Dr. Walt's Health Blog

Archives for posts tagged ‘sleep and children’

Video violence keeps preschool kids awake at night

Researchers are reporting that violent content on the TV or computer during the day disrupts sleep for preschool children. And it’s worse for any TV or computer time in the evening regardless of content, according to Michelle Garrison, PhD, and colleagues at the Seattle Children’s Research Institute in Seattle.

Click to continue reading “Video violence keeps preschool kids awake at night”

Sleep deprivation associated with carbohydrate craving and depression

In a number of past blogs I’ve discussed the association with lack of sleep and overweight and obesity. This association is found in children, teens, and adults. Now we know another reason why this occurs.

Click to continue reading “Sleep deprivation associated with carbohydrate craving and depression”

Electronic device use prior to bed hindering Americans’ sleep quality

HealthDay reported that “many Americans might be losing valuable shut-eye because they spend the hour before bedtime in front of the electronic glow of a television, cell phone, or computer,” according to the National Sleep Foundation’s annual Sleep in America poll results released earlier this year.

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Younger children with regular sleep schedules less likely to be obese, research suggests

If you hate enforcing bedtime with your kids, here’s another good reason why you should. A new study published in the journal Pediatrics suggests that younger children who get more regular sleep are less likely to be obese.

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Insufficient, irregular sleep associated with childhood obesity

In my book, SuperSized Kids: How to protect your child from the obesity threat, I made the then startling claim that childhood obesity was associated with a lack of sleep. And, in a clinical study, we showed that families who make wise nutrition choices, activity choices, AND increase the amount of sleep children get, can prevent or treat childhood obesity.

Since the publication of the book, study after study (many reviewed in this blog) have demonstrated the association between poor sleep or inadequate sleep and childhood obesity. Now, a new study suggests that sleeping in on the weekend may help children fight obesity. Here are some details from HealthDay News:

Too little sleep puts kids at risk of obesity and other health conditions, but “catch-up” sleep on weekends and holidays can mitigate the effects of weekday sleep deprivation, researchers say.

“In the United States, the sleep of our children is clearly not enough,” said lead researcher Dr. David Gozal, chair of pediatrics at Comer Children’s Hospital at the University of Chicago.

Gozal’s team monitored the sleep patterns of 308 children for a week and compared their sleep patterns with their body mass index (BMI), which is a measurement that takes into account height and weight. The children, who were 4 to 10 years old, averaged eight hours of sleep a night.

“This is way lower than the recommended amount of sleep that kids should get, which is about 9.5 to 10 hours at this age,” Gozal said.

Among the children who got the recommended amount of sleep, the risk of obesity, diabetes and cardiovascular problems was nil, Gozal said.

“But, as the amount of sleep became shorter and the regularity of sleep became less organized, the risk for obesity increased,” he said.

“Kids who had the shortest sleep and had a more disorganized sleep schedule had more than a fourfold increase in the risk of being obese,” he noted.

These children also had increased risk for cardiovascular problems and pre-diabetes, Gozal said.

However, if these children consistently slept longer on weekends to compensate, the risk for obesity and metabolic problems was reduced to a 2.8-fold increase. “It did not normalize it. It’s still a risk but not as much as keeping your crazy short sleep schedule even during weekends,” Gozal said.

It is this combination of less sleep and irregular sleep that appears to result in metabolic problems, such as high blood sugar, Gozal said.

The report is published online Jan. 24 in advance of print publication in the journal Pediatrics.

Gozal says that other studies have shown that inadequate sleep has biological effects, including high blood sugar and cravings for sweet and high-fat foods. Insufficient sleep also makes it harder to lose weight, he said.

“All this would suggest that sleep is an important regulator of metabolism,” Gozal said. “If we abuse our sleep by not sleeping enough, then we are likely to pay the price by being heavy and being at risk for cardiovascular and all the other metabolic complications,” he said.

Children are sleeping less for various reasons, Gozal said. Busy family schedules and electronic media — cell phones, computers and TV — interfere with healthy bedtime routines. The result is that sleep suffers, he said, noting that while bedtime can be extended, we still have to get up at the same time.

