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Good Times and Bedtimes

18/02/2010

Good sleep is important for all of us and we need enough of it to lead happy and healthy lives. This is not rocket science, surely? I was brought-up on that old saying ‘early to bed and early to rise…’

A series of recent research reports – some populist opinion polling and some robust scientific work – have raised issues about the amount and quality of sleep our children are getting. Children themselves admit that they need more sleep (BBC: Newsround research: “Children Missing out on Sleep” 18.02.10).

We know that lack of good quality sleep correlates with a drop-off in school performance. For example, recent work by Kheirandish-Gozal et al (2010), published last month in the European Respiratory Journal (“Obstructive Sleep Apnea is associated with impaired pictorial memory task acquisition and retention in children”; 14.01.10 online), pupils with the respiratory condition Obstructive Sleep Apnea (OSA) were slower to learn tasks and retained less information from these exercises the following day.

But the BBC study asked healthy 9-11 year olds about their bedtimes and about half the 1000 questioned admitted staying up late to play on computers, watch TV or texting friends.

Parents have known for a long time that poor sleep links to moody and restless behaviour the following day. Now, there is a body of evidence linking sleep loss to impaired growth and distorted appetite  as well as problems with concentration, behaviour and school work.

There are important links to healthy lifestyles involved here. The physician and author Alexa Fleckenstein notes “Sleep improves immune function, takes stress away, and allows us to process the day’s events. Reducing stress lowers cortisol which otherwise would make us overeat.”

As Paul Gringrass, from the children’s sleep clinic at Guy’s and St. Thomas’s Hospital in London, puts it “Children aren’t just little adults. There’s a huge amount of brain development that’s going on and we know that even moderate sleep loss impacts on their ability to concentrate and behave the following day.  There are certain hormones we produce more of when we’ve had a bad, disruptive night, which make us hungrier. And we have this obesity epidemic. It’s a vicious cycle”.

Kathleen McGrath, author of the Good-night Guide for Children (published by the UK Sleep Council), says that attention, memory and learning are some of the first casualties of sleep shortage, so schools have a vested interest in getting children to take their sleep more seriously. “Sleep deficiency impacts strongly on the prefrontal cortex of the brain. This is the area engaged in what you might call higher-order thinking, involving creative and conceptual processes, as well as short-term memory.”

The impact gets worse for teenagers and adolescents, as poor quality sleep and lack of sleep are also linked to depressed mood states and self-harm. James Gangwisch and his colleagues at Columbia University have looked at the sleep patterns and of nearly 16,000 11-17 year olds. They found that those teenagers who were getting enough sleep at night were less likely to suffer from depression: “Later bedtimes appear to result in shorter sleep durations and a higher likelihood of not getting enough sleep, which in turn are associated with depression and suicidal ideation.”

Lack of sleep could lead to depression in a couple of ways. First, it might result in maladjusted emotional brain responses. Second, the resultant moodiness could harm interpersonal relationships, eventually leading to depression. Lack of sleep could also cause suicidal ideation by impairing judgment, concentration, and impulse control.

“Behavioral interventions that involve educating adolescents and their parents about healthier sleep practices and helping them modify maladaptive sleep habits could serve as primary preventive measures against depression and suicidal ideation,” the researchers concluded. (Gangwisch J, et al “Earlier parental set bedtimes as a protective factor against depression and suicidal ideation” Sleep 2010; 33: 97-106.)

Clearly, children need calmer and earlier bedtimes. Parents who take the digital gadgets away at bedtime are doing their kids a favour. Reading stories and talking to their children about their day will help them to ‘put the day to bed’. This has profound implications for everyone. If children have not been used to parentally imposed bedtimes, a new regime will be hard to enforce. But however hard the change, it will benefit all, as happier and healthier children sleep earlier and longer…and parents get a bit of grown-up time to call their own. And, as you set about removing the TV, mobile phone and games console from your children’s bedrooms, what is to prevent you from doing the same thing yourselves?!

So, there you have it. As Thomas Dekker, writing a little less recently, once said “Sleep is the golden chain that ties health and our bodies together.”

Good night!

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From → Children, Research

One Comment
  1. Sleep is getting scarcer in out times of TV and computer. You are right that adolescents are especially vulnerable. But the public has not even begun to see this as a problem.

    Our grandmothers’ saying that the sleep before midnight is the most precious has been confirmed by modern sleep studies. Repair of body cells takes place mostly if one is asleep.

    Alexa Fleckenstein M.D., physician, author.

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