Sleep sappers

National health agency says children, parents suffering from hazardous lack of slumber, but why?

Wednesday, July 9, 2014

Parents everywhere dream of bedtime, when their little darlings will drift off to sleep and leave the house quiet for the grown-ups.

Every parent knows the horrors sleep-deprived children can unleash -- the whining, the clinging and the full-blown, ear-shattering meltdowns.

"If my middle child doesn't get enough sleep, he is a different child. He is ornery, he talks back, he's just unhappy," says Aletta Smith of Emerson, mother of Kyle, 11, Norman, 10, and Joseph, 6. "Even just an hour's difference, I can tell it in him. And I can tell it in his behavior report from school. I hear about it from the teachers. They definitely notice."

But the fantasy of well-rested children and quiet evenings doesn't square with the reality, which is that children everywhere are getting less sleep than they need.

Earlier this year, the Centers for Disease Control and Prevention proclaimed insufficient sleep among children -- and their parents -- a "health epidemic." The federal agency's data show only 31 percent of high school students get at least eight hours of sleep, on average -- shy of the recommended nine to 10 hours for that age group.

According to the CDC, insufficient sleep is to blame in the onset of diabetes, cardiovascular disease, obesity and depression, as well as complications in managing those conditions and diseases.

Wendy Ward, associate professor of pediatrics in the University of Arkansas for Medical Sciences College of Medicine and director of psychology training at Arkansas Children's Hospital, notes that research has tied sleep deprivation to weight gain.

"Stress chemicals keep you awake, and they also make you crave sugar so you eat more, and you eat more sugar. It's a very bad cycle," says Ward, who works with patients in the weight management and sleep clinics at Children's Hospital. "If you're not getting enough sleep you're more likely to crave sugar and eat more calories overall."

DIM IDEAS

Even parents who understand the importance of sleep fail to tuck youngsters in on time. Extracurricular activities run late, pushing back bedtime. Homework can take a while. And then there are seemingly harmless "little helpers" that in fact derail routines.

Turning on the television while you do the dinner dishes or pulling up a game on the iPad to calm a child you're trying to ready for sleep, for example, are counterproductive.

"Most people don't understand that Game Boys and iPods and iPads and computer screens, TVs, all those kinds of things, emit a certain kind of light called 'blue light,'" Ward says. "That light is processed by the brain in a very excitatory way so if you look at the brain of a kid reading and the brain of a kid watching TV, while their bodies are in a similar quiet position their brains are all over the place when they're looking at that screen."

All that stimulation means bedtime can be a struggle, and weary-at-the-end-of-the-day parents might opt to put it off rather than muddle through.

And what child hasn't stalled the sleep train because he's afraid of the

dark? "This is completely normal from age 4 to 6," Ward says.

But leaving a light on in the bedroom or a bright light in the closet backfires.

"We know that electric lights produce chemicals that make us stay awake, and darkness produces chemicals that make us sleepy," she says. "So back in pioneer days we had candles, and that was pretty low light and things got dark and everybody got sleepy. Now we have all kinds of artificial light, and we can kind of prolong our wake periods."

MAGIC PILLS?

Ward recommends turning off all electronic devices and lowering lights for 20 minutes to an hour before bedtime, while encouraging quiet activities like playing with Legos, coloring or reading. Dim light and less muscular movement promotes the release of natural melatonin, which readies children's bodies for sleep.

Melatonin can also be administered in an oral form, but Ward recommends using it as a last resort. Dr. Jerry Byrum, a pediatrician with All for Kids Pediatric Clinic in Little Rock, agrees.

"What you're actually doing is taking over the function of your brain in its sleep-wake cycles," Byrum says. "The question is, is that a wise thing? There are going to be some feedback mechanisms that are going with the melatonin that you're taking so your brain is going to make less and may make your sleep problems worse in the future."

HYPED UP

Ward warns that when children are sleep-deprived, they often look anything but sleepy.

"They actually look hyper because as their stress hormones are being produced they kind of get revved up," she says. "So you'll notice you'll talk to families about it and they'll say, 'Well, Johnny was kind of sleepy at like 4:30 but then he perked up after that and he was zooming around.' And so the issue was that he needed a little mini-nap or he needed to go to bed early."

Moving back bedtime has helped Sondra Rodocker of Conway gain control of her family's nights.

Bedtime for 6-year-old Nathan and 3-year-old Caleb used to be 9 p.m., but by then the boys were overtired, and bedtime became a two-hour struggle. First she tried 8 p.m. and then 7 when she realized that's when they showed signs of being ready to sleep.

Their bedtime routine begins with dinner and bath time, followed by getting into pajamas and climbing into their parents' bed and chatting about their day.

"We talk to them about random silly stuff, whatever they want to talk about," Rodocker says. "Our youngest loves trains, and we talk to him about his trains and which train he played with today and what adventure his train went on."

Then it's into the kids' room for a lullaby CD, prayers and hugs and kisses goodnight.

"Nine times out of 10 they are asleep by 7:30," Rodocker says.

Her children are happier during the day now, and as an added benefit, she and her husband get some time alone. "That's really important because you tend to forget how to be a couple because you're focused on being parents," she says.

Smith is a stickler for bedtime, too, and for that reason has banned extracurricular activities for her boys during the school year.

"I honestly don't know how they would have time for them," she says. "I tell people during the school year, you do not come visit me, you do not call me ... when it hits 3:30, we have a tight schedule and I will not answer the phone or anything. Everything has to go perfect for us to get them in bed on time.

"We take them to do stuff on the weekends, and we let them do stuff in the summer, but I've told them that when they're in school, that's their No. 1 job. I don't think they're missing out."

HANG UP

For older children and teens, social interactions beyond extracurricular activities are sleep stealers.

"The first thing to know is that a cellphone for a teenager is just an invention fraught with danger," Byrum says.

Cellphones allow for 'round the clock texting, Snapchatting, Instagramming, Facebooking -- and the list goes on.

"I look at teenagers every day and I'm amazed by how tired they look," he says. "And I know that cellphone in their pockets kept them up all night. They stay up all night texting and their texts and other social interactions in the middle of the night will cost them some sleep. And so what happens is that your brain will basically make up the debt by being less alert the next day.

"Your brain will literally just make you go into a little trance, a little nap, and that nap is kind of forced. You'll have times when you're not paying attention, you'll just zone out because actually what your brain is doing is making up for the sleep debt."

Fatigue impairs judgment.

"What happens is that, unfortunately, things you might not do in the daytime, in the middle of the night you will do, whether it be trying drugs or driving fast or having sex with someone. In other words, a cellphone is a big problem, and it is the No. 1 disrupter of sleep, period, for a teenager," Byrum says.

"Honestly, there are clandestine rendezvous that happen in the middle of the night. I know of a seventh-grader who was clocked at 92 mph on Highway 10 in his mother's car at 1 o'clock in the morning. He had four other people in the car with him when he was caught. What you have to understand is that a cellphone was used to arrange that clandestine meeting."

He recommends that parents hold off providing cellphones -- especially Internet-enabled ones -- until children are mature enough to be responsible. Even then, he says, parents should remove the temptation of overnight use by charging the phones next to their own beds.

Parents' sleep-related responsibilities extend further on a more basic level: They have to make sleep a priority for the whole household.

"Our culture promotes poor sleep habits," Ward says. "Parents are not sleeping well, and why would they expect their kids to do anything different if they're not able to do it well themselves?

"Parents stay up too late, they get insufficient sleep, and it kind of goes from there. Kids model what their parents do."

Family on 07/09/2014