“Children should follow a regular [sleep] schedule,” Gozal said. “Follow the rule of sleep and you will be happy,” he urged.

Frederick J. Zimmerman, of the department of health services at the University of California Los Angeles, said the study largely confirms earlier research that found inadequate sleep is a risk factor for obesity among children.

The new research offers a “tantalizing suggestion that sleep that is inadequate both in duration and in consistency may have adverse metabolic effects,” he added. However, it does not explain why obesity and sleep are related, Zimmerman said.

“It could be that obesity causes disturbed sleep or that inadequate sleep increases the risk of obesity. It could also be that a third factor, such as nighttime television, may lead both to obesity and to poor sleep,” he said.

Despite these uncertainties, the consensus is that parents should create an environment in which children can consistently get adequate, restful sleep, Zimmerman said.

“As difficult as it is for parents to consistently enforce early bedtimes, it may still be one of the easiest ways to promote happy, healthy children,” he added.

So, watch the clock, these experts say. The study found that parents tend to overestimate the amount of sleep their kids get, usually by 60 to 90 minutes, Gozal said.

More information

For more information on children and sleep, visit the Nemours Foundation. Or, purchase a copy of my book, SuperSized Kids: How to protect your child from the obesity threat. It’s on sale at my website. The hardcover is on sale for $3.99 here, and the soft cover for $1.99 here (plus shipping).

Overweight Children Are Affected More By Stress

American kids are really stressed out — not least of all overweight and obese kids, according to a new survey from the American Psychological Association. The report found that children who are overweight or obese feel particularly stressed, more so than their normal-weighted peers. And such stress has a lasting impact on other lifestyle behaviors that negatively affect overweight kids’ health.

Below I have some of the details from a report in Time. If, however, your kids are overweight or obese, you may want to pick up a copy of my book, SuperSized Kids: How to protect your child from the obesity threat. The book is currently on sale in HARDCOVER for $4.99 here (save $18) and in SOFTCOVER for $1.99 here (save $11). The book is chock-full of ways you, as a parent, can help your children make wise decisions about activity, nutrition, and sleep.  

If you have children or teens who are overweight, NOW is the time to make some changes. And, my book has an 8-week plan your family can put into action to start the New Year. The reason to do so is that to NOT act is to doom your kids to a shorter life with lower quality.

The new report, “Stress in America 2010,” found that the majority of Americans continue to live with moderate to high levels of stress, and while they know this isn’t healthy, they say they face obstacles that prevent them from managing or reducing their stress. They also acknowledge that they have trouble adopting other healthy behaviors like eating right, exercising and getting enough sleep. (More here on Study: Parent-Only Education Helps Children Lose Weight)

The effects of all of that appears to be trickling down to their families, particularly in households with overweight or obese parents. Obese parents were more likely than normal-weight parents to have overweight kids, and parents with overweight kids were less likely to report often or always eating healthy foods, compared with parents of thin children. What’s more, thin parents said they engaged in physical activity with their families more often than fat parents.

Along with the tendency toward unhealthy lifestyle behaviors, fat parents and fat children shared higher levels of stress.

For instance, while 31% of overweight children reported worrying about their lives, only 14% of their healthy weighted counterparts did the same.

When researchers asked about specific symptoms of stress and depression, the rates of positive responses in overweight children went up and stayed higher than in normal-weight kids: overweight children were more likely than children of healthy weight to have trouble:

  • sleeping at night (48% vs. 33%),
  • feel angry or get into fights (22% vs. 13%),
  • experience headaches (43% vs. 28%) or
  • feel listless and like they didn’t want to do anything (34% vs. 21%).

Further, children who believed they were overweight were more likely to report a parent who was “always” or often stressed out in the past month (39% vs. 30%). (More here on Do Parents Discriminate Against Their Own Chubby Children?)

Although the majority of parents didn’t their kids were affected by their stress, 91% of all children surveyed said they could tell when a parent was upset about something, and could perceive their emotional distress when they argued, complained or acted worried.

