parents advisor Jodi Mindell, PhD, coauthor of Take Charge
of Your Child's Sleep. "They need to know how to put themselves back to sleep."
-
Swaddle for the first 3 months.
Research shows that
infants who are swaddled wake up less and sleep longer than
other babies.
-
Tune out. If your
baby seems sensitive to household sounds, try running a white-noise machine or a fan in her room.
-
Let the sun in.
Expose your baby to about 30 minutes of light each morning. Why? Light suppresses the release of the sleep hormone melatonin;
this helps set her internal clock - making it easier for her to fall asleep at night.
Your Toughest Questions Answered
Q. My 8-month-old daughter routinely
falls asleep with a pacifier in her mouth. Is this okay?
A. "It's fine, but unless you
want to get up several times a night to retrieve it from the floor and put it back in her mouth, be sure to leave several
pacifiers in the same corner of the crib so she'll know where to look for them," says Dr. Mindell.
Q. My 3-year-old is too big for
his crib, but we're worried he'll have problems moving to a big-kid bed. Any tips?
A. Talk up the idea several days
before you make the switch. Get him excited about his bed by letting him help you pick out new sheets. And make the transition slowly so he's less anxious; some moms start by putting the mattress on the floor for several days before moving it to the bed frame.
Think about safety too: Add a guardrail to his bed and make sure you've covered electrical outlets
and attached bookcases to the wall.
Q. My child started sleeping through
the night at 4 months. Now, at 9 months, she wakes up every few hours. Help!
A. "She may be teething, not feeling
well, or going through a bout of separation anxiety - all of which could make her cry out at night," says Dr. Mindell. Give it a few more nights, but if she's still waking up
at night after several days or a week, it's time to help her relearn how to fall back asleep on her own.
To
do this, check on her when she cries, but don't pick her up, bring her into your bed, or rock her. Instead,
talk to her in a soft voice, then leave the room. Keep checking on her in 10-minute intervals until she dozes off.
Nap Know-How
Like nighttime sleep,
naps give your child's brain & body a chance to recharge. (And let's face it,
a couple of hours of downtime for you doesn't hurt either!)
Here, 5 ways to help your little one nap like a pro.
Time it right. Just as you do at bedtime, look for cues that your
child is sleepy. "The younger the child, the shorter the time he should be awake," says Dr. Weissbluth. "A newborn should
be soothed back to sleep after just 1 or 2 hours of being up."
Follow your child's lead. Some babies take three 45-minute naps per
day, while others hunker down for two 90-minute naps; either one is fine.
Aim for the same time, the same place. Siblings' schedules will sometimes
get in the way of your baby's nap, but try to be consistent. "Putting a baby down 30 to 40 minutes later than usual for a nap can throw off his schedule for the day," says Dr. Weissbluth.
And while letting your child nap in his car seat or swing is okay on occasion, it's important for a child to identify his
crib as the spot where he regularly sleeps.
Set a pattern. Your child is able to anticipate bedtime because of the routine you've created for her, so do the same for naptime. Read her a story, turn on some music,
or sing her some of her favorite songs.
Make adjustments. Babies & toddlers will skip their naps from
time to time. "If your 6-month-old refuses to sleep during her normal morning nap, move her afternoon nap to an earlier time,"
says pediatrician & Parents advisor Ari Brown, MD, coauthor of Baby 411: Clear Answers & Smart Advice for Your Baby's
First Year.
Extra Sleep for Young Children May Resist Extra Pounds
By Neil Osterweil, Senior Associate Editor, MedPage Today
February 08, 2007
EVANSTON, Ill., Feb. 8 Lack of sleep can weigh heavily
on children.
Children who get less shut-eye
than their classmates are more likely to be overweight, reported Emily K. Snell of Northwestern University here and colleagues,
in the January-February issue of Child Development.
"Our
study suggests that earlier bedtimes, later wake times and later school start times could be an important and relatively low-cost
strategy to help reduce childhood weight problems,"
said Snell, a doctoral candidate in human development and
social policy and colleagues.
In a longitudinal
study comparing weight and body mass index in children from the ages of 3 to 17, they found that "even an hour of sleep makes
a big difference in weight status."
"Sleeping an
additional hour reduced young children's chance of being overweight from 36% to 30%, while it reduced older children's risk
from 34% to 30%," said Snell.
