According to (Leahy and Gradisar 2010), 40% of children aged between four and eleven have struggled with some form of sleep issue, even if this this is for a short amount of time. Sleep is essential for humans at all ages; without adequate sleep we would be unable to survive. According to Meijer et al., (2008) in European countries the average time for a child aged 11- 12 to sleep is 9 – 10 hours. However, there are many studies that I shall be discussing in this essay that document children getting a lot less sleep than this. It is clear to see that it is complex to study the effects of sleep on children due to ethical and moral implications of sleep deprivation and the effects that it has on the body. In this essay I am going to discuss what happens when children do not get enough sleep. I shall look at the immediate but also the possible long term effects of sleep deprivation on the individual, comparing both mental and physical symptoms, as well as the impact that it can have on those around them.
The sleep needs of children differ due to their age and therefore the stage the developmental stage that they are at. Generally, as we progress through our lives the amount of sleep that we get decreases. It is more common for elderly people to wake up in the night, probably due to decreased levels of melatonin; a hormone responsible for helping us to go to and stay asleep (Ohayon et al. 2004). Humans run on a 24-hour sleep cycle, generally spending waking hours in the daylight and sleeping through the night. Newly born children therefore struggle to adapt to this due to being in constant darkness in their mother’s womb. When a child is born they will generally sleep a lot and may seem to not have a very set sleeping patterns. This can be very challenging for new parents as they will be experiencing much disrupted sleep. However, by 16 weeks it is expected that a baby will sleep for 6 hours continuously, continuing to transition into a cycle (Feldman, 2006). According to Oswold (2004) around 20% of our sleep is REM (rapid eye movement). During this time our temperature regulation is impaired, therefore the body can sometimes become cold or sweaty. Cerebral blood flow is increased and this is the time in which eye movements are rapid and an individual may have vivid dreams. According to Stores (2009), a hormone that is responsible for growth is linked to NREM (non rapid eye movement) sleep. Therefore, if sleep is being disrupted regularly a child may not be able to fully grow or develop.
Dewald et al. (2012), conducted a meta- analytic review on ‘the influence of sleep quality, sleep durations and sleepiness on school performance in children and adolescents.’ Through looking at many different studies and drawing a collective conclusion we are able to analyse a greater amount of data to try to draw more accurate conclusions. It was noted by Mercer (1998) and Gibson (2006) that adolescents and children generally need an average of eight hours of sleep per night, however that 45% of this group only manage to sleep eight or less hours a night. They also noted that there are biological factors such as puberty that affect the body, and therefore need to be taken into account when looking at an adolescent’s sleep. It is also noted that bed times are generally getting later, however getting up times are staying the same, therefore meaning that sleep is being lost (Pagel, 2007).
Fallone (2002) concluded that the processes that happen within our brain overnight are linked to the change in physical and emotional feelings and performance and well as cognitive ability. They also found that the most noticeable side effect of lack of sleep within children is increased sleepiness. This therefore meaning that the child is less aware and alert, particularly in certain areas of the brain such as the prefrontal cortex (Dahl, 1996). This can therefore be linked to less cognitive ability and functioning. From this information we are able to see that this is why a child may start to struggle to keep up in school. With an impaired cognitive ability, the child may find it hard to remember information or think logically about the things that they are learning about. This could cause them to fall behind within their peer group and therefore their learning development may slow down. Another issue that may arise is that the child may struggle to remain focused. This can impact on a whole class, if some members of are not able to concentrate the teachers may need to spend more time making sure that they are listening or working effectively.
Rimpelä, M and Rimpelä, A (1983) studied the effects of lack of sleep on a group of Finnish children. They found that roughly 10% of the children struggled to fall asleep and had regularly disrupted sleep. This lead to increased tiredness in the morning and subsequently was linked to a lower academic performance at school. Dahl (1996) concluded that poor sleep in children caused by lack of sleep or from being woken up throughout the night caused many difficulties for children, for example issues with maintaining attention, emotional issues such as being irrational and having low resilience to upset or anger. These findings have been backed up by the research of Curcio et al. (2006), showing a link between poor sleep and poor educational consequences. There has been discussion as to whether the timings of the school day should be pushed back in order to compensate for the fact that during adolescents sleeping patterns change, going to sleep later and therefore waking up later as a consequence of this (Hagenauer et al. 2009). Many educational settings believe that adolescents are just choosing to stay up late and therefore this is why they can be irritable or unwilling to learn in the morning, however according to Stickgold (2005), sleep and the amount that a person has had can play a large role in long term memory and the way in which we learn information. Edwards (2012), analysed different start times in schools of a large cohort due to changes in transport to and from school. It was found that the pupils that started school an hour later had a 2% gain in mathematics scores across the school. This was also similar for other subjects such as English and reading.
