Sleep Deficits In Texas Adults - CDC data

This article from the CDC discusses insufficient sleep issues specifically to adults in Texas. - JR

Read more on Texas adults here.

Read about sleep statistics for others states here.

Behavioral Problems in Children: Think Sleep Apnea

This article discusses different types of sleep-related breathing problems in children and other associated sleep issues.

Children with sleep-related breathing problems (such as snoring or apnea) frequently have concurrent behavioral sleep problems (such as waking repeatedly) -- and vice versa, according to research led by a scientist at Albert Einstein College of Medicine of Yeshiva University. However, children with one type of sleep problem are not routinely evaluated and treated for the other. The findings suggest that pediatricians and... pediatric ...sleep medicine specialists should work together whenever a sleep problem is suspected.

The study was published Dec. 4 in the online edition of Behavioral Sleep Medicine.

"Our findings should raise awareness among parents and physicians that if a child is sleeping poorly, they should delve deeper to see if there is an unrecognized respiratory-related sleep problem," said senior author Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein. "The best way to make sure this happens is by taking an interdisciplinary approach to the care of these children."

According to Dr. Bonuck, little was known about the co-occurrence of behavioral sleep problems and sleep-disordered breathing (SDB). She and her colleagues carried out this study to find the prevalence and duration of behavioral sleep problems and of SDB -- and the rate at which they co-occur -- in a large, population-based sample of children (aged 18 months to nearly 5 years). The researchers analyzed data on more than 11,000 children enrolled in the Avon Longitudinal Study of Parents and Children, a project based in the United Kingdom.

In response to mailed questionnaires, parents reported their child's snoring and apnea at 18, 30, 42, and 57 months of age. For the same time intervals, parents were also asked whether their child refused to go to bed, and whether they regularly woke early, had difficulty sleeping, had nightmares, got up after being put to bed, woke in the night, or awakened after a few hours. Children with five or more of these behaviors simultaneously were considered to have a clinically significant behavioral sleep problem.

The prevalence of behavioral sleep problems over the 18 to 57-month age reporting period ranged from 15 to 27 percent with a peak at 30 months of age. Among children with behavioral sleep problems, 26 to 40 percent had habitual SDB, again peaking at 30 months. Among children who had habitual SDB, 25 to 37 percent also had a behavioral sleep problem, peaking at 30 months.

While it is unlikely that behavioral sleep problems cause SDB, the converse may be true, noted Dr. Bonuck. Frequent night wakings initially related to SDB may be reinforced by the parents' anxious responses. These behaviors may, in turn, develop into a persistent behavioral sleep problem, despite adequate treatment for SDB.

"It's important that we pay attention to how our children are sleeping," said Dr. Bonuck. "There's ample evidence that anything that interrupts sleep can negatively affect a child's emotional, cognitive, behavioral and academic development. Fortunately, snoring and apnea are highly treatable, and there are many effective interventions for behavioral sleep problems."

Read more here

How do you treat sleep apnea in children? Can medicine help?

What medicines may treat sleep apnea in children? Following a sleep study diagnosing sleep apnea,  This article shows that a commonly prescribed medicine for allergies might help to treat sleep apnea. - JR

Pediatrics. 2012 Sep;130(3):e575-80. doi: 10.1542/peds.2012-0310. Epub 2012 Aug 6.

Montelukast for children with obstructive sleep apnea: a double-blind, placebo-controlled study.

Goldbart AD, Greenberg-Dotan S, Tal A.

Source

Department of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, POB 151, Beer Sheva, Israel. avivgold@bgu.ac.il

Abstract

OBJECTIVES:

Children with nonsevere obstructive sleep apnea (OSA) benefit from alternative therapeutic interventions such as leukotriene modifiers. We hypothesized that montelukast might improve OSA in children. We tested this hypothesis in a double-blind, randomized, placebo-controlled fashion.

METHODS:

Of 50 possible candidates, we recruited 46 children with polysomnographically diagnosed OSA. In this prospective, double-blind, randomized trial, children received daily oral montelukast at 4 or 5 mg (<6 or="or">6 years of age, respectively) or placebo for 12 weeks. Polysomnographic assessments, parent questionnaires, and radiographs to assess adenoid size were performed before and after therapy.

