Is melatonin safe for children?

This article discusses the research that has been done on melatonin and children.

Melatonin hormone should be made easily available according to some sleep experts despite the conflict of interest among researchers as to whether it is safe for inducing sleep in children or not, reports The Sydney Morning Herald.

Melatonin is a natural hormone secreted by the pineal gland of the body. The small pea-sized gland which is located just above the middle of the brain is inactive during the day and gets turned on by the suprachiasmatic nucleus (SCN) located in the hypothalamus when it gets dark. It then secretes the melatonin in the blood which is responsible for inducing sleep naturally.

Sleep plays a vital part during the early development of brain in the newborns. The Circadian rhythm or the sleep-wake cycle in the body is regulated by the light and dark and it takes time to develop, resulting in the irregular sleep schedules of newborns. The rhythms begin to develop at about six weeks, and by three to six months most infants have a regular sleep-wake cycle.

However, 30 percent of children aged under three suffer from sleep problems, with the most common causes which are either behavioral or medical, according to a Monash University study.

Pediatric sleep specialist Dr Chris Seton, Woolcock Institute of Medical Research says, melatonin is a better alternative to the antidepressants and blood pressure medication that is commonly used by the parents which cause severe side effects.

But the medical experts do not seem to be readily accepting the claim as some of the research reveals that melatonin could adversely affect development during adolescence. They also have raised concern over the increasing trend of use of the hormone for treating sleep related issues in children.

There are reports which say that children with epilepsy and cerebral palsy were prescribed with melatonin way back since 1991. But it is now believed children with behavioural issues, such as ADHD, are more likely to be given melatonin now.

A senior research fellow at The University of Adelaide, David Kennaway says that the studies done on adults and animals have linked melatonin to a negative impact on reproductive, immune, cardiovascular and metabolic systems. In a research article published in the Journal of Paediatrics and Child Health, he says “It is not registered for use in children anywhere in the world and it has not undergone the formal safety testing expected for a new drug, especially long-term in children.”

But Dr Chris Seton, feels otherwise and says,”There is no evidence that it’s anything but a very safe drug. In the contexts of drugs given to kids, it’s at the top in terms of safety”.

The Sleep Health Foundation has cautiously approved the use of melatonin in children, stating it “appears to be safe and works well in the short term”.

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Young kids' sleep and obesity

Young kids not getting enough sleep could lead to obesity later in life.

Lack of sleep and sleep-related breathing problems appear to boost children's risk of obesity, a new study finds.

What isn't clear from the study, however, is whether the sleep issues actually cause obesity, or if something else might explain the association between sleep problems and obesity.

Researchers analyzed data from about 1,900 youngsters in England. The researchers had about 15 years of follow-up on the children. Those who got the least amount of sleep at ages 5 and 6 had between a 60 percent and 100 percent increased risk of being obese at age 15. (For children aged 5 or 6, fewer than 10.5 hours of sleep a night is considered too little, according to the researchers.)

Children who got too little sleep at other ages were not at increased risk for obesity, according to the study.

The researchers also found that one-quarter of the children were at increased risk of obesity due to sleep-related breathing problems such as snoring and sleep apnea. Those with the most severe sleep-related breathing problems were twice as likely to become obese by ages 7, 10 and 15.

The risk was slightly lower in children whose sleep-related breathing problems peaked at ages 5 or 6, but was still 60 percent to 80 percent higher than among those without sleep-related breathing problems.

The researchers didn't look at whether children with both these risk factors had a higher risk of obesity than those with just one of the risk factors.

"In recent years, lack of sleep has become a well-recognized risk for childhood obesity," study author Karen Bonuck, a professor of family and social medicine, and obstetrics, gynecology and women's health at Albert Einstein College of Medicine in New York City, said in a college news release.

"We know that the road to obesity often begins early in life. Our research strengthens the case that insufficient sleep and SDB (sleep-disordered breathing) -- especially when present early in childhood -- increase the risk for becoming obese later in childhood," she added.

"If impaired sleep in childhood is conclusively shown to cause future obesity, it may be vital for parents and physicians to identify sleep problems early, so that corrective action can be taken and obesity prevented. With childhood obesity hovering at 17 percent in the United States, we're hopeful that efforts to address both of these risk factors could have a tremendous public health impact," Bonuck concluded.

