Child at 2 AM: “Mooooooooooooooom!” “Daaaaaaaaaaaaaaaad!”

Parent: (Rush out of bed, trip over a Lego minefield, burst into child’s room commando-style to subdue the threat prompting such an alert at this ungodly hour.)

Child: “I’m thirsty”

If you’re a parent, the above scenario is all too common.

Children are notorious for wee-hour requests of all sorts, impacting both their sleep patterns and ours. While a certain amount of this is normal, can more frequent disruptions in children’s sleep cause health concerns?

According to the Centers for Disease Control (CDC), roughly 1 in 3 American adults don’t get the recommended 7-9 hours of sleep per night and there’s a growing mountain of evidence to suggest their health pays the price.  Current research is beginning to examine children’s sleep patterns and how they impact both acute and long-term health.

How much sleep do kids need? According to The American Academy of Sleep (as reported by the CDC) kids age 5-10 need 10-12 hours per night.  It appears that like adults, less than optimal sleep increases children’s risk for a variety of health problems, childhood obesity being a focus of concern.

  • Research published in the Archives of Pediatric and Adolescent Medicine suggests  In young children (0-4yrs), shortened nighttime sleep was associated with increased risk ofoverweight and/or obesity. Daytime sleep (naps) did not improve risk.
  • A study published in Pediatrics discovered kids age 4-10 with the shortest sleep durations were 4 times more likely to be obese. Short and inconsistent sleep duration was also associated with altered insulin, LDL, and C-reactive protein.
  • Research from the University of Illinois, Urbana-Champaign examined family routines and subsequent health outcomes.  Their findings suggest that kids sleeping less than 7 hours per night are 3 times more likely to be overweight.  Additionally, kids of parents getting less than 7 hours of sleep per night were 1.3 times more likely to be overweight. The researchers concluded that sleep may be one of the most important early factors to target in childhood obesity prevention.
  • A study of over 1,000 people in New Zealand discovered shorter sleep times in childhood increased likelihood of obesity by age 32.
  • A systematic review of over 36 publications published in Obesity notes a significant link between short sleep duration during childhood and lifelong obesity.
  • Other health risks, such as Type 2 diabetes were examined in a literary review of 23 studies published in Nutrition and DiabetesIt was determined that shortened sleep duration appears to be associated with biomarkers for Type II Diabetes in children.

How are childhood obesity and lack of sleep related?

Researchers report that while there are some important findings, it is difficult to determine exactly why and how sleep impairment impacts childhood obesity. Some suggest it could be somewhat of a “chicken or the egg” phenomenon.  Rates of sleep disturbances such as sleep apnea are much higher in obese youth. However, the commonly proposed mechanisms by which sleep impacts obesity are similar in adults and children.

Hunger hormone imbalance- When we are sleep impaired at any age, a hormone called Leptin decreases significantly.  This hormone signals to our brain to stop eating.  This decrease is paired with an increase in a hormone called Ghrelin, which makes us hungry and increases our affinity for food. We’ve all probably experienced a substantial sweet tooth after a night of poor sleep.  When this is prolonged, it can add on the pounds.

Decreased energy expenditure– It goes without saying that when we’re sleep deprived, we’re less active.  This is demonstrated across the literature. When we’re tired, our core temperature lowers, which contributes to fatigue. Pair this decreased energy expenditure with an increased energy intake and BMI problems arise.

Increased Cortisol levels- When we sleep less than what is required, the stress hormone Cortisol increases in our system.  Chronic increases in Cortisol have been linked to insulin resistance and increased bodyweights in both adults and children.

What’s Keeping Our Kids Up at Night?

Our sleep mechanisms were baked into our DNA thousands of years ago.  When the sun was up, we were active. When it went down, we slept.  Our physiology adapted to this cycle, revving up when the sun came up, cooling down when the sun went down. Very few distractions interrupted this cycle.

Fast forward to now and can control the “day” and “night” in our homes with a light switch. Kids spend hours staring at intense blue light (hand-held devices) and highly stimulating images on huge TV and computer screens. Their primitive brains have a much more expanded context for what constitutes day and night. As technology progresses, there are fewer and fewer natural environmental prompts for “sleep time”.This can be paired with growing sugar and caffeine intake, high rates of daytime inactivity, and ever-increasing time demands from school and other activities.

Much like adults, it’s becoming harder for kids to “unplug” when it’s time for sleep. While various recommendations for helping children get better quality sleep or offered, the most common that researchers appear to agree on include:

Limit sugary and caffeinated beverages. While increasing the intake of these is also associated with increased weight gain, they can interfere with regular sleep cycles. Make sure to educate yourself as a parent in regards to where these can be hidden in apparently “healthy”foods.  Eating together as a family increases the likelihood children will eat more fruits and vegetables.

Limit technology prior to bedtime.  Watching television immediately prior to bedtime has been associated with impaired sleep duration in children. 

Turning off the television and other screen devices at least 30 minutes prior to bedtime is often recommended by physicians and researchers.  Young children should not have television or other screened devices in their rooms.  

Encourage activity during the daytime.  Not only does exercising during the day expend more calories and contribute to becoming appropriately tired at bedtime, it creates a drastic core temperature differential that helps quality of sleep. Sixty minutes of vigorous daily activity is recommended for kids.

Maintain consistent bedtimes.  Children’s physiology and psychology respond well to routine. Going to bed and waking up at the same time each day aids in creating an optimal sleep/wake cycle. With external demands (school and other activities) it’s essential that parents and educators evaluate the purpose of these demands for time.  While children need to learn how to apply rigor to various disciplines, it’s also essential they are provided time for physical play and relaxation.

On this note, it’s also important for us as parents to aid in facilitating (and demonstrating) effective time management skills.  The number of hours per day both children and adults spend with recreational technology continues to increase. This interferes with time that could be spent and more fruitful ventures.

Even with our best efforts as parents, we’ll still be getting glasses of water and checking under the bed for monsters at 2 a.m. However, realizing the important relationship between childrens’ sleep and their health, we can take steps to make nighttime rest a time to recharge happy, healthy young lives.

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