Are Children Getting Enough Sleep?

When my daughter, Kara, was 10 years-old and frequently read and critiqued my blogs, she suggested that I should write about kids and sleep.  I asked her why and she said that it was very important for children and she didn’t believe that all of her fifth grade classmates got enough sleep.  She said that children need different amounts of sleep at different ages.  After thinking about this for a while and observing her 18 year-old  brother, who didn’t seem to get much sleep, at least during the night, I decided that Kara was right – sleep is an important issue for children and maybe one that families don’t think about a great deal.

It’s an understatement to say that families and children are busier now than ever before.  Children are involved in so many activities outside the home, such as music, dance, karate, sports, and club meetings.  With all of these activities, children may not even get dinner until later in the evening.  Consequently, they have to accommodate to their parents’ schedules, which means getting to bed around 10 or 10:30 p.m. and getting up at 6:30 a.m.  Children, who are members of multiple households because of the divorce of their parents, may have more inconsistent bedtimes and suffer greater sleep disorders. Generally speaking, many children may not be getting enough sleep.  Researchers tell us that a preschool child needs about 10 hours of sleep a day, and school-age children need slightly less, or about 8 ½  to 9 hours.  By the teenage years the amount of sleep needed has increased again, although by all accounts, teenagers get less sleep than their school-aged counterparts.

Sleep problems in younger children may take the form of sleep association disorder – needing a particular object to get to sleep.  Some children may get into the routine of needing to be held or rocked to get to sleep.  A common sleep problem with school-aged children can be anxiety.  Children may worry about school problems, peer relationships, or family issues and have difficulty falling asleep or staying asleep once they wake.  Snoring has been identified as a particularly difficult sleep problem for children.  The form of snoring where breathing becomes a struggle is referred to as “sleep apnea.”

Sleep researchers point to circadian rhythm as one of the sleep problems of adolescents.  Researchers have found that over 50 percent of adolescents go to bed at 10:00 p.m. or later and 21 percent go to bed at 11:00 p.m. or later on a school night. They also get up by 7:00 a.m., surprising early and different from the perception that they are in bed until noon.  All this adds up to sleepy teenagers who experience school and relationship problems as a consequence.  Researchers have suggested that the circadian rhythm of teenagers is later than for preteens, meaning that they are just reacting to a natural pattern.  Some researchers have suggested accommodating adolescents by starting school later, while others suggest changing the circadian rhythm. 

A recent research study at Brown University found that as many as 37 percent of children from kindergarten through the fourth grade have some form of sleep disorder.  Since parents, teachers and health care practitioners assume that children get enough sleep, there may be far reaching consequences of sleep deficits in children.  Those that should be aware of these deficits do not seem to recognize the problem. Without good sleep, children become good candidates for school problems since it is associated with reasoning and memory loss and temporary reduction in IQ.

Researchers conclude that children who are deprived of sleep are frequently misdiagnosed with attention deficit hyperactivity disorder (ADHD).  Sleep deprived children often display inattention, hyperactivity, and difficulty in controlling their responses to situations.  The ability to think rationally and control impulsive emotional reactions and the regulation of sleep are all moderated by the prefrontal cortex.  This would indicate that a disruption in the sleep-wake systems might be related to the attentional, behavioral and emotional problems seem in ADHD.   

Many children express sleepiness and being inattentive and hyperactive.  According to Dr Ronald Chervin, a sleep researcher at the University of Michigan, the association between ADHD and sleep disorders in children is clear, but it is not clear which causes the other.  However, Chervin has found that children who snore are more likely to have indicators of behavior that are consistent with the diagnosis of ADHD.  The implication from this and other similar research is that at the first symptoms of hyperactivity, parents should assess the sleeping patterns of their children.  It is very likely that changing these sleeping patterns will significantly reduce the hyperactivity or inattention behavior.

To assess if your child has a sleep problem ask the following questions:

• Does my child complain of not falling asleep quickly? 
• Does my child delay going to bed past their bedtime?
• Does my child seem sleepy during the day?
• Does my child wake frequently during the night?
• Does my child sleep in excessively on the weekends?
• Does my child snore loudly?
• Does my child seem to have problems breathing?

If you answered yes to some of these questions, your child may not be getting enough sleep.  If your child has symptoms of ADHD, and you also answered yes to a number of these questions, you may want to consult with your pediatrician.  Improving your child’s sleep patterns may have far reaching implication on his or her behavior.