Although several previous
studies have linked lack of sleep with overweight and obesity in both children and adults, the authors tried to determine
just how the sleep (or lack of it) and BMI are causally related. To evaluate the relationship between sleeping and BMI, the
authors first looked at sleep behaviors in children and teens and then looked for associations between sleep and subsequent
BMI and overweight/obesity status.
"Many previous studies control
neither for prior weight nor for potentially confounding variables, so we can't know whether child overweight status contributed
to sleep problems or whether child or family characteristics (such as child health status
or family schedules) differed in some other way that influenced both sleep behavior and weight," they wrote.
In addition, "little is known
about the potentially moderating influences of age on the relationships between sleep and developmental outcomes, although
we know that there are age-related shifts in children's sleep needs and the circadian timing of sleep, particularly as children
enter the adolescent years."
They drew on data from the
first and second waves of the Child Development Supplement of the Panel Survey of Income Dynamics. The survey is a longitudinal
study of a representative sample of U.S. individuals and their families.
In 1997, the investigators
of that study surveyed 2,394 families who provided information on a total of 3,563 children, known as the first wave (or time
1). In 2002-2003, 2,021 of the families were re-interviewed, resulting in a total of 2,907 child interviews, making up the
second wave (or time 2).
Snell and co-authors excluded
from their study data on the sleep habits of children who were 3 years old or younger in 1997, because of potential significant
differences in the nature of nighttime sleep between infants/toddlers and older children.
Sleep behaviors were recorded
by either older children or the parents/caregivers of younger children. The time diaries included data on bedtime, time asleep
and wake time over the course of a weekday and a weekend day.
The main outcome
measures were children's standardized BMI and overweight status at the time of the second wave.
In their analysis
of sleep behaviors, they found cross-sectional associations between measures of weight and both sleeping very little and having
later bedtimes.
Sleeping less than 8 hours
a night was correlated with higher BMI as well as being overweight during the first wave, while sleeping between 10 and 11
hours a night was correlated with not being overweight, they wrote.
In addition, later bedtimes
were correlated with being overweight during the first wave. They also found measures of sleep during the first wave to be
correlated with BMI and overweight status during the second.
They also found that the more
sleep kids got at baseline, the less likely they were to have a high BMI or be overweight during the second wave.
In addition, among younger
children (3 to 8) later bedtimes were associated with being overweight, while among children 9 to 13 earlier wake times were
more often associated with overweight.
There were no significant
gender-related differences in the effect of sleep on weight and the authors didn't find any associations between lack of sleep
and difference in growth rates.
However, they
noticed a trend toward children getting less sleep than recommended. For example, they found 7 year-old children were getting
fewer than 10 hours of sleep on weekdays, compared with the 10 to 11 hours recommended by the National Sleep Foundation.
Similarly, 16% of adolescents
got fewer than 7 hours of sleep on weeknights, compared with the 8 to 9 hours recommended for their age group.
They found that even 1 additional
hour could have a significant positive effect on BMI and overweight status, noting that the chance of a child being overweight
during the second wave declined by 5.3 percentage points, from 35.6% to 30.3%, when the average sleep length during the first
wave increased from the sample average of 9.9 hours to 10.9 hours.
"If our results
represent a true causal relationship between sleep and weight," they wrote, "encouraging parents to put their younger children
to bed earlier at night and allowing both younger and older children to sleep longer in the morning, as well as urging school
districts to avoid very early school start times for later elementary and middle school aged children, might represent an
important and relatively low cost strategy to reduce childhood weight problems."
Sleep Deprived Children Have Health Problems - By Patti Teel
If your child has frequent health and/or emotional
problems, consider that a lack of sleep may be all or at least part of the problem.
Every function in the body is affected
by sleep. And for a child, the risks of sleep deprivation are much more serious than simply waking up in a grumpy mood. Research
shows that children with sleep disturbances have more medical problems—such as allergies, ear infections, and hearing
problems. They are also more likely to have social and emotional problems.
There is a whole host of health problems
that have consistently been associated with inadequate sleep.
Sleep loss is linked to obesity and diabetes
Sleep
loss can contribute to weight gain and obesity by triggering the hormones that regulate appetite and hunger. In other words,
inadequate sleep may cause children to overeat. University of Chicago researchers reported new evidence in December 2004,
Annals of Internal Medicine, that a lack of sleep changes the circulating levels of the hormones that regulate hunger, boosting
appetite and a person's preference for high-calorie, high-carbohydrate foods.