A common cause of sleep-related breathing problems in children is enlarged tonsils or adenoids. If these are a problem, they can be removed through surgery. Another possible cause is misalignment of the jaws and teeth. This problem can be treated with a night guard or orthodontics.

Learning good sleep habits can help children get adequate sleep, Bonuck said.

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Sleep issues in children with mental health diagnoses

Sleep issues are common among children with mental health diagnoses, and may go undiagnosed due to the co-existing conditions.

Sleep difficulties, particularly problems falling asleep, are common among toddlers and preschoolers with mental health issues, according to a new study.

"Sleep problems in young children frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal preschool adjustment, and problems of irritability, hyperactivity and attention," said the study's leader, John Boekamp, clinical director of the pediatric partial hospital program at Bradley Hospital in Providence, R.I.

However, he said, sleep disorders may be unrecognized and underdiagnosed in young children, particularly when behavioral or emotional problems are present.

The study, published online in Child Psychiatry & Human Development, involved 183 children aged 6 years or younger receiving outpatient treatment for psychiatric problems. The researchers examined the prevalence of sleep disorders among these children and the nature of the sleep problems.

"The most common sleep difficulties reported nationally for toddlers and preschoolers are problems of going to bed, falling asleep and frequent night awakenings. Collectively, these problems are referred to as behavioral insomnias of childhood," said Boekamp in a hospital news release.

Recognized sleep disorders, particularly sleep onset insomnia, were more common than expected, the researchers found. Overall, 41 percent of children in the study met the criteria to diagnose a sleep disorder.

Sleep problems were most common in kids with disruptive behavior, and attention, anxiety and mood problems, the researchers found.

Early sleep problems could not only be the result of behavioral and emotional problems, but could also contribute to them, the researchers noted.

"Essentially, these young children might be caught in a cycle, with sleep disruption affecting their psychiatric symptoms, and psychiatric symptoms affecting their sleep-wake organization," said Boekamp. "It is important for families to be aware of how important sleep is to the behavioral adjustment and well-being of young children."

Sleep problems can complicate treatment for challenging behaviors, such as aggression and attention and mood problems. Daytime sleepiness and fatigue can make these problems even worse, the study's authors noted.

"This study is a great reminder that it's critical for mental health providers working with young children and their families to ask about children's sleep," said Boekamp.

"Simple questions about children's sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment," he explained.

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Study: Sleep issues common for children with psychiatric disorders

A study found that sleep issues are more common for children with a psychiatric disorder.

John Boekamp, Ph.D., clinical director of the Pediatric Partial Hospital Program (PPHP) at Bradley Hospital recently led a study that found sleep difficulties - particularly problems with falling asleep - were very common among toddlers and preschool-aged children who were receiving clinical treatment for a wide range of psychiatric disorders. The study, titled "Sleep Onset and Night Waking Insomnias in Preschoolers with Psychiatric Disorders," is now published online in the journal Child Psychiatry & Human Development.

"The most common sleep difficulties reported nationally for toddlers and preschoolers are problems of going to bed, falling asleep and frequent night awakenings – collectively, these problems are referred to as behavioral insomnias of childhood," said Boekamp. "Sleep problems in young children frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal preschooladjustment, and problems of irritability, hyperactivity and attention."

Boekamp's team was interested in learning more about sleep and sleep problems in young children with behavior problems, as early sleep problems may be both a cause and consequence of children's difficulties with behavioral and emotional self-regulation. "Essentially, these young children might be caught in a cycle, with sleep disruption affecting their psychiatric symptoms and psychiatric symptoms affecting their sleep-wake organization," said Boekamp.

The partial program that Boekamp leads at Bradley Hospital is a family-centered, intensive day treatment program for very young children aged from newborn to six who have serious emotional, behavioral or relationship disturbances. This study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a group of 183 young children admitted to the program. Diagnosable sleep disorders, particularly SOI, were quite common in the group, exceeding previous estimates obtained in community settings. Overall, 41 percent of children in the study also met diagnostic criteria for a sleep disorder. Sleep problems were especially common in children with disruptive behavior, attention, anxiety and mood problems.