RESULTS:

Compared with the 23 children that received placebo, the 23 children that received montelukast showed significant improvements in polysomnographic measures of respiratory disturbance (obstructive apnea index), children's symptoms, and adenoid size. The obstructive apnea index decreased by >50% in 65.2% of treated children. No attrition or side effects occurred.

CONCLUSIONS:

A 12-week treatment with daily, oral montelukast effectively reduced the severity of OSA and the magnitude of the underlying adenoidal hypertrophy in children with nonsevere OSA.

How to get kids' sleep schedules back on track for school

I recommended that families start this to 3 weeks ago.  But, here we are.  see my advice at the end of this post...JR



How to get kids' sleep schedules back on track for school

This article offers great tips for getting kids back on a regular sleep schedule for school. There is also a great slideshow on the site itself.

After a summer filled with camp, amusement park trips and swim lessons, switching back to that 6 a.m. morning routine is a rude awakening -- literally.

"A lot of kids get out of a regular schedule in the summertime,” Dr. Dennis Rosen, M.D., associate medical director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital, tells The Huffington Post, “shifting their internal clocks later, to the point that they’re out of sync with the external clock.”

Those later summertime bedtimes lead to later wake up times for school-aged children, too, he explains, especially teens. But sleeping until noon only causesproblems when September rolls around.

“Waking up earlier becomes quite difficult, almost akin to jet lag,” says Rosen. Not only does it feel crummy, he says, but because sleep plays an important roll in processing and consolidating memories, this seasonal version of jet lag can have an effect inside the classroom as well.

Unlike adults, who need around seven to nine hours of sleep a night, children of different ages require a wide range of sleep amounts to be at their best. Preschoolers typically need about 11 to 13 hours of sleep a night, kids up to 12 years old need 10 to 11 hours of sleep a night and teens need about 8.5 to 9.25 hours, according to the National Sleep Foundation.

But the bell rings at most schools in the U.S. at 8 a.m., HuffPost Education reported in May, and 20 percent of kids and teens must report to first period by 7:45 or before, making it difficult to hit the hay early enough to log the recommended winks.

That’s part of the reason a number of sleep advocates have been pushing for later school start times, a move that would not only allow children and teens to get more -- and better -- sleep, but may also aid learning, boost memory and improve grades and overall performance.

So how can you help your children get their sleep on track in time for headingback to school? Many of our favorite sleep rules still apply: Make your child’s bedroom a peaceful environment for sleep only. Take any electronic gadgets out of the bedroom, and keep it cool, dark and quiet. But there are some summer-specific methods the experts suggest, as well.

Read more here

Children  and teenagers get a circadian rhythm disorder at this time of year called to lead sleep phase  syndrome.  In essence, this is jetlag without the fun of travel.  

Their brain clock is set to go to sleep at a certain time.   This time will not change just because a parent so so.  

 Here is what will happen this week. If your child is set to go to sleep at midnight, they will continue to go to sleep at a late hour. Then because of school, they will be  awakened at 6 or 7. The 1st day they will drag. They may be emotional. They may be inattentive. If they are a set up for ADHD, headaches, tics, seizures,  you may see these increase.

If you  tell your child to go to bed at 9 PM but they have been going to sleep at midnight all week, don't expect a miracle. They are jetlagged by 3 hours.

Have some realistic and gradual expectations.  You need to set up your child to be physiologically ready to accept behavioral change.

 Also,  many people are not aware that the tendency to stay up late is the natural state of the young person's brain.  They live in a 25 hour world.  Unfortunately,  schools still function in a 24-hour world.

Like jetlag the principles of treating are the same.   You need to be awake during the day and sleep when the sun goes down.

So,

• Get your child or teen up at his regular school time this weekend.  Keep them up all day and do not allow napping until the regular bedtime.  
• Get them outside early in the day to expose them to natural bright light. 
• Do not allow  any gizmos that make light after sundown.
• Do not allow caffeine.
• Consistency is key.  Don't change schedules on the weekend.
• Please understand that sometimes this is a difficult problem to treat and medical intervention may be required. A  pediatric sleep specialist  can help.