3 big costs of ignoring poor sleep in children

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As a society, we’re slowing clueing into the idea that good sleep is essential for adults for our physical health, productivity, emotional stability and overall happiness. Yet when it comes to our children, sleep myths abound. Many parents, social media sites and even some health professionals are quick to normalise poor childhood sleep.

We often believe our child’s poor sleep is just part of the many challenges thrown at us in the exhausting trenches of parenting rather than a serious health issue. It’s understandable in a way. Parenting is hard enough, and we want to reassure each other that we’re doing the right thing.

‘Frequent waking – they’ll grow out of it.’
‘He wakes up with his head at the wrong end of the bed? How precious.’
‘You can hear her breathe? At least you know she’s alive!’
‘Being sleepless is just part of being a parent!’

Such ideas encourage parents not to worry about ongoing poor sleep patterns.  It’s time we stop dismissing concerns about poor sleep in children – our own or other people’s.

The truth is that poor sleep is also a significant health issue for children. Up to 40% of all children, and 35% of children under two years of age, have frequent problems sleeping.

This is a high-priority public health issue, with ramifications for mental and physical performance and health. The Australian Government takes sleep seriously releasing a document ‘Bedtime Reading’ on April 5th, 2019 with calls to action on raising sleep health awareness, for everyone! And the earlier we get on top of sleep issues in children, the better.

In this post, I identify the three big costs of ignoring poor sleep in children.

Children who are not sleeping properly often do not grow well, have poor appetites and are frequently sick. This is due to the disruptive effect poor sleep has on hormones and the brain.

There’s the delay of growth hormone release. Human growth hormone promotes a healthy metabolism and physical development in children.

Melatonin, the hormone that helps trigger our sleep cycle, stimulates the release of somatotropin, the growth hormone. When a child’s sleep onset is delayed or their sleep cycles are disrupted, melatonin release is disrupted and growth hormone fails to be stimulated, potentially contributing to a child’s poor growth.

Poor sleep also causes imbalances in hunger and satiety hormones. Leptin and ghrelin play a key role in regulating the amount of food that children consume and their feelings of hunger and ‘fullness’.

Not only that, tired children tend to crave high-energy foods like sweets, biscuits and chips, followed by not realising when they are full, leading to weight gain. Obesity then contributes to poor sleep, and potentially obstructive sleep apnoea.

This can become a vicious cycle: disordered sleeping disrupts these hormone levels, which leads to overeating, which leads to more weight gain, which leads to disordered sleeping…

All of this produces an increase of the stress hormone, cortisol. This hormone increases with poor sleep because the body is working harder to breathe, which prevents it from entering critical deep sleep cycles.

The combination of poor sleep and increased cortisol leads to impaired memory, increased anxiety and aggression.

Children with increased levels of cortisol may also have poor immunity, as immune memory is formed during deep sleep. Consequently, children with sleep-disordered breathing (which induces light sleep and sleep fragmentation) get sick more often because their immune systems are weakened. Not only that the cortisol keeps kids ‘wired’.

Children who don’t get the right amount or right quality of sleep have problems with their moods as well as a lower ability focus, solve problems and self-regulate. A press release by the Johns Hopkins Medicine media department reported that childhood sleep apnoea was linked to brain damage.

Even small increments of sleep loss (as little as 30 minutes per night) can result in reduced performance on intelligence tests and affect learning in a significant way. Children who don’t get their sleep quota find it very hard to focus.

Obstructive sleep apnoea (OSA) is one sleep disorder that is associated with a of range neurocognitive deficits. This refers to the brain’s ability to think and learn.Children with this level of sleep disruption are unable to focus, reason and problem solve as expected for their age.

When a child’s sleep problem is connected to disordered breathing, blood-oxygen levels can drop. Low oxygenation worsens virtually all medical, emotional and developmental problems. OSA can reduce a child’s IQ by as many as 10 points compared to their IQ with proper sleep.

Behavioural problems resulting from poor sleep and sleep disorders can look a lot like Attention Deficit Hyperactivity Disorder (ADHD). If they have ADHD, then good sleep is harder to get, and their poor sleep exacerbates their condition. Children who aren’t sleeping well often to succumb to some or all of the following problems:

  • Trouble with literacy
  • Difficulty sitting still
  • Poor concentration, focus and attention
  • Aggression, impulsivity and hyperactivity
  • Interrupting and talking out of turn

Social competence is a pivotal component of children’s psycho-emotional development and mental health and has implications for society as a whole.

Sleep problems have a known impact on executive brain function (emotional regulation, reasoning and problem solving) and language and speech development and can therefore hinder a child’s capacity to develop communication skills, communicate well and to form and sustain relationships.

Insufficient sleep interferes with the capacity to regulate behaviour and emotion, increasing the risk of anxiety and impulsivity while compromising children’s ability to respond appropriately to social stresses.

The waking synchronisation of several behaviours governed by the prefrontal cortex is also sensitive to sleep loss, meaning that poor sleep may interfere with the processing required for effective social interaction.

Children who struggle to self-regulate have been found to be more likely to be rejected by their peers. This creates a vicious cycle where poor behavioural control fuels peer rejection, which contributes to worse behaviour, thereby establishing patterns of poor social-emotional function from early primary school.

Counting the cost for sleep-deprived children

As you can see, poor sleep in children is nothing to be dismissed. For sleep-deprived children, the three key domains for development – physical (growth, immunity), mental (IQ, focus, problem solving) and social/emotional (mood and emotional regulation, communication skills) – are all detrimentally affected.

In a landmark study, Growing up in Australia, researcher Dr Kate Williams found that, while 70% of children were regulating their own sleep by five years of age, the remaining 30% might find their lack of regulation developmentally detrimental over time.

And a study at Duke University in 2015 showed that children with attention problems in early childhood were 40% less likely to graduate from high school. Simply, children who sleep poorly have a lower quality of life and lower development potential than those who sleep well. In fact, children with obstructive sleep apnoea have been found to have a higher incidence of unsatisfactory life quality in all areas.

This is a cumulative impact that puts these children behind their peers for years to come. In some cases, these children may never catch up. But this outcome is not set in stone. The good news is that early intervention works. When sleep is addressed, many of these concerns show themselves to be reversible.

Once sleep improves, your child can enter an upward spiral and get their development back on track.

Early intervention is the key.

What can you do?

If you’re ready to help your kids get a good night’s sleep, I’ve written a book that helps parents do just that. If this blog resonates with you check out: Sleep-Wrecked Kids; Raising happy healthy children one sleep at a time.

In Sleep-Wrecked Kids, you are supported to become the lifeguard of your child’s sleep. Packed full of information and practical help including which medical experts may need to help you get on the way to good sleep for all the family.

Sharon Moore

Author, speaker, sleep health advocate and speech pathologist

I'm Sharon Moore, author, speaker, sleep health advocate and speech pathologist at Well Spoken Upper Airway & Communication Solutions. I've seen more than 40,000 families over 4 decades of clinical work and I’ve seen first-hand how upper airway issues impact both health and happiness. The ripple effects span across family, school, community and society, and left untreated can last a life-time. I believe that great treatment transforms lives, the earlier the better and that everyone has a right to be happy, healthy and heard. I've worked in medical settings in Australia and London and currently run Well Spoken clinic in Canberra treating patients of all ages referred by medical and dental specialists for disorders of function of the upper airway that impact breathing, eating and communication.

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