"It is important for families to be aware of how important sleep is to the behavioral adjustment and wellbeing of young children," said Boekamp. "Sleep disorders may be unrecognized and under-diagnosed in young children, particularly when other behavioral or emotional problems are present."

Difficulties with sleep may be particularly important to address when children are also struggling with challenging daytime behaviors, such as problems with compliance, aggression, attention and mood. Sleepiness and fatigue may exacerbate these problem behaviors.

"This study is a great reminder that it's critical for mental health providers working with young children and their families to ask about children's sleep," said Boekamp. "Simple questions about children's sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment."

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Sleep and Childhood Concussion - Brain Injury. Often Problematic. Often Overlooked.

Following brain injury, sleep disorders are often overlooked in the care of children, teens and young adults. JR
Sleep disorders in children with traumatic brain injury: a case of serious neglect

1. Gregory Stores^1,* and
2. Rachel Stores²

Article first published online: 12 MAY 2013

"Findings in the following recent studies illustrate the frequent persistence of disturbed sleep, which clearly has implications for rehabilitation. Castriotta et al.[9] reported the presence of sleep disturbance in 46% of adult patients at least 3 months after TBI; Baumann et al.[10]described 72% of adults with TBI as having sleep disturbances 6 months after the injury that were not present before the accident; Fogelberg et al.[11] found persistent sleep difficulties in 44% of rehabilitation patients 1 year after TBI, and in the subsequent study by Baumann's group[12] such sleep problems were shown to be still present 3 years after injury in two-thirds of patients.

Studies of TBI and sleep disturbance in children are few, and the findings can be inconsistent.

 Using retrospective parental reports for pre-injury sleep and repeated prospective post-injury assessments up to 2 years, Beebe et al.[13] described children aged 6 to 12 years with severe TBI as being at increased risk for post-injury sleep problems compared with those with moderate TBI and a comparison group of children with only an orthopaedic injury. I

n contrast, a small group of 7- to 12-year-old children with a mild TBI 6 months before assessment were said to have greater sleep disturbance than children with orthopaedic injuries.[14] 

In a small-scale study, Kaufman et al.[15] found that adolescents who had suffered a minor head injury 3 years previously still complained of severe sleep disturbances and showed polysomnographic and actometry results in keeping with their complaints. 

Subsequently, researchers from the same group followed a larger number of adolescents who had suffered a minor head injury up to 6 years previously, and found that over a quarter still had subjective sleep disturbance.[16]

A more recent prospective study over 2 years of children aged up to 17 years of age who had experienced TBI confirmed a higher rate of sleep disturbance (with more prolonged duration) than comparison children who had experienced an orthopaedic injury.[17] 

Risk factors included pain, psychosocial factors, and mild TBI, which has been reported to be possibly more closely correlated with an increased likelihood of sleep disturbance than severe forms of TBI.[18] The counter-intuitive recurrent theme that mild TBI particularly seems to predispose to sleep disturbance is just one of the many current imponderables in this area of enquiry."

Aim

The aim of this study was to review the basic aspects of sleep disturbance in children with traumatic brain injury (TBI).

Method

A search was performed on reports of sleep disturbances in children who had suffered TBI. Adults with TBI were also considered to anticipate the nature and significance of such disturbances in younger patients. Types of reported sleep disturbance were noted and their possible aetiology and management considered.

Results

Sleep disturbance has consistently been associated with TBI but the literature suggests that this aspect of patient care is often inadequately considered and there has been little research on the subject, especially in relation to children. Excessive daytime sleepiness is often mentioned, less so insomnia and parasomnias, but there is little information about the specific sleep disorders underlying these problems.

Interpretation

Sleep disorders with potentially important developmental consequences have been neglected in the care of children with TBI. Screening for sleep problems should be routine and followed, if indicated, by a detailed diagnosis of the child's underlying specific sleep disorder, the possible aetiology of which includes neuropathology and potential medical, psychological, or psychiatric comorbidities. Appropriate assessments and modern treatment options are now well defined although generally underutilized. Further well-designed research is needed for which guidelines are available.

