Well-rested kids are healthier, happier and more successful

By Reut Gruber Board of Directors Canadian Sleep Society Research says well-rested children and youth do better in school. Healthy sleep improves memory and attention, so kids are better able to learn. Well-rested children also have improved executive functioning, so they’re better able to plan and can perform difficult tasks with greater accuracy and speed. Well-rested children are also less irritable and impulsive, so they’re better able to self-regulate and have improved mood. They’re also more physically active, so are in better overall health. Yet sleep problems in kids are common, often minimized, ignored or (when acknowledged) inadequately addressed. We need to change that. So what’s disturbing the sleep of so many Canadian kids? In a special issue of Sleep Medicine Journal, the official publication of the World Association of Sleep Medicine, dedicated to “Pediatric Sleep in Canada,” researchers document the connections between sleep and the productivity, mental and physical health of Canadian children and youth. What happens when kids don’t get enough sleep? Children who don’t sleep well frequently miss school; they try to sleep in or they’re simply too tired and can’t make it to school. When they attend school, they have hard time focusing, remembering and following teacher’s instructions, so their performance suffers. They’re irritable and have difficulty regulating emotions, so they suffer from higher levels of anxiety and depression. Poor or insufficient sleep is also connected with higher suicide risks and drugs use. In terms of physical health, tired kids can find it hard to engage in sports and are less physically active – and the less they’re active, the worse sleep they have. It’s not surprising that data show connection between sleep deprivation and obesity in children and adolescents. And when a child doesn’t sleep, the child’s parents are frequently unable to sleep well, too, and they suffer – their marriage, work and quality of life can all be affected. But there’s good news. Healthy sleep can be obtained and maintained. The solutions aren’t necessarily complex. They require prioritizing healthy sleep education in Canadian schools, targeting sleep health promotion in public health campaigns and integrating sleep into health and social services provided to children and their families as an integral part of their care. Few across the country have access to timely and proper diagnosis and care. Evidence-based treatments for pediatric sleep disorders are effective, including therapeutic measures like cognitive behavioural therapy and controlled comforting, or medical interventions, like continuous positive airway pressure, use of oral appliances or adenotonsillectomy (an operation to remove both the adenoids and tonsils). We need sufficient publicly funded resources allocated for both sleep diagnosis and services provided by experts. We also need to support healthy sleep education in schools and school-based sleep promotion programs. Current research in Quebec shows that school-based sleep health promotion is an effective means to improve youth academic performance and well-being. Delaying school start time by even 10 minutes has also shown to have a significant positive impact on adolescents’ sleep and physical activity. Health-care providers also need formal training regarding pediatric sleep. They currently receive little or no education in sleep medicine during their training. Worryingly, 89 per cent of Canadian pediatricians and family physicians surveyed have recommended sedating medications to treat insomnia in youth. But these medications are often not approved for use in this context and are ineffective over the long term. Also, a recent study revealed that about one-third of health practitioners reported providing advice for behavioural sleep problems that could actually worsen the problem. Screening for sleep disturbances in the transition to school or during the first years in school using easy-to-administer parent surveys could identify children at risk of poor mental health or academic performance. Similarly, sleep-related questions can be used to screen for adolescents at risk of self-harm. Solutions like this are vitally important. But we must also engage with policy-makers at all levels of government to ensure that children and families have access to sleep laboratories, sleep physicians and experts when they need them. And together, we need to generate community awareness on the importance of healthy sleep for our children and youth. Reut Gruber is an associate professor with the Department of Psychiatry at McGill University and director of the Attention, Behaviour and Sleep Lab at the Douglas Mental Health University Institute. She is a board-certified diplomate of the American Academy of Cognitive Therapy (ACT), a licensed psychologist and an expert in pediatric sleep. She serves on the Canadian Sleep Society board of directors.

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