Nearly half of “tween” children aged 8 to 12  and one-third of teens aged 13 to 17 reported feeling sad in response to a parent’s distress, while large proportions also felt worried or frustrated. And while 86% of tweens said they felt comfortable talking to their parents about stressful situations, only 50% had done so in the previous month.

Additional survey data suggested that while overweight kids feel more stress, stress can also lead to additional weight gain.

Most of the children interviewed said they used sedentary activities to manage their stress:

  • 36% of tweens and 66% of teens listened to music,
  • 56% of tweens and 41% of teens played video games, and
  • 34% of tweens and 30% of teens watched TV.
  • Further, 48% of overweight teens and tweens reported disordered eating (either too much or too little) when stressed out, compared with only 16% of children at a healthy weight. (More here on Study: Fast-Food Ads Target Kids with Unhealthy Food, and It Works)

With nearly 1 in 5 children in America being overweight, according to the Centers for Disease Control and Prevention, managing stress as part of a total weight-control plan can only help.

For more data on stress in America, see the full report here.

Kids’ use of electronic media at night linked to problems

More than half of children who use electronic media before bedtime may have mood or learning problems during the day, a preliminary study of 40 young people suggests. The kids in the study, average age 14½, were all treated at the JFK Medical Center Sleep Laboratory in Edison, N.J. About 77% had trouble falling asleep; others had daytime sleepiness. Here are more details from USA Today:

And it’s no wonder: Turns out they sent an average 34 text messages or e-mails a night, according to the study, to be presented today at the meeting of the American College of Chest Physicians in Vancouver, British Columbia. Texts were sent anywhere from 10 minutes to four hours after bedtime.

“Across the board, all of the children admitted to using electronic media — texting, computers, video gaming — after lights out,” says co-author Peter Polos, a physician at the JFK clinic.

Kids texted an average of four people a night. Electronic media woke them up once a night, when they were texted or called by a friend.

Young people who used the most bedtime media — from cellphones to video games — were more likely to have attention-deficit hyperactivity disorder, anxiety, depression and learning problems during the day.

Polos notes that the study has limitations: It can’t prove that late-night media use caused problems such as attention-deficit hyperactivity disorders. He adds that results may not represent all kids; everyone in the study came to the clinic with a problem.

HELP KIDS GET THEIR SLEEP

Parents and kids should talk to each other and find solutions together, says Kim West, a family counselor and author of Good Night, Sleep Tight: Gentle, Proven Solutions to Help Your Child Sleep Well and Wake Up Happy. Her tips

  • Make the bedroom a technology-free zone, with no TVs, cellphones, iPods, computers or video games.
  • Turn off electronic devices at least half an hour before bed.
  • Don’t allow kids to read or do homework in front of a computer screen so they can avoid the temptation of checking in on Facebook or answering an instant message.

Now, one caution about these data. They were presented at CHEST 2010, the annual meeting of the American College of Chest Physicians in Vancouver, British Columbia. Therefore, the findings should be considered preliminary as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.

Melatonin for Kids?

Melatonin is becoming a popular sleep aid for children. Especially since more than 10% of kids have trouble sleeping.

Many parents believe that melatonin might be helpful for their kids, especially those with ADHD or sleep-wake disturbances due developmental disabilities, etc.

But, according to the experts at the Natural Medicines Comprehensive Database, melatonin isn’t considered a first choice for sleep in most kids.

Here’s what they recommend to healthcare professionals:

  • Instead, suggest improving sleep habits by having a consistent bedtime routine and avoiding caffeine and TV before bedtime. You can see my blog on “Strategies for Getting a Good Night’s Sleep” here.
  • For kids on stimulants (methylphenidate, etc), suggest giving the stimulant earlier in the day or switching to one with a shorter duration of action.
  • Short-term use of melatonin might be appropriate when these other strategies aren’t enough.
    • Suggest starting with melatonin 3 mg about 30 to 60 min before bedtime.
    • Doses between 0.3 mg and 6 mg are usually needed.
    • Explain to parents that side effects are usually mild, such as headache or morning drowsiness. If these are a problem, suggest lowering the dose.