LINK to Full Article HERE

Study: Children with ADHD benefit from treating sleep problems

A study shows that children with ADHD benefit from treating underlying sleep problems.

Addressing sleep problems often improves psychiatric symptoms in children and teens, including those with attention-deficit/hyperactivity disorder and chronic pain.

Sleep-focused treatment improves mood and quality of life in children with attention-deficit/hyperactivity disorder (ADHD), asthma, chronic pain, and cancer, according to speakers at symposium on sleep in children with chronic health conditions at the annual meeting of the American Academy of Sleep Medicine and Sleep Research Society in Minneapolis in June.

Children with ADHD are two to three times more likely to have trouble sleeping than children without the disorder, said Penny Corkum, Ph.D., a professor of psychology and neuroscience at Dalhousie University in Halifax, Nova Scotia. Their sleep problems may undermine daytime performance, said Corkum, who directs research and training at Colchester Regional Hospital’s ADHD Clinic.

In research reported at the meeting, she and colleagues assessed sleep in 30 children newly diagnosed with ADHD and 30 age- and sex-matched typically developing controls. The children’s mean age was about 8.5. At baseline, children with ADHD took 47 minutes to fall asleep in the sleep laboratory, while controls took 24 minutes. Children with ADHD slept about 30 minutes less than controls.

In a four-week medication trial, the researchers gave the 30 children with ADHD either a standard single daily morning dose of methylphenidate or a placebo, in random order for two weeks. While children took longer to fall asleep and slept less when taking the stimulant than when taking the placebo, parents and teachers said their behavior improved.

Children being evaluated for problems with attention, Corkum said, should also be screened for sleep disorders. Consequences of sleep disorders such as obstructive sleep apnea, insomnia, and periodic limb movement disorder/restless leg syndrome may mimic symptoms of ADHD.

Children with and without ADHD, she added, benefit from having a consistent bedtime, learning to fall asleep on their own, sleeping in a dark room, and avoiding television, computers, telephones, and other electronic devices near bedtime.

Children and adolescents with persistent pain commonly report difficulty falling or staying asleep or complain of poor quality sleep, said symposium speaker Tonya Palermo, Ph.D., a professor of anesthesiology and pain medicine at the University of Washington, Seattle.

About 5 percent to 8 percent of children and adolescents in community samples experience moderate to severe disability from persistent pain, most often in the head, abdomen, or limbs, she noted. Common causes include headache disorders, juvenile arthritis, and sickle-cell disease.

Some have depression. Their pain medications may be sedating. These youngsters often say, “I’m always tired,” Palermo noted. Many take frequent and often long naps that may interfere with school or social activities. Concerned parents may allow children to stay in bed late in the morning.

Engaging children and adolescents in self-assessment, Palermo said, may foster improved sleep habits. She asks them to abstain from watching television in their bedroom for a week, for example, to see how that affects their sleep. She also encourages them to use an alarm clock and get up on their own and to maintain a consistent weekday/weekend schedule.

Palermo and colleagues also found that poor sleep diminishes the effectiveness of cognitive-behavioral therapy for chronic pain. She said sleep-specific intervention may need to be delivered before pain-focused behavioral therapy starts.

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Children with autism face more health complications when obese

Children who have autism and are obese are more likely to suffer from other health complications, such as anxiety, depression, and sleep problems.

Adding to the complications of autism, overweight and obese children with the disorder are prone to a host of other troubles, including depression, anxiety and sleep problems, reports a study published 2 February in the Journal of Autism and Developmental Disorders.

The findings suggest that excess weight can signal, or even trigger, less obvious conditions in autism, and that variations in weight may affect results about the prevalence of sleep, mood and anxiety problems in behavioral research studies.

In the new study, researchers calculated the body mass index (BMI), a measure of body fat based on weight and height, of 376 children with autism living in Oregon. (The healthy range for a BMI is between 18 and 25.) The participants, ranging in age from 2 to 18 years, are part of the Autism Treatment Network, a group of collaborating hospitals organized by the research and advocacy group Autism Speaks.

The researchers then analyzed the relationship between parent and clinician reports and the children’s BMI. The reports documented the children’s behavior and other conditions.

