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Lack of sleep not just an adult problem

Recent studies suggest that an increasing number of children have sleep disorders; TV, the Internet, and obesity are the most cited sleep-stealers.

By Victoria Stagg Elliott, AMNews staff. June 23, 2003.

Kids and teens are getting less sleep than ever before. The quality of their sleep is deteriorating, and increasing numbers are complaining of insomnia and snoring, according to several studies presented this month during the Associated Professional Sleep Societies annual meeting in Chicago.

"It's a bigger problem than anyone realizes," said Sajjan K. Nemani, MD, director of neurodiagnostic and sleep disorder services at St. Mary's Good Samaritan Hospital in Centralia, Ill. "Being asleep is just as important as being awake."

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Sleep experts have long been sounding the alarm about the many adults who are chronically sleep-deprived. The problem now appears to have trickled down to the under-18 set. The subject was the focus of a special session of the American Academy of Pediatrics annual conference last year and the topic of numerous studies presented at the recent APSS meeting.

A study by a team of researchers at the University of Kentucky in Lexington found that sleep among healthy children and adolescents has declined significantly in quality in the past 25 years. Research conducted at Emory University in Atlanta found that more than 40% of tots attending day care did not get the 12 hours of sleep recommended for their age group. The study suggested these children may experience the greatest number of colds, flus and other infections.

A study done at Brown University in Providence, R.I., suggested that insomnia and snoring were increasing among adolescents, particularly teenage girls.

"At the time when they need more sleep, they're getting less, and that's creating problems," said Andrew L. Chesson, MD, American Academy of Sleep Medicine president.

Physicians blame the phenomenon on a variety of factors. Children and adolescents, much like their parents, have the 24-hour a day distractions of the Internet and television. School activities, sports and homework can claim enormous chunks of time. And, the increasing rate of childhood and teen obesity also may be contributing to an increase in disorders such as sleep apnea. One study also correlated obesity with a reduction in sleep time, although it was unclear which was the cause and which was the effect.

"These are the sleep-stealers," said Nurudeen A. Lawal, MD, an internist at the University of Benin Teaching Hospital in Nigeria. "We have the television, the computer and the weight problems. The whole world is sleeping far less than it should be, and that's unhealthy."

The ill effects of severely restricted or disordered sleep are readily apparent, and even a small loss of sleep is probably not a good thing.

In the Emory study, preschool-age children were getting an average of 11.5 hours of sleep per night, just a half hour shy of the usual recommendation of 12 hours. But experts say that even that lack sets a child up for chronic sleep deprivation and sets a pattern that could effect a child for the rest of his or her life.

Several studies at the conference documented that even small reductions in sleep amounts can impair learning and motor skill development, which is particularly important for young children. Some experts also suggest that some children diagnosed with attention-deficit disorders may actually be sleep-deprived.

"We see a lot of psychopathology because of a lack of sleep," said Dr. Nemani.

There is significant agreement that the downward trend of sleep patterns among the young is a growing problem. The solution, though, is a matter of debate -- much more complicated than just sending Junior to bed early.

Some school districts, for instance, are opting for later start times. But experts suggest that many sleep issues can be dealt with in the primary care physician's office, long before a person ends up in a sleep clinic. Physicians can add questions about sleep duration to their general health assessment and advise patients on the issue much like they do on alcohol consumption or exercise.

"We have to ask about the problem," said Lois Krahn, MD, a psychiatrist at the Mayo Clinic's sleep disorder center in Rochester, Minn. "For some patients, it may be enough to just try and educate them about the importance of going to bed earlier."

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