Lack of sleep a behavior disorder in children?

A lack of sleep can affect many aspects of a child’s life.  Sleep deprivation can affect a child’s mood, behaviour and academic performance, writes Paula Goodyer. What’s the difference between a child who’s overtired and one with a behaviour disorder? Not a lot, says sleep specialist Dr Chris Seton, recalling a US experiment in which 50 children with ADHD were put together in a hall with 50 sleep deprived children – and sleep physicians and ADHD experts were asked to tell them apart.

“Most of them couldn’t do it – there was one specialist who managed to identify 62 per cent of children accurately, but his was the highest score,” says Seton who works with the Sleep Disorders Clinic at Westmead Children’s Hospital in Sydney. “A tired five-year-old and a five-year-old with ADHD can both act in the same way. There’s probably a common pathway, but so far researchers have been unable to find what it is.” But he has no doubt that increasing numbers of Australian children are sleep deprived – and worse off for it. While some research links childhood obesity to lack of sleep, there’s stronger evidence that
children’s behaviour, academic performance and mood are impaired by chronic lack of sleep, says Seton who believes electronic media and mobile phone use take much of the blame. “Texting is worse than talking on the phone because kids stay awake waiting for the next message. Although we don’t have good figures on this in Australia, a study of 13-year-olds in the US that included checking mobile phone records, found that 45 per cent of them used their phones after 3am,” he says, urging parents to be more assertive about keeping computers and TVs out of children’s bedrooms, and making it a rule that mobiles stay on the kitchen bench until morning.

How much sleep at what age?

Seton says the best way to judge how much sleep a child needs is to assess whether it’s “enough for them to wake spontaneously – meaning without an alarm clock – on most mornings and avoid tiredness during the day at least until the last hour before bedtime”.

As a guide:

- Preschoolers: 12 hours’ sleep in a 24-hour period.

- Primary schoolchildren: nine-11 hours.

- 12- to 17-year-olds: nine-10 hours.

But these are averages from which some children may vary, Seton says.

Rewards and routines

Recently the parent of a seven-year-old was referred to Seton because her son’s attachment to Nintendo kept him awake until 11pm.  When Seton suggested strategies such as removing access to the game in the evenings, then rewarding him with Nintendo time during the day if his sleep improved, the boy’s mother said this was impossible. Her son was addicted, she said, and asked if Seton could prescribe medication.  While this is the pointy end of parents losing their grip over children’s sleep routines, Seton estimates he’d see a similar situation once each month.  But while technology is one issue that’s eroding children’s sleep, so are tightly packed schedules that make for later bedtimes as well as early morning starts, says Seton who sees an increasing trend for
primary schoolchildren – not just high school students – to have extra-curricular activities before their school day begins.

There’s also the fact that sleep’s contribution to general health and wellbeing has slipped off the public radar.“What we have in its place is an idea that functioning on too little sleep is heroic, a badge of courage,” Seton laments.”Sleep deprivation has become normalised, and ideally we need a public health campaign to re-educate people about the value of sleep and to give parents guidelines to help them get their children to sleep.”

The adolescent saboteur

For 20 per cent of adolescents the sleep saboteur is not so much electronic, but a glitch in their body clocks. It’s a problem called delayed sleep phasing in which they have a circadian rhythm of 25 to 27 hours, instead of the typical 24 hours, Seton explains.  For them, the surge of melatonin, the “sleep hormone” that helps us feel drowsy doesn’t kick in until 11pm or later – and it’s a condition that can run in families. About 80 per cent of his patients have a parent with the same problem. “But it’s possible to treat it by following a pre-bedtime ritual that helps cue the body for sleep and which gradually resets the teenagers’ internal clock to help them sleep better,” he says. Seton’s advice for any parent who’s concerned about their child’s sleep is to get help. “There are sleep clinics at many public hospitals, as well as private clinics. You don’t have to be sick to see a doctor.”

Article by: Paula Goodyer

Advertisement