It’s becoming more widely known that sleep disordered breathing leads to poor behavior in children. Estimates show that as many of 25% of children diagnosed with ADD or ADHD may actually have an underlying sleep problem that can be treated – resulting in better behavior and improved learning skills.
Most often a sleep problem is identified in children and then health providers, researchers and parents look for behavior issues. A new study at the University of Michigan approached children, behavior and their sleep with a new twist: the study first looked for children with certain behaviors, and then looked at the sleep patterns of those children.
The cross sectional survey at the University of Michigan showed some very intriguing results: kids who show aggressive behavior in school are twice as likely to have symptoms of sleep disordered breathing as children that do not exhibit aggressive behaviors. Of the 341 students surveyed by the researchers, about 32% were assessed by their parent or teacher as having a conduct problem via a standardized behavior questionnaire. Parents of these children also completed a standardized pediatric sleep questionnaire, and scores for identification of symptoms for sleep disordered breathing (snoring, stopping breathing, daytime sleepiness, etc.) were collected. The results from the study abstract were as follows:
Children with conduct problems, bullying, or discipline referrals, in comparison to non-aggressive peers, more often had symptoms suggestive of sleep-disordered breathing. However, a sleepiness subscale alone, and not a snoring subscale, predicted conduct problems after accounting for age, gender, a measure of socioeconomic status, and stimulant use. Results were reported to be statistically significant.
I spoke with Dr. Louise O’Brien, one of the sleep researchers at the University of Michigan. She told me that these results were surprising. “While many people thought that it would be snoring that was driving this aggressive behavior it appeared to be the daytime sleepiness that was driving it.“ Unfortunately, Dr. O’Brien’s landmark study was not designed to determine what was causing the sleepiness during the day: behavioral factors, environmental issues or actual diagnosed sleep disorders. Another study will be in the works to look at some of these outstanding questions. While the questionnaire used in the study did not include cyberbullying, a case might be made that this type of behavior would fall under these results as well.
So aggressive kids appear to be sleepy kids, and it is not always because they are snoring (which might make you think they are not getting good quality sleep). What could be the culprits?
So what is a concerned parent to do?
Step #1: Get your child to bed on time! Below I have provided recommended sleep times from the National Sleep Foundation for children, and added my suggested bedtimes based on a 7a.m. wake time:
Age and Recommended Sleep Time with Bedtime based on 7a.m. wake time
Step #2: Make sure their bedroom is conducive to sleep! Remove distractions, televisions, make it cool, dark, quiet and comfortable.
Step #3: If you think that your child may be suffering from a sleep disorder, speak to your pediatrician immediately. Kids should not snore, stop breathing in their sleep, walk, talk, or show any other abnormal or unusual behaviors in their sleep! Don’t just think that they will grow out of it. Speak to your physician about these types of behavior.
As parents, it is our responsibility to pay attention to the safety and health of not just our children, but those children who our kids interact with everyday. Based on this new study, looks like a well rested kid is less likely to get you that call from the principal.
Michael J. Breus, PhD
The Sleep Doctor™