Changing behaviors and thoughts

When the pandemic hit, no one knew how long it would last. Very few of us thought our kids would spend a whole year attending school via video conference, and we never imagined we’d have to deal with the disruption, fear, and social isolation associated with COVID-19 into 2021.

Many families have been able to take things in stride, but still, changes like this take a toll. Over time, these pressures add up and chronic stress can begin to affect our health in ways we may not be aware of. We all know that children are sponges. They pick up on subtle and notso-subtle signs that things aren’t going well. As parents, it is up to us to help them recognize and work through their feelings, and to regulate our own.

Get enough sleep

Probably the single biggest action we can take as parents to help our children remain healthy right now is to make sure they get enough sleep. According to the Sleep Foundation (sleepfoundation.org/ children-and-sleep), “In addition to having a direct effect on happiness, sleep impacts alertness and attention, cognitive performance, mood, resiliency, vocabulary acquisition and learning” as well as “executive attention, and motor skill development.”

So, if children are not getting enough sleep, they are likely to be more irritable, less resilient, more distracted, and less able to achieve in school. Sound like anyone you know?

When children don’t get enough sleep, the brain starts making the stress hormone cortisol. For short bursts, cortisol is great; when you need a quick fight or flight response, it’s amazing. But, when cortisol floods the bloodstream for long periods of time, things get out of balance. Too much cortisol can cause anxiety and depression, headaches, problems with memory and concentration, digestive issues, and trouble sleeping. It can also cause problems with metabolism and insulin, which can lead to type-2 diabetes.

According to the Centers for Disease Control and Prevention (CDC), “Insufficient sleep has been linked to the development of a number of chronic diseases including type-2 diabetes, cardiovascular disease, obesity and depression” and that “optimizing sleep duration and quality may be important in improving blood sugar control.”

When you have diabetes, your body cannot regulate the amount of glucose in your bloodstream. Glucose is important because it is converted into energy to fuel every cell of your body. Insulin is the hormone that regulates glucose and enables it to feed your cells. With type-2 diabetes, insulin doesn’t work as well, which can result in poor regulation of glucose in the body. For children who are genetically predisposed to diabetes, chronic sleep insufficiency and a long-term flood of cortisol can affect insulin and energy regulation. I’ve seen a significant uptick in insulin resistance and diabetes in pediatric patients since the pandemic began—a worrisome trend.

What to do

So, what can parents do? Working with children and teens to create a bedtime routine can improve sleep. This should include stopping screen time at least an hour before bedtime and if possible, removing electronic devices from bedrooms overnight. Clearly, routines will vary depending on the age of the child, but all of us can benefit from a routine that signals to the body that it is time to power down.

One of the challenges of the pandemic is that bedrooms are now used for so many of the day’s activities, everything from schoolwork to social time with peers to entertainment— mostly using screens that emit blue light that keep us awake. Ideally, beds should only be used for sleep; that way, when we get into bed, our bodies know what to do. If this isn’t practical, at least make sure it’s dark, cool, and quiet at bedtime so the brain can rest and recharge.

If you’d like support developing your child’s sleep routine or are concerned about your child’s stress level, schedule an appointment with your child’s pediatric provider. We can help you assess your child’s wellness and work with you to help them achieve optimum health.

Dr. Johnston is a pediatrician at MCHC Health Centersa community-based and patient-directed organization that serves Mendocino and Lake Counties, providing comprehensive primary healthcare services as well as supportive services such as education and translation that promote access to healthcare. All MCHC health centers accept Medi-cal/ Partnership Healthplan of California, Medicare, Covered California, and other insurance. Learn more at mchcinc.org.