Fixing your children's sleep problems may improve their grades and
their behavior.

By  Michael Breus, PhD 
Reviewed By Stuart Meyers, MD
on Wednesday, August 20, 2003
WebMD Feature

 

The new school year is upon us. From bedtime battles to the misery of
morning call, summertime sleep habits die hard. Late summer nights
combined with early school start times, and the stresses of just being
a kid, deprive our children of essential sleep. And sleep deprivation
often wreaks havoc with health, academic performance, and behavior. It
is an unrecognized epidemic.

From elementary school through high school and beyond, a great many of
our children are chronically sleep-deprived. With more than 1/3 of
elementary school-age children having some kind of sleep problem and
most adolescents not getting enough sleep, many will struggle to meet
the barrage of new challenges, demands, and emotions of a new school
year.

It is not widely recognized and appreciated just how pervasive and
critical quality sleep is for brain development and how it directly
influences daytime functioning, performance, mood, and behavior. When
was the last time your doctor asked about your child's sleep? Parents
wouldn't think of letting their child skip meals or run into a busy
street, but staying up late is very often of little concern. It
shouldn't be.

Sleep Affects How Your Child Thinks, Feels and Functions

More and more research studies demonstrate that daytime sleepiness
from chronic sleep deprivation and poor-quality sleep has significant
affects on daytime behavior as well as concentration, attention, and
mood. Even 20 fewer minutes of needed sleep may significantly affect
behavior in many areas. One study showed that those students with C's,
D's and F's got about 25 fewer minutes op sleep and went to bed an
average of 40 minutes later than A and B students. The pediatric
research findings are startling and alarming:

Poor sleepers reported being significantly more depressed, without
energy, tired, tense, moody, stressed, irritable, and less rested and
alert than good sleepers. Interestingly and importantly, they were
also more likely to have a negative self-image, which, in light of
the above, is not surprising.
Insufficient sleep has been associated with daytime fatigue, inability
to concentrate in school, ADHD, a tendency to doze off in class,
problematic behaviors, and lower levels of social skills.
Persistent sleep problems have been associated with learning
difficulties throughout the school years.
Poor sleepers were more likely to display type A behavior patterns.
Teenage insomnia has been related to anger, depression, difficulty
with school adjustments, and stress. And studies suggest that insomnia
often begins early in life and persists into adulthood.
Sleep-disturbed elementary school-age children may have poorer coping
behaviors and display more behavioral problems at home and in school.
Several studies report that more total sleep, earlier bedtimes, and
later weekday rise time are associated with better grades in school.
Those with poor grades are more likely to sleep less, go to bed later,
and have more irregular sleep/wake habits.

From Elementary to High School, Sleep Problems Are Pervasive and
Widespread

You may be surprised to learn how prevalent sleep problems are. In
studies of elementary school-age children, nearly 40% showed some
kind of sleep problem, 15% exhibited bedtime resistance, and 10% had
daytime sleepiness. Up to half of adolescents reported at least
occasional difficulty falling or staying asleep, with up to 13%
experiencing chronic and severe insomnia. Clearly, the sleep time
most teenagers get is insufficient: the average is under 7 ½ hours,
with only 15% sleeping 8 ½ hours or more on school nights and more
than 25% typically sleeping 6 ½ hours or less.

Does My Child Have a Sleep Problem? Awareness Is Key

Given the prevalence and enormous impact of sleep problems on daytime
functioning, we should all regularly look at our own children to see
if they are getting the sound sleep they deserve. For some it may be
obvious, but for most of us it requires some education, investigation,
and a keen, watchful eye. This is because few of us really know what
normal, healthy sleep should be, plus there is a great deal of
individual variation among children and at different ages. Sleep
deprivation is also difficult to detect because sleep problems are
masters of disguise, often masquerading in myriad manifestations.
Consider that:

Children rarely complain about sleep problems. A study of adolescents
showed that very few sought help for their sleep, even though some
considered their problems to be very severe. Another found that almost
90% of adolescents say that they need more sleep, but how many parents
have heard their child say, "You know, I think I am going to go to bed
early tonight."
Adolescent sleepiness is so prevalent that it almost seems normal.
Though bedtimes get later and later, the biological need for sleep in
adolescents does not decease with age.
Parents may overestimate the amount of sleep their child gets because
we may be unaware of when our child actually falls asleep, as well as
night awakenings. Research has shown that medical conditions may cause
or contribute to sleep problems even when overt medical symptoms seem
well controlled. For example, asymptomatic children with asthma may
have poor sleep and daytime fatigue. Allergies may cause respiratory
distress when sleeping. In one study, almost 1/3 of the children in
elementary school reported significant body pains during the night,
of which parents were largely unaware.
Sleep deprivation may present itself in many ways other than daytime
sleepiness -- inattention, poor concentration, moodiness, behavioral
problems, and poor academic performance and social skills, to name a
few. Interestingly, poor sleepers were found not to be consistently
more tired than good sleepers, and they were actually least tired in
the evenings, when most good sleepers were tired.

What Can I Do? Think Sleep!

With so many hidden faces of sleep deprivation, you must be aware and
"think sleep." As a parent, if you do not recognize the problem, it
may well go unrecognized. You will also likely implement any remedies
required. Early intervention is important, given the consequences and
that children do not "grow out of" sleep problems; rather, the sleep
problems of childhood tend to persist into adulthood.

Talk with you child. Just taking the time to ask some of the right
questions can go a long way. If there is a problem, discuss it and
make a plan agreeable to all. Include detailed targeted behavior
changes and rewards.

With your child in school during the day and with after-school
activities and part-time jobs for many, it is critical to talk with
teachers, coaches, bosses, etc. to see if your child is exhibiting
any signs of sleep deprivation. This may involve you taking some time
to educate the educators.

Teach your child good sleep habits, also known as "sleep hygiene."
Establish sleep-healthy bedtimes, bedtime routines, habits, and
diets. Identify and reduce as much daytime stress as possible. Limit
TV and other "screen time" (computers, video games), especially at
bedtime, and do not put a TV in your child's bedroom, as it has been
shown to negatively affect sleep.

As in everything in life, do your best to be consistent and ask for
help. Do not hesitate to call your doctor or sleep specialist. It's
too important not to.