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WHY THE FUSS OVER SLEEP?
by Rachel Steinberg, Child-Works LLC
We all know that sleep serves a purpose, but many parents are surprised
to learn the complex functions of sleep in children. Sleep is a
time of intense neurologic and physiologic activity; there are times
where the brain is more active during sleep than awake. For
children this is especially true. By the age of three the average
child has spent more time sleeping than all wakeful times
combined. Research clearly shows that sleep affects behavior,
health and learning. This is true for young and old alike.
For the purposes of this article the primary focus will be on the role
of sleep in children. For more assistance with teaching your
child the skills of sleep please visit www.child-works.com
Behavior
Parents have experienced accrued sleep loss at one time or
another. If we were to make a list of how we felt and behaved
when we were behind on our sleep, followed by a list of how we perceive
our children feel and behave when they are behind on their sleep, there
would be significant overlap. Parents and children exhibit
similar behavior when overtired, however, many times children are
expected to behave as if they are well rested whether they are or not.
If a list of behavior was generated it would include the following:
grumpy, irritable, short tempered, argumentative, cries more, hits
and/or grabs more, whines, etc. An important addition to this
list is hyperactivity. Many parents believe that their child is
not tired until 10pm at night because the child is “bouncing of the
walls” and are surprised to learn that this seemingly wide awake
behavior is a classic sign of being tired. Although it seems
counterintuitive, the body has a neurohormonal stress response in order
to adapt and stay awake. This physiologic response increases
levels of cortisol, epinephrine and norepinephrine. These
hormones help jolt the body so it is able to remain awake. The
more overtired children become the more these hormones are released,
thus making it increasingly difficult to fall asleep and perpetuating a
cycle of poor sleep habits.
If you reflect on how likable you are when overtired, it is easy to
extend this to children. Many researchers have found that
toddlers with sleep problems, most typically night waking, had more
difficult temperaments. Two to five year olds that slept less had
higher levels of aggression and children who were tired complained more
about feeling bored leading people to view these children as
lazy. Three year olds who napped were more adaptable to their
environment than those who did not. What does this mean?
Children who adapt well are able to make transitions easier both at
home and within the classroom and are better at socializing and playing
well with peers.
It is important for parents to understand that children do not outgrow
these behaviors without the help of adequate sleep. Research is
clear in this assertion as well. Children with sleep problems
that persisted from eight months to three years of age illustrated
increased tantrums and other management difficulties by the age of
three. On the flip side, studies that analyzed children ages
seven to eleven found that those who slept more experienced less
hopelessness, a better self-concept and were more adept at sociability
and activity.
Clearly it is in our children’s best interest to ensure quality
sleep. Not only will they feel and behave better, but how others
perceive them--teachers, peers or family--will be positively influence
which directly impacts their own self concept.
Cognitive Functioning
Realizing that lack of sleep affects mood and behavior is easy because
it is tangible. We can feel it in ourselves and see it in
others. Lack of sleep also has a clear impact on learning and
processing of memory. Mothers of newborns have a unique window
into the effects of this. Many can tell outrageous stories of
going to the grocery store still wearing slippers or completely
forgetting a conversation that occurred minutes ago! It is very similar
for babies and older children. Overtired children have greater
difficulty concentrating and are less alert than their well rested
counterparts. Children learn by watching. Research
consistently shows that overtired babies are not able to keenly observe
and process what they are watching as well as rested babies. Some
parents have reported a noticeable acceleration in reaching
developmental milestones once their child was “sleep trained” and no
longer overtired.
Because overtired children are easily bored they are less likely to
play independently for as long as well rested children. Learning
to play independently is an important life long skill. During
this type of play children become more creative, more resourceful and
develop emotional maturity. Studies conducted on infants as young
as five months old found that those children who slept longer during
the day had longer attention spans. The studies looking at seven
to eleven year olds reported that those kids who experienced poor sleep
exhibited more communication problems and intellectual deficits than
those without sleep problems.
It is important that parents understand the link between sleep and the
development and maintenance of learning and processing of memory.
For our children, regardless how young, we need to ensure they receive
adequate sleep in order to optimize their ability to learn.
Health
Sleep is shown to play a role in the growth and healing of body tissue
as well as central nervous system repair. Some scientists are
asserting that poor sleep habits are as important as poor nutrition and
lack of physical activity in the development of chronic illness and
contributing to obesity, diabetes and cardiovascular disease.
Recent studies have shown that cumulative amounts of sleep loss can
cause harmful changes in our metabolic, hormonal and immune
function. This is what you find in normal aging.
Obesity
Studies have shown that sleep loss creates hormonal changes that
promote weight gain. Volunteers with significant sleep loss had
significantly lower leptin concentrations than those who were well
rested. Leptin is a hormone that signals the feeling of being
satiated. Mice that lack leptin become morbidly obese. This
miscue by the body can slow metabolism, increase fat deposition and
over stimulate the appetite. Sleep deprived people overwhelmingly
ask for candy, starchy food and salty snacks.
Inflammation
Modest sleep deprivation may also be associated with low-grade
inflammation, which can lead to a myriad of cardiovascular
problems. Volunteers studied showed elevated levels of cytokines
(molecules released during inflammation and infection), which can cause
this inflammation response. Continuous low-grade inflammation can
damage artery walls, which can lead to the narrowing of vessels, high
blood pressure, heart disease and stroke. Increased cytokines
also contribute to insulin resistance and obesity. Also, sleep
deprived men showed signs of insulin resistance, which can lead to type
II diabetes.
This research is in its infancy and based on adults and animals, but is
very provocative. Certainly more research needs to be done to be
conclusive and research on pediatric sleep needs to occur to draw
definitive conclusions on how it might affect kids.
Education
Behavior, cognitive functioning and health all affect children with
regards to their education. If a child is behind on sleep, they
are more prone to get sick, which can result in increased days missed
at school. Many of the aforementioned studies found poor academic
performance with school-aged children who were sleep deprived.
One prominent sleep researcher suggests that sleep is vital to
communications between centers of the brain. He compares the
brain to a musical instrument. Instruments need to be retuned
after much playing so they work properly. The brain too needs
sleep in order to resynchronize, a process where nerve cells can
regroup and fire at compatible frequencies. When this process is
hampered children have problems integrating multiple centers of the
brain. An overtired child watching television alone is not likely
a problem, but this same child in a stimulating preschool classroom
where they need to employ the frontal lobe and limbic emotional memory
processing simultaneously are unable. This is where multiple
problems are seen.
If you were to reflect on how you feel and behave when you are rested
it is easy to generate a list of positive attributes. The same
holds true for our children. It is important to understand that
children need more sleep than adults. Quality daytime naps affect
nighttime sleep and the reverse is equally true. Each sleep
period serves a specific function. The morning nap has more REM
sleep, which is associated with brain maturation and growth.
Afternoon naps have more nonREM sleep which is associated with
psychological and physical restoration. Thus, it is important for
parents to understand how to achieve and maintain healthy sleep
habits. For more information on this please visit www.child-works.com
Rachel
Steinberg is a sleep consultant and founder of Child-Works, which
provides parents with research-based information and consultation on
children and sleep. Rachel has advised countless parents with
chidren ages four months to six years experiencing problems with sleep.
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