Roughly 18 percent of the children in the study were overweight — with a BMI between 25 and 30 — and 17 percent were obese, with a BMI above 30. For comparison, about 32 percent of typically developing children are overweight or obese.

Among teenagers with developmental disabilities, those with autism are the most likely to be obese, according to a study published 20 February in Maternal and Child Health Journal. The study found that 32 percent of adolescents with autism are obese, compared with 20 percent of those with developmental disabilities such as intellectual disability and attention deficit hyperactivity disorder. In contrast, 13 percent of typical teenagers are obese.

Studies have suggested that depressive symptoms may be both a cause and a consequence of childhood obesity. The Oregon study found that obese children younger than 6 years are more likely to suffer from anxiety and mood problems, such as depression, than are children who weigh less.

Obese children older than 6 years do not show this trend, but that may be because their version of the test poses different questions.  

Roughly 85 percent of overweight and obese children with autism under 11 years also struggle with sleep. Children with the disorder tend not to sleep well in general.

The new study found that roughly 75 percent of the children with autism under 11 years of age with a healthy weight don’t sleep well.

Possibly as a consequence, one in three obese children with autism take the sleep-promoting hormone melatonin, compared with one in five children with autism who have a healthy BMI.

Interestingly, however, some symptoms of autism are less severe among children carrying extra weight. The study found that children with the disorder who are overweight, but not those who are obese, have lower levels of repetitive behaviorsthan their slender peers do.

This relationship is difficult to interpret, the researchers note. It’s possible that repetitive behaviors burn many calories, contributing a healthy BMI, but that does not explain the severity of the behavior among obese children with autism. The researchers also suggest that children with severe repetitive behaviors may take medications, such as risperidone, that cause them to gain weight.

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Autistic boys get less sleep with media in bedrooms

A study shows that media screens in the bedroom of autistic boys resulted in them getting significantly less sleep.

For boys with autism, having easy access to media in the bedroom is linked to significantly less sleep, according to researchers from the University of Missouri.

“Previous research has shown that bedroom access to screen-based media is associated with less time spent sleeping in the general population,” said Christopher Engelhardt, Ph.D., a postdoctoral research fellow at the MU Thompson Center for Autism and Developmental Disorders and the MU School of Health Professions.

“We found that this relationship is stronger among boys with autism.

“Our current results were cross-sectional, meaning that we are not able to determine whether pre-bedtime media exposure causes some children with autism to sleep less,” he said.

“However, the relationship between bedroom media access and sleep was particularly large among boys with autism, suggesting that we should continue to carefully research this possibility.”

For the study, researchers looked at the relationship between media use and sleep among boys with autism compared to typically developing boys or boys with attention-deficit/hyperactivity disorder (ADHD).

Parents of the boys in each group were surveyed regarding the child’s hours of media use each day, bedroom access to media and the average hours of sleep they received per night. The findings revealed a link between bedroom access to a television or computer and reduced sleep among boys with autism.

Furthermore, average video-game exposure was connected to less time spent sleeping among the boys with ASD.

“Even though our findings are preliminary, parents should be aware that media use may have an effect on sleep, especially for children with autism,” Engelhardt said. “If children are having sleep problems, parents might consider monitoring and possibly limiting their children’s media use, especially around bedtime.”

Engelhardt says future research should investigate the processes by which bedroom access to media could contribute to sleep disturbances in children with autism spectrum disorder (ASD).

“It is also important to note that some media use may also be beneficial for children with autism,” Engelhardt said. “Future research is also needed to determine how video games and other technologies may be helpful in teaching and reinforcing skills and behaviors.”

It is estimated that about one in 88 children have ASD, which is characterized by social and communication difficulties as well as repetitive behaviors.

Sleep problems are very common in children with autism, and this may be due to a variety of underlying causes. Media use may worsen some of these underlying factors, and it appears to be an area for future research, Engelhardt said.

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Autistic children's sleep patterns

A study shows that autistic children sleep for shorter periods of time and wake more easily than non-autistic children.

Sleep problems are common in children with Autism. Studies have revealed that 50 to 80% of children with autism experience sleep difficulties at some time. Past research has focused on disrupted sleep patterns linked to Autism however; the quality of the evidence accumulated to date has often been compromised by small sample size, lack of agreed definitions, and poor comparability of study participants.

