BETHESDA, MD. – American children aren't getting enough sleep.
Children in every age group “don't even meet the low end of the range recommended by experts” for sleep in a 24-hour period, according to a national survey, Mary A. Carskadon, Ph.D., said at a conference on sleep disorders sponsored by the National Institutes of Health.
Dr. Carskadon was referring to the results of the National Sleep Foundation's annual Sleep in America poll, which included data on children's sleep for the first time this year. The NSF found that televisions and computers in children's bedrooms are the main contributors to sleep loss. In the phone survey of a random sample of 1,473 parents and caregivers, respondents reported that nearly half (43%) of school-aged children, one-third of preschool children, and “an astounding 20% of infants and toddlers” had TVs in their bedrooms, Dr. Carskadon said.
These children go to sleep an average of 20 minutes later and sleep 40 minutes less per night than children with no TV in their rooms, for a loss of more than 2 hours of sleep every week. Many never “catch up” on their sleep on the weekends, as approximately one-fourth of children 3–10 years old actually sleep less on weekends than on weekdays, said Dr. Carskadon, professor of psychiatry and human behavior at Brown University, Providence, R.I.
For these children, bedtimes are delayed, overall sleep time is decreased, and daytime sleepiness is common. “A paper coming out soon in the Archives of Pediatrics and Adolescent Medicine shows that among young adolescents, watching TV in the bedroom at night predicts major sleep disturbances such as insomnia in young adulthood,” she added.
Most of the parents polled reported that their children get “the right amount” of sleep, apparently unaware that the actual number of hours they say their children sleep falls far short of the experts' recommendations.
The other major culprit in children's sleep loss is caffeine consumption. The NSF poll showed that 26% of children 3–10 years old drink at least one caffeinated beverage every day. Those who have caffeinated drinks sleep less than children who don't ingest caffeine (an average of 9.1 versus 9.7 hours per night), for a loss of about 3.5 hours every week.
Dr. Carskadon noted that myriad caffeinated drinks are specifically targeted to children and adolescents, and coffee shops offer chocolate drinks, teas, and coffee concoctions with flavors calculated to appeal to children and teenagers.
Early school start times are another contributor to children's sleep loss.
With the delay in circadian phase and the delay in the melatonin secretory phase that accompany puberty, preadolescents and adolescents in particular “are under enormous physiological pressure to delay their sleep cycle”–to stay awake until late at night and to rise late in the morning.
“These kids' circadian cycles are already hammered by their biology. Add to that the ridiculously early school start times across much of the country, and sleep gets squeezed right out of their schedules,” Dr. Carskadon said.
Extracurricular activities also affect sleep. Many high school athletes are required to practice every morning before school, at 4 a.m. and 5 a.m. sessions, or after school every day until 6 p.m. to 8 p.m. Games and competitions routinely extend until 10 p.m. or later, excluding travel time.
According to the NSF survey, parents also reported that a majority of children's physicians (52%) never ask about their children's sleep habits, even though most parents (69%) said their children have sleep problems such as difficulty falling asleep, nighttime wakening, and snoring, at least a few nights every week.
The survey also found that the older the child, the less likely a physician was to ask about sleep, even though older children and teens are more likely to have frequent sleep problems than younger children.
Children's Sleep Can Be Improved
Dr. Carskadon discussed several recommendations aimed at improving the quantity and quality of children's sleep:
▸ Make adequate sleep a priority for families. Help parents determine the amount of sleep each family member needs, and urge them to ensure that those needs are met. To motivate parents to regulate their children's sleep, emphasize the strong links between poor sleep and bad behavior, poor school performance, depressed mood, high risk for accidents and injuries, and high risk for alcohol and drug use later in life.
▸ Promote good sleep habits. Advise parents to schedule leisure activities like television viewing, video games, and Internet surfing for specific times and places–and never in children's bedrooms. They also should promote regular bedtime routines, and create quiet and comfortable settings for sleep.