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Sleep
is not an
"Optional Extra"

Recent estimates suggest that 40-70 million Americans experience either chronic or intermittent sleep-related problems. Difficulties with sleep occur in both genders, all races, all socioeconomic groups, and increase with age but are not limited to adults. Untreated sleep disorders have a profound impact nationally in terms of reduced quality of life, lower productivity in school and workplace, increased morbidity and mortality, and the loss of life due to accidents associated with excessive sleepiness. Failure to acknowledge the importance of sleep and the adverse health effects of sleep deprivation has been attributed to the low level of awarenessc.  Even physicians are known to be woefully uninformed about sleep.  Medical schools typically offer less than 2-4 hours of formal undergraduate training in sleep medicine and virtually no programs designed for postgraduate development of skills in the diagnosis and management of sleep disorders. Additional surveys indicate that sleep problems are rarely diagnosed and that most health practitioners are unable to identify insomnia and narcolepsy in patients. These findings underscore the limited medical school training available on sleep and sleep disorders

All too often today children's sleep is considered an "optional extra" by adults.  Sleep is an essential activity but almost never discussed by pediatricians or other healthcare staff with parents or the children themselves. 

The International Sleep Task Force Committee (2004) estimated that 20-to-25% of all adolescents experience sleep problems in childhood. The National Institute of Health (NIH) estimated that as high as 15% of all adolescents may have a significant sleep disorder that is negatively impacting their academics, behaviors, social-emotional development, health, and/or safety (National Institute of Health Research & Grant Website, 2001).  Such disorders have been estimated to impact higher percentages of adolescents with other disorders (e.g., ASDs upward of 70% and ADHDs at over 50%).  Many of these sleep disorders do not disappear without medical or behavioral treatment.

Lack of adequate sleep has been shown to cause behavioral changes consistent with a variety of diagnoses, including: hyperactivity, mania, depression, and psychosis. It has also been shown to result in decreased ability to focus and sustain attention, impairment in concentration, reductions in reaction times, and impairment in the consolidation of information. Research from around the globe on sleep in school-aged children consistently and robustly indicates that inadequate sleep causes increases in:

  • Memory Lapses 
  • Inattention
  • Impulsivity
  • Accidents and Injuries 
  • Behavior Problems 
  • Mood Problems, including irritability

Do these problems, or "symptoms", sound familiar?  They should if you are familiar with ADHD because many of these "symptoms" are central to the diagnosis of ADHD in children.  What does this mean?  Well, frankly it means that looking at the sleep pattern of a child or adolescent should always be a part of any diagnostic workup for ADHD, memory and learning problems, anxiety, behavior problems, or mood disturbance. 

Problems with sleep are not confined to simply how many hours a person is asleep in a given 24 hour period.  There are a variety of other ways that sleep can be disturbed, some are more significant than others, but none of them are insignificant.  Sleep disturbances can be as mild as occasional talking while asleep to as serious as Obstructive Sleep Apnea, which increases blood pressure, decreases attention, focus, and memory, and is indicated in higher risk of accidents and even stroke.  It is important that a person get the right combination of quantity and quality of sleep. 

Our focus at Reinforcement Unlimited is to work with the parents to assess their child's quality and quantity of sleep, screen for any possible medical causes, and refer parents to a well-qualified professional when necessary to their child's health and well-being.  We screen every child who we evaluate at the clinic for sleep disorders unless they have been seen at a sleep clinic within the past 24 months.  Over the past five years we have referred about 20-25% of the children evaluated for follow-up with another professional on some issue relating to their sleep.  We have seen children no longer need behavioral supports, no longer qualify for a diagnosis of ADHD, and a host of other less dramatic improvements when concerns with their sleep are appropriately addressed and resolved. 

Remember, it's both the quantity and the quality of sleep that matter for everyone!

Why not start off by testing your knowledge of sleep by taking the U. S. National Institute of Health's interactive sleep quiz?  It's a ten question interactive quiz that can help you identify any areas that you may have incorrect information on about sleep.  Sleep Quiz


Today's Resource Tips:  A Sleep Hygiene handout is available in Adobe Acrobat pdf format for download from Reinforcement Unlimited

National Center on Sleep Disorders Research has information on sleep and how it helps kids do their best at whatever they do.  The site has several handouts and other materials that are available to download on sleep.

Developed based on information available from the National Institutes of Health by Robert W. Montgomery, Ph.D., www.behavior-consultant.com, (770) 591-9552  10/2014

 

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