In this new study researchers examined longitudinal sleep patterns in children with autistic spectrum disorders (ASDs) by using long term data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a cohort study of children born in Avon, England during 1991 and 1992. The study tracked the health and development of more than 14,000 children.

Parents were asked about their children's sleeping patterns when their kids were 6, 18, 30, 42, 69, 81, 115 and 140 months old, including when their children routinely went to bed and woke up on week days, and how much time they spent sleeping during the daytime.

Researchers also took into account other key information that included the results of the validated The Social Communications Disorders Check List (SCDC) a questionnaire completed by parents which measures social reciprocity and verbal/non-verbal characteristics similar to those found in Autism. The Wechsler Intelligence Scale for Children (WISC-III) was administered at age seven years. TheWISC-III considers a variety of constructs in determining the Full Scale Intelligence Quotient.

Eighty six of the children had been diagnosed with autistic spectrum disorders by the time they were 11 years old. Thirty had classic autism; 15 had atypical autism; and 23 had Asperger's syndrome.

The final analysis was based on 39 children with autistic spectrum disorders and 7043 typical children for who complete data across all time points were available.

Before the age of 30 months (2.6 yrs.) there was no major difference in sleep patterns between the two groups. However, from 30 months onwards, children with autistic spectrum disorders tended to sleep less in total, with the greatest discrepancy (43 minutes) persisting up to 140 months of age, a difference that remained significant after adjusting for sex, ethnicity, high parity and epilepsy.

The reduction in total sleep was wholly due to changes in night rather than daytimesleep duration. Night-time sleep duration was shortened by later bedtimes and earlierwaking times. Frequent waking (3 or more times a night) was also evident among the children with ASD from 30 months of age.

When it comes to disturbed sleep patterns the authors suggested that an increasing body of data suggests that production of the sleep hormone melatonin may be impaired in some children with autistic spectrum disorders.

The authors acknowledge it is unclear just what impact this shortened sleep pattern may have, however they point out that other researchers have suggested that sleep loss may have impact on neuronal development.

"If this hypothesis of cumulative sleep reduction resulting in neuronal loss is confirmed, then clinically [children with autism] might gain from even a small consistent increase in total sleep time," write the team.

In their conclusion the researchers write “Sleep duration in children with ASD is reduced from 30 months of age and persists until adolescence.”

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Childhood sleep issues could signal eating disorders

A study that looked at what may signal a child may eventually develop an eating disorder found that sleep problems during early childhood was the only signal found.

Researchers, clinicians, and sufferers are often interested in finding out what leads to eating disorders, what causes them, and how we can predict them (if at all). A recent research study done in Norway and published by the Journal of Eating Disorders sought to do just that.

Researchers used results from a 15-year-long longitudinal community study to investigate risk factors from early childhood (before age 5) for adolescent eating problems. The study began with 921 mothers completing questionnaires regarding their 1 ½ year old child. 784 mothers completed questionnaires at age 2 ½ and 737 at age 4 ½. When the children were 16 years old, 373 mothers also completed a questionnaire about eating problems called the Eating Attitudes Test.

The study looked at several possible risk factors from early childhood including picky eating in early childhood, sleep problems, internalizing problems, shyness, and emotionality. Interestingly, the only risk factor that was associated with the development of eating problems in adolescent was early childhood sleep problems.

Although this does not mean that sleep problems cause eating disorders, it may mean that there is some type of psychological or biological problem that results in both sleep problems in early childhood and eating problems in adolescence. However, given that this is the only study to show a such a correlation, the results must be duplicated before anyone begins to worry about a sleepless two-year-old developing an eating disorder at age 16.

Interestingly, picky eating in early childhood was not correlated with the development of eating disorders late in life (much to the relief of toddler parents everywhere).

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Sleep problems and heart function in children

A study of blood pressure and sleep problems in children found that there was no association between the two conditions.

The study aims to assess the associations of sleep problems with 24–hour ambulatory blood pressure and cardiovascular reactivity in children. The results suggest that in a healthy community sample of prepubertal children, sleep problems are not associated with an unhealthy cardiovascular phenotype at this age. However, associations may be underestimated because of the low prevalence of sleep breathing disorders in this sample and may not generalize to older populations.

