Health consequences of texting in bed

A study indicates that texting in bed can lead to losing sleep in addition to poor school performance in teens.

Many American teens text in bed, leading to lost sleep, daytime drowsiness and poorer school performance, a new study says.

Researchers from New Jersey looked at nearly 3,200 middle and high school students in the state. They found that nearly 62 percent of the kids used their smartphones in some capacity after bedtime; nearly 57 percent texted, tweeted or messaged in bed; and nearly 21 percent awoke to texts.

"Our study confirms that many teenagers are texting late at night when they should be sleeping. This behavior is more common among older teenagers, especially those in high school, and among girls," said study co-author Vincent DeBari. He is director of research at the Seton Hall University School of Health and Medical Sciences, in South Orange.

"One of the most worrisome aspects of our findings is that in addition to affecting the quality and amount of sleep teenagers are getting, bedtime smartphone use seems to be having a negative impact on their level of alertness during the day and on their grades in school," DeBari said in a university news release.

His study co-author, Dr. Peter Polos, added that teens whose sleep is disrupted by incoming texts may feel compelled to respond to those texts immediately. These exchanges can go on for hours.

"This leads to excessive stimulation at night. Light from electronic devices can suppress the secretion of melatonin, a hormone that promotes sleep. All of these factors combine to make sleep difficult in the face of excessive smartphone use at night," said Polos, a member of the sleep medicine division of the JFK Neuroscience Institute in Edison, N.J.

The researchers also found that smartphone use just before or after bedtime may worsen teens' tendency to go to bed much later and sleep until late morning. This behavior has been linked with depression, anxiety and attention-deficit hyperactivity disorder, the study authors said.

"Repeatedly, studies have shown that today's adolescent students are seriously sleep-deprived, and that it affects their health, their mood and their safety behind the wheel. Our study shows that the unrestricted use of smartphones at night may be a major contributing factor," Dr. Sushanth Bhat, an assistant professor of neuroscience at Seton Hall, said in the news release.

"Since getting the proper amount of sleep is very important for brain development and learning in the teenage years, our study should prompt parents and guardians to consider placing reasonable limitations on adolescent smartphone usage at night," Bhat concluded.

The study findings appear in the October issue of the Journal of Adolescence.

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Study: Children with ADHD may have to squirm to learn

New research indicates that children with ADHD may have to squirm to learn.

For decades, frustrated parents and teachers have barked at fidgety children with ADHD to "Sit still and concentrate!"

But new research conducted at UCF shows that if you want ADHD kids to learn, you have to let them squirm. The foot-tapping, leg-swinging and chair-scooting movements of children with attention-deficit/hyperactivity disorder are actually vital to how they remember information and work out complex cognitive tasks, according to a study published in an early online release of the Journal of Abnormal Child Psychology.

The findings show the longtime prevailing methods for helping children with ADHD may be misguided.

"The typical interventions target reducing hyperactivity. It's exactly the opposite of what we should be doing for a majority of children with ADHD," said one of the study's authors, Mark Rapport, head of the Children's Learning Clinic at the University of Central Florida. "The message isn't 'Let them run around the room,' but you need to be able to facilitate their movement so they can maintain the level of alertness necessary for cognitive activities."

The research has major implications for how parents and teachers should deal with ADHD kids, particularly with the increasing weight given to students' performance on standardized testing. The study suggests that a majority of students with ADHD could perform better on classroom work, tests and homework if they're sitting on activity balls or exercise bikes, for instance.

The study at the UCF clinic included 52 boys ages 8 to 12. Twenty-nine of the children had been diagnosed with ADHD and the other 23 had no clinical disorders and showed normal development.

Each child was asked to perform a series of standardized tasks designed to gauge "working memory," the system for temporarily storing and managing information required to carry out complex cognitive tasks such as learning, reasoning and comprehension.

Children were shown a series of jumbled numbers and a letter that flashed onto a computer screen, then asked to put the numbers in order, followed by the letter. A high-speed camera recorded the kids, and observers recorded their every movement and gauged their attention to the task.

Rapport's previous research had already shown that the excessive movement that's a trademark of hyperactive children -- previously thought to be ever-present -- is actually apparent only when they need to use the brain's executive brain functions, especially their working memory.

The new study goes an important step further, proving the movement serves a purpose.

"What we've found is that when they're moving the most, the majority of them perform better," Rapport said. "They have to move to maintain alertness."

By contrast, the children in the study without ADHD also moved more during the cognitive tests, but it had the opposite effect: They performed worse.

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Children's academic performance and sleep

This article explains how academic performance in children is affected by their sleep.

Making sure school-aged kids get to sleep at a regular hour is often a struggle for parents. But a study by researchers at McGill University and the Douglas Mental Health University Institute in Montreal suggests it's well worth the effort: the researchers found that a good night's sleep is linked to better performance in math and languages -- subjects that are powerful predictors of later learning and academic success.

