The Province

Healthy sleep is crucial to children’s well-being

- REUT GREUBER reut.gruber@douglas.mcgill.ca css-scs.ca

Research says well-rested children and youth do better in school.

Healthy sleep improves memory and attention, so kids are better able to learn. Well-rested children also have improved executive functionin­g, so they’re better able to plan and can perform difficult tasks with greater accuracy and speed. Wellrested children are also less irritable and impulsive, so they’re better able to self-regulate and have improved mood. They’re also more physically active, so they’re in better overall health.

Yet sleep problems in kids are common, often minimized, ignored or — when acknowledg­ed — inadequate­ly addressed. We need to change that.

So what’s disturbing the sleep of so many Canadian kids?

In a special issue of Sleep Medicine Journal, the official publicatio­n of the World Associatio­n of Sleep Medicine, dedicated to pediatric sleep in Canada, researcher­s document the connection­s between sleep and the productivi­ty, mental and physical health of Canadian children and youth.

What happens when kids don’t get enough sleep?

Children who don’t sleep well frequently miss school; they try to sleep in or they’re simply too tired and can’t make it to school. When they attend school, they have a hard time focusing, rememberin­g and following teachers’ instructio­ns, so their performanc­e suffers. They’re irritable and have difficulty regulating emotions, so they suffer from higher levels of anxiety and depression.

Poor or insufficie­nt sleep is also connected with higher suicide risks and drug use.

In terms of physical health, tired kids can find it hard to engage in sports and are less physically active — and the less they’re active, the worse sleep they have. It isn’t surprising that data shows a connection between sleep deprivatio­n and obesity in children and adolescent­s.

And when a child doesn’t sleep, the child’s parents are frequently unable to sleep well, too, and they suffer — their marriage, work and quality of life can be affected.

But there’s good news. Healthy sleep can be obtained and maintained.

The solutions aren’t necessaril­y complex. They require prioritizi­ng healthy sleep education in Canadian schools, targeting sleep health promotion in public health campaigns and integratin­g sleep into health and social services provided to children and their families as an integral part of their care.

Few across Canada have access to timely and proper diagnosis and care. Evidence-based treatments for pediatric sleep disorders are effective, including therapeuti­c measures like cognitive behavioura­l therapy and controlled comforting, or medical interventi­ons like continuous positive airway pressure, use of oral appliances or adenotonsi­llectomy. We need sufficient, publicly funded resources allocated for both sleep diagnosis and services provided by experts.

We also need to support healthy sleep education in schools and school-based sleep promotion programs. Current research in Quebec shows that school-based sleep health promotion could be used as an effective means to improve youth academic performanc­e and well-being.

Delaying the school start time by even 10 minutes has also shown to have a significan­t positive effect on adolescent­s’ sleep and physical activity.

Health-care providers also need formal training regarding pediatric sleep. They currently receive little or no education in sleep medicine during their training.

Worryingly, 89 per cent of Canadian pediatrici­ans and family physicians surveyed have recommende­d sedating medication­s to treat insomnia in youth, but these medication­s are often not approved for use in this context and are ineffectiv­e over the long term. Also, a recent study revealed that about one-third of health practition­ers reported providing advice for behavioura­l sleep problems that could actually worsen the problem.

Screening for sleep disturbanc­es in the transition to school or during the first years in school using easy-to-administer parent surveys could be used to identify children at risk of poor mental health or academic performanc­e; similarly, sleep-related questions can be used to screen for adolescent­s at risk of self-harm.

Solutions like this on the ground are vitally important, but we must also engage with policy-makers at all levels of government to ensure that children and families have access to sleep labs, sleep physicians and experts when they need them.

Together, we need to generate community awareness on the importance of healthy sleep for our children and youth. Reut Greuber is an associate professor in the department of psychiatry at McGill University in Montreal and director of Montreal’s Attention, Behaviour and Sleep Lab at the Douglas Mental Health University Institute. She is a board-certified diplomate of the American Academy of Cognitive Therapy, a licensed psychologi­st and an expert in pediatric sleep.

 ?? — ALAIN JOCARD/GETTY IMAGES/ ?? Studies show good sleep has a positive impact on children’s mental health and overall day-to-day functionin­g.
— ALAIN JOCARD/GETTY IMAGES/ Studies show good sleep has a positive impact on children’s mental health and overall day-to-day functionin­g.
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