You can read my blog on “Strategies for Getting a Good Night’s Sleep”, for tips to help get a better night’s sleep here.

Strategies for Getting a Good Night’s Sleep

Here’s some excellent information on avoiding insomnia and getting a good night’s sleep using common-sense sleep hygiene. It’s from my friends at the Natural Medicines Comprehensive Database. However, I find that many of my patients are not aware of some (or even most) of this information. So, here’s to a good night’s sleep for each of you.

What Is Insomnia?

Insomnia is a common complaint. Some symptoms of insomnia are difficulty falling asleep, difficulty staying asleep, and difficulty with early morning awakening.

Sometimes insomnia only lasts for a short time and can be easily managed. Persistent insomnia is more troublesome and can affect work, school, social relationships, and health.

Many conditions are associated with insomnia such as depression, anxiety, allergies, and pain. Much of the time insomnia is simply the result of poor sleep habits.

How Is Insomnia Treated?

Insomnia treatment in adults may include use of an over-the-counter medication or, in other cases, use of a prescription sedative.

Over-the-counter sleep medications (diphenhydramine [Benadryl]) may worsen insomnia in children.

It is important to determine the cause of insomnia before treatment begins. Maintaining a sleep diary for one to two weeks is a good way to start. Keeping track of sleep times, caffeine and alcohol ingestion, etc. may provide clues as to the cause of insomnia.

Behavioral changes are often all that’s needed to improve sleep. By maintaining good sleep habits (sleep hygiene) the need for medication may be avoided. In children, ensure a regular sleep schedule and calming bedtime routine.

PRINCIPLES OF SLEEP HYGIENE

  • Stick to a regular sleep schedule—even on weekends.
  • Exercise regularly—avoid exercise in the late evening.
  • Go to bed only when sleepy.
  • Put your worries away when you go to bed.
  • Do something relaxing and enjoyable before bedtime.
  • Make your bedroom quiet and comfortable.
  • Avoid large meals just before bedtime.
  • Use your bedroom only for sleep and sexual activity.
  • If you cannot sleep within 15 to 20 minutes get up and go to another room. Return to bed only when drowsy.
  • Remove the clock from eyesight.
  • Do not nap during the day. If you must nap, limit it to 30 minutes in the early afternoon.
  • Avoid alcohol, nicotine, and caffeine use.
  • Avoid frequent use of sedatives.
  • Schedule outdoor time at the same time each day.
  • Have your pharmacist check your medications for potential sleep effects.
  • Avoid bright lights (e.g. from TV, computers, video games) before bed.

Adapted from Jermain DM. Sleep disorders. PSAP. 1995:139-154.

What If Nondrug Treatment Fails?

If you or your child are still having difficulty getting a good night’s sleep, you should talk to your pharmacist or other healthcare provider. The cause of your insomnia will need to be determined and a medication may be needed.

Even if medication is used for insomnia, sleep hygiene principles should still be followed and can provide added benefit.

Study Links Regular Bedtimes to Better Language, Reading, and Math Skills in Preschool Children

Children in households with bedtime rules and children who get adequate sleep score higher on a range of developmental assessments, according to a research abstract that was recently presented at at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies.

Click to continue reading “Study Links Regular Bedtimes to Better Language, Reading, and Math Skills in Preschool Children”

Are your teens having trouble getting to sleep? Many are too caffeinated!

According to a new report in Reuters Health, caffeine-fueled teens are texting, web-surfing, and gaming for hours into the night, which is affecting their alertness and ability to function during the day. What can you, as a parent, do about this?

More Information:

Click to continue reading “Are your teens having trouble getting to sleep? Many are too caffeinated!”

Bedtime routines improve kids’ sleep (as well as Mom’s mental health and the child’s school scores )

According to a just-released study, following a consistent bedtime routine improves infants’ and toddlers’ sleep patterns as well as their bedtime behaviors. Better yet, carrying out a regular bedtime routine also benefited mothers’ moods.

More Information:

Click to continue reading “Bedtime routines improve kids’ sleep (as well as Mom’s mental health and the child’s school scores )”

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