In findings published recently in the journal Sleep Medicine, the researchers reported that "sleep efficiency" is associated with higher academic performance in those key subjects. Sleep efficiency is a gauge of sleep quality that compares the amount of actual sleep time with the total time spent in bed.

While other studies have pointed to links between sleep and general academic performance, the Montreal scientists examined the impact of sleep quality on report-card grades in specific subjects. The upshot: with greater sleep efficiency, the children did better in math and languages -- but grades in science and art weren't affected.

"We believe that executive functions (the mental skills involved in planning, paying attention, and multitasking, for example) underlie the impact of sleep on academic performance, and these skills are more critical in math and languages than in other subjects," says Reut Gruber, a clinical child psychologist who led the study. Low academic achievement in children is a common and serious problem that affects 10-20 % of the population. "Short or poor sleep is a significant risk factor for poor academic performance that is frequently ignored," says Gruber, who is a researcher at the Douglas Institute and professor in McGill's Department of Psychiatry.

Gruber's research team, in collaboration with the Riverside School Board in Saint-Hubert, Quebec, studied 75 healthy children between 7 and 11 years of age. The children's nighttime sleep was monitored by actigraphy, which uses a wristwatch-like device to evaluate sleep by measuring movements. "We averaged the data over five nights to build the children's habitual sleep patterns and correlated the data with their report-card grades," Gruber says.

The takeaway for parents

The findings underscore the importance of identifying sleep issues that may otherwise go unnoticed, Gruber says. That doesn't mean parents need to rush out and have their kids tested at sleep clinics -- but it does point to a need for pediatricians to incorporate questions about sleep into routine checkups, she adds.

"I think many kids might have some sleep issues that nobody is aware of," she says. "And if the pediatrician doesn't ask about it, we don't know that it's there. Regular screening for possible sleep issues is particularly important for students who exhibit difficulties in math, languages or reading."

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ADHD affects school performance as early as 2nd grade

A study claims that ADHD can negatively affect a child's performance in school as early as the 2nd grade.

Attention-deficit/hyperactivity disorder can harm a child's academic performance and social skills as early as the second grade, a new Australian study contends.

Children between 6 and 8 years old who were tested and scored high for ADHD symptoms were more likely to get lower grades in elementary school and have trouble fitting in with other kids, compared with children without ADHD, the study authors reported.

Kids with ADHD also were more likely to have other mental health or developmental disorders, including anxiety, depression and autism, according to the study.

"Already at this stage, which is relatively young, it's very clear the children have important functional problems in every domain we registered," said study lead author Dr. Daryl Efron, a developmental-behavioral pediatrician with the Royal Children's Hospital Melbourne. "On every measure, we found the kids with ADHD were performing far poorer than the control children."

The researchers also said they discovered that about 80 percent of the young children with ADHD symptoms had not been diagnosed with the disorder, a finding called "striking" by Dr. David Fassler, a clinical professor of psychiatry at the University of Vermont College of Medicine.

"For this reason, I would fully agree with the authors' conclusion that the results of the study underscore the need for earlier recognition and treatment of ADHD in young children," Fassler said.

The study, published online Sept. 29 in the journal Pediatrics, is one of the first reports from the Children's Attention Project, a long-term examination of ADHD funded by the Australian government.

The researchers tested nearly 400 children between 6 and 8 years of age at 43 Melbourne schools, identifying 179 with ADHD and another 212 without ADHD who will serve as a "control group." These children will be observed throughout their academic careers.

By the second grade, the children with ADHD were already struggling. They were more likely to score below-average in reading and mathematics, and more likely to have problems connecting socially with their peers, the researchers said.

For example, 33 percent of kids with ADHD were reading below average and 46 percent had math skills below average. For non-ADHD kids, only about 6 percent were reading below average and nearly 15 percent had below-average math skills, the researchers found.

And the ADHD children were more likely to have other mental health or developmental problems -- such as anxiety, obsessive-compulsive disorder, depression, mania and autism, said Efron, who's also a senior lecturer at the University of Melbourne.

"Some people think it's only when kids get older you can pick up these comorbidities [overlapping health issues]. But we've shown you can pick them up at this early stage if you are looking for them," he said.

What's more, these problems seem to accumulate in some kids with ADHD, with 30 percent having two such impairments and 24 percent having three. By comparison, about 6 percent of non-ADHD kids had two such impairments, and about 1 percent had three, according to the study.

The investigators found that boys and girls with ADHD were equally impaired by the disorder.

"There hasn't been that much research into girls with ADHD, so we don't know that much," Efron said. "When we do see girls, in my experience, they are as impaired as the boys. But it is a novel research finding."

In another study published in the same issue of Pediatrics, researchers presented disappointing results for a drug that some had hoped would ease the insomnia experienced by many children with ADHD.

The drug, eszopiclone, failed to help children aged 6 to 17 with their ADHD-related insomnia. Both low and high doses of the drug proved ineffective, the researchers found.

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