Many physicians believe that sleep loss
can also affect the ability to metabolize sugar and trigger insulin resistance, a well-known factor for diabetes. At the American
Diabetes Association’s 61st Annual Scientific Session, new evidence was presented that inadequate sleep may prompt development
of insulin-resistance, a well-known risk factor for diabetes. (In recent years, there has been a dramatic rise in the incidence
of childhood obesity as well as type 2 diabetes.)
Sleep loss is associated with anxiety and depression
Insomnia
is a significant risk factor for depression. It also contributes to anxiety by raising corstisol, the stress hormone. We have
known for some time that depression and anxiety can contribute to insomnia; however, recent research has shown that insomnia
often precedes the first episode of depression or of a relapse. Physicians are looking more closely at the importance of solving
sleep problems in order to eliminate or decrease the severity of anxiety or emerging depression.
Sleep loss may
impede physical development
The highest levels of growth hormone are released into the bloodstream during deep
sleep. Because sleep deprivation results in a decrease in the release of growth hormone, height and growth may be affected
by a lack of sleep.
Sleep loss affects immunity
During sleep, interleukin-1, an immune boosting substance,
is released. Several
nights of poor rest can hamper a child’s immunity.
Sleep deprived children are more
accident prone
A lack of sleep has an adverse affect on motor skills. Dr. Carl Hunt, director of National Center
on Sleep Disorders Research at the National Institute of Health says, “A tired child is an accident waiting to happen.”
Bicycle injuries and accidents on playground equipment are more likely to occur when a child is sleep deprived. And unfortunately,
the stakes get continually higher when poor sleeping habits continue and the accident prone child becomes the teenager who
is driving while drowsy.
Sleep loss may affect the response to vaccinations
A study published in the
Journal of American Medical Association (September 25, 2002) reported that sleep deprivation limited the effectiveness of
the flu shot.
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By Michael Smith, Senior Staff Writer, MedPage Today
PITTSBURGH, Jan. 2 -- Poor sleep is a frequent companion of
depression in children, according to researchers here.
Just like in adults, sleep disturbances and depression go hand
in hand in children, reported Xianchen Liu, M.D., Ph.D., of the University of Pittsburgh, in the Jan. 1 issue of Sleep.
In research conducted as part of a larger study in Hungary,
Dr. Liu and colleagues found that 72.7% of 553 children with a current depressive episode also reported a sleep disturbance.
Among the study participants, 53.5% had insomnia alone, 9.0%
had hypersomnia alone, and 10.1% had both disturbances, the researchers found.
Analysis of the patients revealed that average depression severity
scores -- on the Interview Schedule for Children and Adolescents-Diagnostic Version -- differed significantly (at P<0.001
for all comparisons) between children without a sleep disturbance and children with insomnia alone, hypersomnia alone, or
insomnia as well as hypersomnia.
Also, children with both sleep disturbances had
significantly more severe depression than did children with insomnia or hypersomnia alone (at P<0.001 and P<0.01,
respectively).
On the other hand, there was no significant difference between
children with insomnia and hypersomnia alone.
What's more, children with more than one form of sleep disturbance
were more likely to be in a recurrent episode of depression and to have had the illness longer than those with either insomnia
or hypersomnia alone, Dr. Liu and colleagues said.
Depressed girls were more likely to have sleep disturbance than
boys -- 77.0% versus 69.2%, which was statistically significant at P<0.05 -- but age had no significant effect.
When the researchers controlled for other depressive symptoms,
age, and sex they found that:
- Insomnia alone independently correlated with depressed mood,
diurnal variation, and agitation.
- Hypersomnia alone correlated with weight loss, weight gain,
and worthlessness.
- Insomnia plus hypersomnia correlated with anhedonia,
weight loss, agitation, distinct sadness, and guilt.
"These results suggest that three groups of sleep-disturbed
children are distinguishable from each other in the presentation of depressive symptoms," the researchers said.
The differences may indicate that different treatments are needed,
depending on the extent and type of sleep disturbance, but clinical trials and longitudinal studies will be needed to determine
that, Dr. Liu and colleagues said.
The study has several important limitations, the
researchers said. For one thing, the clinical interview from which the data were gathered was not designed to assess sleep
patterns and disorders, so that there is no data on bedtime, morning rise time, and sleep duration.