Moreira and Pradella-Hallinan (2017) discussed the possible reasons that children did not get enough sleep. They concluded that many other issues such as chronic pain, movement disorder and sleep disordered breathing are all things that could effect the quality of sleep that a child is getting and that this therefore could predispose a child to daytime sleepiness. Due to some children becoming hyperactive due to lack of sleep and their arousal mechanisms going into overdrive, children may start to exhibit signs of behavioural issues. They may start to become easily irritated or struggle to regulate their mood. This can cause an array of different issues for the child. For example, they might start to struggle in social settings, for example at school. Irritability and lack of emotional regulation can also be present in a child’s home life and could lead to issues regarding parental or sibling relationships. If a child starts to feel isolated this could lead to bad mood and could cause the child emotional instability, perhaps predisposing the child to be more affected by mental health issues.
According to Willis and Gregory (2015), there is a connection between sleep and anxiety for children and adolescents. It has been recorded by Alfano et al., (2010) that from a sample group of 7 -14 year olds that struggled with an anxiety disorder, 85% of them suffered with some significant kind of sleep disorder. Alfano et al., (2007) also studied children with diagnosable clinical anxiety and found that 88% were found to have one sleep related problem, these included nightmares and issues falling asleep or sleeping by themselves. It is, however, important to state that although sleep and anxiety are linked together there is no concrete evidence showing which causes the other.
In order to draw concrete conclusions, it is important to assess other areas of a child’s life, for example their parent’s mental health and their family environment. Gregory et al (2005) studied the long term effects of childhood sleep issues and concluded that from studying a sample of 5-9-year-old children that reported to have ongoing sleep issues, 46% went on to develop an anxiety disorder. There are however, other studies to suggest that sleep issues are just a by product of anxiety or depression and that lack of sleep does not contribute as a leading causation factor. For example, Johnson et al (2000) looked at cross sectional analysis about the correlation of children not getting enough sleep and the risk of depression or anxiety setting in. He concluded that children suffering with sleep related issues at the age of six were no more likely to be struggling with anxiety or depression aged eleven.
Anxiety through lack of sleep can cause many issues for a child. If sleep issues remain undiagnosed a child may seem to be completely ‘healthy’ in all other aspects of their life and therefore clinicians may struggle to diagnose the root of the issue. Heightened anxiety can cause social issues for children; they may struggle to interact with their peers and may find it hard to integrate within a school environment. A child may also struggle to vocalise their feelings of anxiety and it may come across as aggression or misbehaviour, leading to family relationships being strained. This can mean that in extreme cases parents may be more likely to exert physical punishments (Quine,1992).
Gangwisch et al, (2010) studied the impact of parent regulation and control around setting bedtimes for children and adolescents. They found that adolescents that were not set regulated bed times by their parents or who were allowed to go to bed at 12am or later were 24% more likely to suffer with depression. Furthermore, they were also 20% more like to have suicidal thoughts or tendencies compared to their peers that were going to bed before or around 10pm due to their parent’s involvement in their bed time. It is clinically documented that a side effect of depression can be a lack of healthy sleep (Allgöwer et al, 2001). This may include difficulty falling asleep and waking early or a child spending too much time sleeping, waking up not feeling refreshed. The link between parent set bedtimes and the likelihood of the onset of depression or suicidal tendencies are primarily drawn on the concept that non parent regulated bedtimes mean that children and adolescents are getting to sleep later, however are still waking up for school at the same time as those who have parent regulated bedtimes and have gone to sleep much earlier. This therefore meaning that sleep time is considerably shortened. This shortened sleep pattern is therefore considered to be linked towards these depressive tendencies.
A child’s lack of sleep can also be linked to physical health issues, an example of this is the link with obesity (Jiang et al., 2009). Sleep plays a large part in energy metabolisms (Spiegel, 2009). It also helps to control how the appetite regulating hormones are created (Spiegel, 2004). If sleep is disturbed or children are not getting adequate sleep this can cause these systems to preform differently. An example of this is that children may not be able to regulate their appetite as well and this may then lead to over eating. Jiang et al. (2009) found that the less sleep that a child had or a poor sleeping pattern (frequent waking) were linked to eating behaviours increasing and therefore as a result, overeating. This study looked at children of a healthy weight and therefore shows that this link is prevalent in all children, regardless of the weight that they are, showing that this may be associated with obesity as they grow up.