Methods

• Sleep problems in 285 term-born, healthy 8-year-olds (mean [standard deviation]=8.1 [0.3]years) were measured with a parent-rated Sleep Disturbance Scale for Children.
• Ambulatory blood pressure (n=241) was measured for 24hours (41% nonschool days) with an oscillometric device.
• The children (n=274) underwent the Trier Social Stress Test for Children during which blood pressure, electrocardiography, and thoracic impedance were recorded and processed offline to give measures of cardiovascular and autonomic function.

Results

• No associations were found between sleep problems and 24-hour ambulatory blood pressure.
• Children with sleep breathing disorders (n=5) had higher baseline sympathetic vascular activity (p=.014) and higher heart rate (p=.044) and sympathetic cardiac activity (p=.031) in reaction to stress.
• Children with disorders of excessive somnolence (n=55) had higher baseline parasympathetic activity (p=.016).
• None of the associations remained significant after controlling for multiple testing.

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What Are Common Sleep Problems in Toddlers?

This article discusses five common sleep issues in toddlers such as breathing pauses, sweating, nightmares, teeth grinding, and twitching, jerking and restlessness. This article also gives solution to the sleep problems.

It’s a lovely idea to think you can put your toddler to bed and night and not worry about them until morning. But as many parents of toddlers already know all too well, that’s not always the case.

Things like teeth grinding, breathing pauses, sweating, twitching and jerking, and nightmares can keep toddlers from getting a restful night’s sleep, and when they don’t sleep well or enough, it can lead to problems during the day.

Here are five common toddler sleep problems, according to BabyCenter.com, as well as potential solutions for all of them:

Breathing Pauses

Some toddlers might experience breathing pauses while they’re asleep. It could be a sign of sleep apnea, which, according to the Mayo Clinic, is a potentially serious sleep disorder.
However, occasional breathing pauses (along with snoring and snorting) aren’t necessarily a cause for concern. Breathing patterns can change during sleep and many toddlers also sigh in their sleep, which might make them appear as if they’ve stopped breathing for a brief time, but it can, in fact, be normal.
If you suspect your toddler might have sleep apnea, a doctor should be consulted so that potential complications such as a heart problem can be diagnosed and treated.

Sweating

Despite the room temperature being perfect comfortable and their bedding and pajamas being seasonally appropriate, some toddlers will still sweat enough at night to wake up soaked through.
Nighttime perspiration is usually nothing to worry about because it’s probably a sign that the body is "restoring itself". For toddlers who sweat a lot a night, light cotton clothes are recommended for sleeping and rooms should be kept on the cool side.
Livestrong.com advises that “if a toddler is sweating excessively and it appears unrelated to body temperature control, speak to your pediatrician to rule out medical conditions like hyperhidrosis.”

Nightmares

Toddlers aren’t too young to have nightmares, which are often caused by stress and anxiety and occasionally by fevers or medication. They tend to happen later at night when they are deeply asleep.
The Cleveland Clinic advises ensuring toddlers who experience nightmares get adequate sleep, have a bedtime routine that is light, happy and fun, discuss the nightmares during the day, and are comforted, coddled and reassured so that they can sleep more peacefully.

Twitching, Jerking and Restlessness

It’s not uncommon for some toddlers to twitch or jerk or flex their ankles for a few seconds a couple of times a minute for as long as a few hours while falling asleep or while they’re already sleeping. It won’t hurt them, but it might prevent them from getting a peaceful night’s sleep.
The twitches and jerks could be a sign that their levels of iron or folic acid are insufficient, which can be discussed with their pediatrician.
It can also be a sign of restless legs syndrome, which, according to the U.S. National Library of Medicine, is a disorder in which there is an urge or need to move the legs to stop unpleasant sensations.
Techniques such as gentle stretching exercises, massage and warm baths can help muscles relax and lead to a more relaxed night’s sleep.

Teeth Grinding

Bruxism is the medical term for teeth grinding or the clenching of jaws, and according to KidsHealth.org, two to three out of every 10 kids will do it, although most outgrow it.
Kids grind their teeth as a result of tension, anxiety, pain from an earache or teething, allergies, or their teeth not being properly aligned.
Teeth grinding isn’t harmful, but it’s worth mentioning to the dentist to double check there are no problems.
Soothing a toddler who grinds their teeth at bedtime with a bath, backrub or extra cuddling might help alleviate the problem.