Also, no objective measures of sleep were used in the study,
such as nocturnal polysomnography.
The children ranged in age from 7.3 to 14.9 years, but the researchers
did not collect data on puberty, so that the effects of pubertal development are a potential confounding element.
In addition, they pointed out that "no causal relationships
can be concluded based on the current cross-sectional analysis. For example, the relationship between sleep disturbance and
depressive symptoms and comorbid anxiety disorders may be bidirectional."
Underlying Sleep Problem Linked To Attention-Deficit/Hyperactivity Disorder In Children
This is the first study
to compare in-home measurements of sleep architecture in children with ADHD and no co-morbidities with that of controls, while also controlling
for potential confounders.
A study in the March 1 issue of the journal SLEEP
suggests the presence of an intrinsic sleep problem specific to attention-deficit/hyperactivity disorder (ADHD) and supports the idea that children with ADHD may be chronically sleep deprived
and have abnormal REM sleep.
Results show that
children with ADHD have a total sleep time that is significantly shorter than that of controls.
Children in the ADHD group had an average total sleep time of 8 hours, 19 minutes; this
was 33 minutes less than the average sleep time of 8 hours, 52 minutes, in controls.
Children with
ADHD also had an average rapid eye movement (REM) sleep time that was significantly reduced by 16 minutes.
According to the principal investigator and the lead author, Reut Gruber, PhD, director of the Attention, Behavior
and Sleep Lab at the Douglas Mental Health University Institute, results of the study were encouraging, as the researchers
were able to control for many confounding factors, which reduced some of the confusion and contradictions discovered in previous
studies. Measuring sleep architecture in the children's beds at home using portable PSG,
also allowed researchers to better represent the natural sleep pattern, thus increasing
the validity of the study.
"I do not believe
that sleep per se is the cause of ADHD, but it may make the symptoms worse in children with sleep
problems. There are reports in the literature in which treating sleep problems led to improvement
in ADHD symptoms but I suspect that these results were seen in children with sleep apnea. More research needs to be done in
order to determine if sleep affects ADHD children with no primary sleep disorder."
According to the authors, ADHD is one of the most prevalent conditions in child psychiatry, and
25% to 50% of children and adolescents diagnosed with the disorder have clinically reported sleep
problems.
Partial sleep loss on a chronic basis accumulates to become a sleep
debt, which can produce significant daytime sleepiness and neurobehavioral impairment. Studies also have shown that disrupted
sleep can affect daytime learning and attention in childhood and can lead to ADHD-like symptoms.
Portable polysomnography sleep recorders were
used to perform overnight sleep recordings on 15 children diagnosed with ADHD without comorbid
psychiatric problems, and on 23 healthy controls. The children were between the ages of 7 and 11, were not taking medication
and were instructed to avoid products containing caffeine for at least seven days leading up to the overnight sleep study, which was performed in each child's home.
Parents completed
the Child Behavioral Checklist, a 113-item questionnaire assessing behavioral and emotional problems. Children also were assessed
for pubertal development. Factors such as age, sex, gender, socioeconomic status and parents' marital status were controlled.
According to the authors, this study may suggest that ADHD children suffer from
an intrinsic sleep problem that could be related to the underlying pathophysiology of the
disorder. They report that the impact of sleep duration on neuropsychological functioning
in children with ADHD should be investigated further. Additional studies also will be required to examine whether shorter
sleep duration in children with ADHD is associated with ADHD-like symptoms, including behavioral
problems and poor neurocognitive functioning.
The authors suggest that
if a functional alteration of sleep in children with ADHD can be confirmed, then it may
be possible to develop therapeutic approaches for optimizing and individualizing the children's sleep
regimes.
Notes:
More information about sleep and ADHD in children is available from the AASM at click here.
SLEEP is the official journal of the Associated
Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research
Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. SLEEP, a peer-reviewed
scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the SLEEP
Meeting of the APSS.
The study: "Sleep Disturbances in Prepubertal Children with
Attention Deficit Hyperactivity Disorder: A Home Polysomnography Study"
AASM is a professional membership organization
dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders
centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The
organization serves its members and advances the field of sleep health care by setting the clinical standards for the field
of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated
to providing optimal sleep health care and fostering the development and application of scientific knowledge. Source:
Kelly Wagner American Academy of Sleep Medicine
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