If a child does not get enough sleep they therefore may be more likely to over eat and become overweight or obese. In the UK in 2016/17 almost ¼ of children were overweight or obese by the time they start school (age 4-5) and over 1/3 of children were overweight or obese by the time they were in year 6 (age 10-11) (NCMP, NHS 2016/17). Obesity can cause many detrimental effects on the body, both mentally and physically. According to Lee (2009), obese children are around 3 times more likely to suffer with cardiovascular problems such as hypertension (high blood pressure) than children of a healthy weight. It has also been documented that a higher BMI (body mass index) in childhood is linked to an increased risk of developing coronary heart disease later in life (Baker, 2007). Another notable consequence that comes from childhood obesity is the psychological or emotional problems that a child may face (Lee, 2009). According to Richardson et al. (1961), obese children were generally ranked as being the least desired friends. This could lead to bullying or social isolation. Psychological issues can progress into adulthood too, those who were obese as children are more likely to report lack of confidence and a poor body image. These rates are higher if an individual becomes obese during childhood, due to the concept that many feelings around self esteem and body confidence or image are developed through mid childhood (Monello and Mayer, 1963).
Sleep patterns change during adolescence, this can be due to the fact that during this period there is lots of emotional, physical and cognitive changes happening (Wolfson and Carskadon, 1998). There are studies to show that a reduced amount of sleep can impact on cognitive thinking ability (Thorpy et al., 1988), and subsequently that children and adolescents who do not get enough sleep do not perform as well in school (Allen, 1992). According to Morrison et al. (1992), adolescents that are not getting enough sleep or that are having sleep disturbances are more likely to suffer with attention issues, they are also more likely to feel anxious, depressed or to suffer with conduct related behavioural issues. Czeisler (2009), found that the most common time for adolescents to have driving related incidents is in the morning. This can be linked towards increased sleepiness and attention issues that arise due to lack of sleep. A school in Kentucky in the US moved school times an hour later and students generally recorded sleeping an hour longer due to going to bed at the same time that they normally would. The rate for driving related incidents for drivers in the school district went down by 16.5% (Danner and Phillips, 2008). This shows that even up to an hour of extra sleep can have positive outcomes for the safety of young people.
Due to the reduction in cognitive function that is related to lack of sleep, combined with the detrimental affects that sleep difficulties or reduction have on mood, it has been thought that a lack of sleep may be linked to an adolescent being more likely to take part in risk taking behaviours. According to a study by Irwin & Millstein (1986), risk taking behaviours are those that can increase the risk of mortality. Examples include, heavy alcohol use, smoking and practicing dangerous sexual health decisions. In this study it has been found that those who slept less on school nights were the group that drank the most alcohol. It was also found that those who had the biggest difference between the amount that they slept on school nights, compared to weekends were reported to partake in more risk- taking behaviour and also had a lower performance at school academically. There are, however, also other risk factors that can cause a child to partake in these activities, for example the dynamic and attitudes of their peer group or the way that they are parented (O’Brien and Mindell, 2005).
To conclude, there are many issues that can arise when a child does not get enough sleep. Key factors that I have discovered in this essay are the link between lack of sleep and cognitive thinking, and how this could affect a child’s ability to learn and perform in school. I have also spoken about links between physical and mental health, with examples being depression, anxiety and obesity. It is clear to see that it is not just the length of sleep that is important when studying these links, but also the quality of the sleep and the amount of disturbances that occur throughout the night. It is important to study sleep and the effects this can have on children due to the vast amount of physical and psychological affects that it may have a correlation with, most importantly noting the effects of long term sleep deprivation. Generally, an individual is able to recover from infrequent bad nights sleep, however issues start to arise when this becomes a regular occurrence. It is also important to realise that sleep disorders may be hard to diagnose, for example bedtime anxiousness is hard to quantify and therefore scale. We must realise, however, that many of the issues I have addressed in the essay have a link to lack of sleep, but this does not mean that sleep is the only cause, therefore other social, environmental and physical factors must also be addressed to draw accurate and valid conclusions.