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Study claims February is the worst month for sleep

A study from the UK shows that it takes longer for us to fall asleep in February than in other months, and we are up for longer during the night.

If you're feeling particularly sleepy this month, you are not alone.

But sadly, going to bed early may not be the solution.

A number of factors combine to make February a post-New Year 'sleep dip', experts claim. But by next month things will improve, they say.

It takes an extra eight minutes on average to get to sleep this month compared with March, and we spend an extra 10 minutes awake during the night.

As a result one-third more people report low energy levels, with women coming off worse than men.

Findings from The Great British Sleep Survey of over 21,000 UK adults show that February will be the worst month for sleep until the start of next winter.

Dark days, long nights and centrally heated homes all conspire to reduce both the amount and quality of sleep at this time of year, it is claimed.

The survey was sponsored by Sleepio, an online sleep improvement programme which uses cognitive behavioural techniques.

Professor Colin Espie, sleep expert and co-founder of Sleepio, said ‘These results demonstrate the difficulty many people experience with sleep during the shorter, darker days typical of this time of the year.

‘With Spring coming up, we’re at the tail end of a bad spell for sleep but the improvement in light levels in March will also bring better sleep.’ One in three Britons is believed to suffer insomnia, with numbers increasing among older people.

The survey findings are based on questionnaire results from last winter about people’s sleep patterns and scores out of 10 for sleep quality.

The results show Britons spend an average of 8 minutes longer trying to get to sleep this month, with a further 10 minutes awake during the night than in March.'

The average time taken to get to sleep was 56 minutes and time awake at night 59 minutes for those completing the survey in February, versus 48 and 49 minutes respectively in March.

Almost a third more people say they suffer from low energy levels in February than in March.

Of those who completed the survey during the month of February, 68 per cent complained of low energy, compared to 39 per cent who completed the survey in March.

Women are particularly affected, as their sleep quality is seven per cent worse in February than the average for the rest of the year. Men experience a five per cent fall in sleep quality.

However, in March the survey predicts a 14 per cent increase sleep quality, based on in the nation’s average Sleep Score, and a 26 per cent fall in those who felt frustrated due to their sleep.

The average Sleep Score of those completing the survey in the month of February was 4.8, compared to an average of 5.5 for those completing it in the month of March, an increase of 14 per cent.

The figures for February are worse than January. The average Sleep Score for January is 4.9, which dips to 4.8 in February.

People are awake for two minutes more during the night in February than January (59 minutes versus 57 minutes) and it takes them an extra minute to get to sleep. So February is the ‘low water mark’ before our sleep starts to improve again towards the Summer.

Of those who completed the survey during the month of February, 26 per cent reported feeling negative and 32 per cent felt frustrated due to their sleep, compared to those who completed the survey in March, only 10 per cent of whom reported feeling negative and 8 per cent frustrated.

Prof Espie said ‘The body clock is highly regulated by ambient light, the light coming from outside, which provides the alerting signal for an even keel of wakefulness during the day.

‘Those signals are not so distinct in winter and drowsiness is promoted by stuffy centrally heated homes, buildings with low levels of light and lack of fresh air, which has an adverse effect on the quality of sleep at night.

‘It is unsurprising that women are affected slightly more than men - this reflects the general higher prevalence of sleep problems amongst the female population.

‘With poor quality of sleep affecting all aspects of our lives - from relationships to energy and productivity at work - the potential impact of this shouldn’t be underestimated’ he added.

Launched by Sleepio.com in March 2010, the Great British Sleep Survey is an ongoing assessment of how Britons are sleeping, Research shows the £49.99 programme can help three-quarters of even long-term poor sleepers retrain their mind and body to achieve healthy sleep in six weeks without the need for sleeping pills.

Anyone can take part in the survey by visiting www.GreatBritishSleepSurvey.com. The questionnaire takes just 5-10 minutes to fill in and everyone who completes it gets a free personal sleep report tailored to their specific problems.

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